Revision 24-3; Effective Sept. 10, 2024
STAR+PLUS Plan Codes
| Service Area | Plan Name | Plan Codes | Contract Number | Plan Codes Effective Dates |
|---|
| Bexar | Community First Health | S1 | 1033142 | Sept. 1, 2024 |
| Bexar | Molina | 46 | 1014430 | Sept. 1, 2011 |
| Bexar | Superior | 47 | 1014433 | Sept. 1, 2011 – Aug. 31, 2024 |
| Bexar | United Healthcare | S5 | 1033147 | Sept. 1, 2024 |
| Bexar | Wellpoint | 45 | 1014439 | Sept. 1, 2011 – Aug. 31, 2024 |
| Dallas | Molina | 9F | 1018980 | March 1, 2012 |
| Dallas | Superior | 9H | 1018981 | March 1, 2012 |
| Dallas | United Healthcare | S6 | 1033148 | Sept. 1, 2024 |
| El Paso | El Paso Health | S2 | 1033143 | Sept. 1, 2024 |
| El Paso | Molina | 33 | 1019987 | March 1, 2012 |
| El Paso | Wellpoint | 34 | 1019979 | March 1, 2012 – Aug. 31, 2024 |
| Harris | Community Health Choice | S3 | 1033145 | Sept. 1, 2024 |
| Harris | Molina | 7S | 1014431 | Sept. 1, 2011 |
| Harris | United Healthcare | 7R | 1014435 | Sept. 1, 2011 |
| Harris | Wellpoint | 7P | 1014440 | Sept. 1, 2011 – Aug. 31, 2024 |
| Hidalgo | Cigna-HealthSpring | H7 | 1019984 | March 1, 2012 – Dec. 31, 2021 |
| Hidalgo | Molina | H6 | 1019988 | March 1, 2012 |
| Hidalgo | Superior | H5 | 1019985 | March 1, 2012 |
| Hidalgo | United Healthcare | S7 | 1033149 | Sept. 1, 2024 |
| Jefferson | Molina | 8T | 1019598 | Sept. 1, 2011 |
| Jefferson | United Healthcare | 8S | 1019600 | Sept. 1, 2011 – Aug. 31, 2024 |
| Jefferson | Wellpoint | 8R | 1019599 | Sept. 1, 2011 |
| Lubbock | Superior | 5B | 1019986 | March 1, 2012 |
| Lubbock | Wellpoint | 5A | 1019983 | March 1, 2012 |
| Medicaid Rural Service Area (RSA) West Texas | Superior | W6 | 1025730 | Sept. 1, 2014 |
| Medicaid Rural Service Area (RSA) West Texas | Wellpoint | W5 | 1025729 | Sept. 1, 2014 |
| Medicaid RSA Northeast Texas | Cigna-HealthSpring | N3 | 1025733 | Sept. 1, 2014 – Dec. 31, 2021 |
| Medicaid RSA Northeast Texas | Molina | P2 | 1031928 | Jan. 1, 2022 |
| Medicaid RSA Northeast Texas | United Healthcare | N4 | 1025734 | Sept. 1, 2014 |
| Medicaid RSA Central Texas | Superior | C4 | 1025731 | Sept. 1, 2014 |
| Medicaid RSA Central Texas | United Healthcare | C5 | 1025732 | Sept. 1, 2014 |
| Nueces | Superior | 86 | 1014434 | Sept. 1, 2011 |
| Nueces | United | 85 | 1014437 | Sept. 1, 2011 – Aug. 31, 2024 |
| Nueces | Wellpoint | S9 | 1033141 | Sept. 1, 2024 |
| Tarrant | Cigna-HealthSpring | 6C | 1018979 | Sept. 1, 2011 – Dec. 31, 2021 |
| Tarrant | Molina | P1 | 1031927 | Jan. 1, 2022 |
| Tarrant | United Healthcare | S8 | 1033140 | Sept. 1, 2024 |
| Tarrant | Wellpoint | 69 | 1018977 | Sept. 1, 2011 – Aug. 31, 2024 |
| Travis | Superior | S4 | 1033146 | Sept. 1, 2024 |
| Travis | United | 18 | 1014438 | Sept. 1, 2011 |
| Travis | Wellpoint | 19 | 1014442 | Sept. 1, 2011 – Aug. 31, 2024 |
Medicare-Medicaid Plan (MMP) Codes
| Service Area | Plan Name | Plan Codes | Contract Number | Plan Codes Dates |
|---|
| Bexar | Molina | 4G | 1026341 | Sept. 1, 2015 |
| Bexar | Superior | 4H | 1026337 | Sept. 1, 2015 |
| Bexar | Wellpoint | 4F | 1026326 | Sept. 1, 2015 – Aug. 31, 2024 |
| Dallas | Molina | 9J | 1026342 | Sept. 1, 2015 |
| Dallas | Superior | 9K | 1026338 | Sept. 1, 2015 |
| El Paso | Molina | 3H | 1026343 | Sept. 1, 2015 |
| El Paso | Wellpoint | 3G | 1026328 | Sept. 1, 2015 – Aug. 31, 2024 |
| Harris | Molina | 7V | 1026344 | Sept. 1, 2015 |
| Harris | United Healthcare | 7Q | 1026334 | Sept. 1, 2015 |
| Harris | Wellpoint | 7Z | 1026331 | Sept. 1, 2015 – Aug. 31, 2024 |
| Hidalgo | Cigna-HealthSpring | H8 | 1026335 | Sept. 1, 2015 – Dec. 31, 2021 |
| Hidalgo | Molina | H9 | 1026345 | Sept. 1, 2015 |
| Hidalgo | Superior | HA | 1026339 | Sept. 1, 2015 |
| Tarrant | Cigna-HealthSpring | 6G | 1026333 | Sept. 1, 2015– Dec. 31, 2021 |
| Tarrant | Wellpoint | 6F | 1026332 | Sept. 1, 2015 – Aug. 31, 2024 |
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