Revision 19-5; Effective November 25, 2019
Value-added services (VAS) are extra benefits offered by managed care organizations (MCOs) beyond the Medicaid-covered services. VAS may include routine dental, vision, podiatry, and health and wellness services. VAS may be actual health care services, benefits or positive incentives that Texas Health and Human Services Commission determines will promote healthy lifestyles and improve health outcomes among members. Each MCO offers a different set of VAS and the MCO can change the VAS it offers once per fiscal year beginning September 1.
MCOs must cover all benefits in Medicaid managed care programs, such as STAR+PLUS, STAR Kids and STAR Health. The MCOs use VAS as an incentive to assist the member in making the best plan choice. In addition, members may use VAS to help choose which MCO has the added benefits best suited for their needs.
VAS are not considered non-waiver resources and therefore, waiver program providers do not consider VAS offered by the MCO when considering third-party resources. VAS is an added benefit available to individuals from the MCO providing their acute care services.