Texas Health and Human Services. STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 6. People in STAR+PLUS get Medicaid health- care and long- term services and support through a medical plan that they choose. STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 6. People in STAR+PLUS get Medicaid health- care and long- term services and support through a medical plan that they choose. Another feature of STAR+PLUS is service coordination. A STAR+PLUS staff member works with the member, the member’s family and the member’s doctors and other providers to help the member get the medical and long- term services and support they need. To get services through STAR+PLUS you must: (1) be approved for Medicaid, (2) live in a STAR+PLUS service area (now statewide) and (3) be one or more of the following: Age 2. Supplemental Security Income (SSI) benefits, and able to get Medicaid due to low income. Not getting SSI and able to get STAR+PLUS Home and Community- Based Waiver Services. Age 2. 1 or older, getting Medicaid through what are called “Social Security Exclusion programs” and meet program rules for income and asset levels. Age 2. 1 or over residing in a nursing home and receiving Medicaid while in the nursing home. Children age 2. 0 and younger who have Medicaid and get SSI can be in STAR+PLUS. STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 65 or older. People in STAR+PLUS get Medicaid health-care and long-term. Star Behavioral Health Providers (SBHP) is a resource for veterans, service members and their families to locate behavioral health professionals with specialized. Or they can keep getting their Medicaid services in traditional Medicaid until November 1, 2. STAR Kids. The following people can’t be in the STAR+PLUS program: People over 2. Medicaid 1. 91. 5(c) waiver services, and do not receive Medicare other than Community- Based Alternative services. People who are not able to get full Medicaid benefits, such as Frail Elderly program members, Qualified Medicare Beneficiaries, Specified Low- Income Medicare Beneficiaries, Qualified Disabled Working Individuals and illegal immigrants. People who aren’t able to get Medicaid. Children in state foster care. People who receive Full Medicaid and Medicare who get Medicaid 1. Intellectual Developmental Disabilities (IDD). Age 2. 0 or younger and live in a nursing home. Important notes for those covered by Medicare: You can get STAR+PLUS even if you get Medicare unless you get Medicaid 1. STAR is managed care Medicaid. You pick a medical plan that provides your Medicaid services and a main doctor that is your point of contact for Medicaid services. Texas Medicaid and CHIP STAR: Medicaid Managed Care Program. STAR is the program through which most people in Texas get their Medicaid coverage. FirstCare STAR Program Welcome to FirstCare STAR Our goal is to give you quality care and a great network of doctors, specialists, and hospitals. Cigna-HealthSpring works with the State of Texas to help individuals and families get health coverage in the Texas STAR+PLUS Program. Through STAR+PLUS, Cigna. Section 1331 of the Affordable Care Act gives states the option of creating a Basic Health Program (BHP), a health benefits coverage program for low-income residents. STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 65 or older. People in STAR+PLUS get Medicaid health-care and long. STAR is a Texas Medicaid managed care program. You pick a medical plan. This plan gives you Medicaid services. It also gives you a main doctor. Intellectual Developmental Disabilities (IDD). If you are covered by both Medicare and Medicaid (also known as “dual eligible”) and you join STAR+PLUS, you will keep getting regular health- care services through your Medicare doctor. STAR+PLUS does not change the way you get Medicare services. Back to the top. STAR+PLUS Service Areas and Medical Plans. Service Area. Medical Plans. Bexar Service Area. Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson counties. Amerigroup, Molina Healthcare of Texas, Superior Health. Plan. Dallas Service Area. Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall counties. Molina Healthcare of Texas, Superior Health. Plan. El Paso Service Area. El Paso and Hudspeth counties. Amerigroup, Molina Healthcare of Texas. Harris Service Area Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Waller, and Wharton counties. Amerigroup, Molina Healthcare of Texas, United. Healthcare Community Plan. Hidalgo Service Area Cameron, Duval, Hidalgo, Jim Hogg, Maverick, Mc. Mullen, Starr, Webb, Willacy, and Zapata counties. Health. Spring, Molina Healthcare of Texas, Superior Health. Plan. Jefferson Service Area. Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, and Walker counties. Amerigroup, Molina Healthcare of Texas, United. Healthcare Community Plan. Lubbock Service Area. Amerigroup, Superior Health. Plan. MRSA Central Texas. Bell, Blanco, Bosque, Brazos,Burleson, Colorado, Comanche, Coryell, De. Witt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, Mc. Lennan, Milam, Mills, Robertson, San Saba, Somervell, Washington. Superior Health. Plan, United. Healthcare. MRS Northeast Texas. Anderson, Angelina, Bowie, Camp, Cass, Cherokee, Cooke, Delta, Fannin, Franklin, Grayson, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Montague,Morris, Nacogdoches, Panola, Rains, Red River, Rusk, Sabine, San Augustine, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt, Wood. Cigna- Health. Spring, United. Healthcare. MRSA West Texas. Andrews, Archer, Armstrong, Bailey, Baylor, Borden, Brewster, Briscoe, Brown, Callahan, Castro, Childress, Clay, Cochran, Coke, Coleman, Collingsworth, Concho, Cottle, Crane, Crockett, Culberson, Dallam, Dawson, Dickens, Dimmit, Donley, Eastland, Ector, Edwards, Fisher, Foard, Frio, Gaines, Glasscock, Gray, Hall, Hansford, Hardeman, Hartley, Haskell, Hemphill, Howard, Irion, Jack, Jeff Davis, Jones, Kent, Kerr, Kimble, King, Kinney, Knox, La Salle, Lipscomb, Loving, Martin, Mason, Mc. Culloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Palo Pinto, Parmer, Pecos, Presidio, Reagan,Real, Reeves, Roberts, Runnels, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Taylor, Terrell, Throckmorton, Tom Green, Upton, Uvalde, Val Verde, Ward, Wheeler, Wichita, Wilbarger, Winkler, Yoakum, Young, Zavala. Amerigroup, Superior Health. Plan. Nueces Service Area. Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio and Victoria counties. Superior Health. Plan, United. Healthcare Community Plan. Tarrant Service Area. Denton, Hood, Johnson, Parker, Tarrant, and Wise counties. Amerigroup, Health. Spring. Travis Service Area. Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis and Williamson counties. Amerigroup, United. Healthcare Community Plan. Map of STAR+PLUS health plans by county. Map of STAR+PLUS Health Plans by Rural Service Area (PDF)More facts about Medicaid managed care initiatives. Back to the top. STAR+PLUS does not change how people get their Medicare services. They must pick a STAR+PLUS medical plan, but don’t pick a main doctor. They get regular health care from their Medicare doctor and providers. The STAR+PLUS medical plan only gives Medicaid long- term services and supports. Back to the top. Picking a medical plan and main doctor If you are approved for STAR+PLUS, you will get a packet in the mail. It will tell you about the program and the medical plans in your area. If you don’t get Medicare, you also will need to pick a main doctor. You have 1. 5 days pick a medical plan. The 1. 5 days start once you get the packet in the mail. If you don’t pick a medical plan, HHSC will pick a medical plan and main doctor for you. Enrollment event calendar. Getting services Your main doctor takes care of basic health- care needs. The main doctor also can refer you to a specialist, if needed. Regular health care and long- term services and supports are part of a plan of care put together by you, your family, and your doctor and other health- care providers. Back to the top. You can change your medical plan or main doctor as often as once a month. If you ask to change your plan or doctor, you must wait until we tell you the change is made before you go to your new doctor. The following is an overview of the services STAR+PLUS offers. Medical plans must have a service coordinator visit with the member within 3. The coordinator must find out the member’s needs and develop a plan of care. Long- term services and supports can include: Day Activity and Health Services (DAHS)Primary Home Care (PHC)Other services under the STAR+PLUS Home and Community- Based Services Waiver include: Personal assistance services. Adaptive aids. Adult foster care home services. Assisted living. Emergency response services. Home delivered meals. Medical supplies. Minor home modifications (making changes to your home so you can safely move around)Nursing services. Respite care (short- term care to provide a break for caregivers)Therapies (occupational, physical, and speech- language)Transitional assistance services. Back to the top. Along with all of the traditional Medicaid and other services listed above, each STAR+PLUS medical plan offers its own set of “value- added” services. These are extra services not covered by Medicaid. Each medical plan’s value- added services are shown in charts that are included in the packet mailed to people approved for STAR+PLUS Medicaid. STAR+PLUS value- added comparison charts.
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