COVID-19 Flexibility Update
Upgrades for STAR+PLUS members who left a nursing facility without HCBS in place
HHSC is allowing STAR+PLUS health plans to use the existing process for requesting upgrades to STAR+PLUS Home and Community Based Services (HCBS) for members who exited a NF through Aug. 31, 2023. Health plans are currently identifying and informing eligible members of the option to upgrade and conducting the STAR+PLUS HCBS Program assessment for program eligibility.
STAR+PLUS and MMP members who were discharged from a NF on or after March 18, 2020, through Aug. 31, 2023, currently do not reside in a NF, and still have NF Medicaid should reach out to their health plan for more information about requesting an upgrade to STAR+PLUS HCBS.
STAR+PLUS is a Texas Medicaid managed care program for adults who have disabilities or are age 65 or older. Adults in STAR+PLUS get Medicaid health-care and long-term services and supports through a health plan that they choose.
Adults with complex medical needs can choose to live and receive care in a home setting instead of a nursing facility. Hear Dorothy and Robert’s stories and learn more about HHS home and community-based services.
Provider Information
STAR+PLUS Service Areas and Health Plans
Effective January 1, 2022, Cigna-Healthspring will no longer participate in the STAR+PLUS Medicaid managed care program and will transfer its Texas Medicaid business to Molina Healthcare of Texas. The following links have more information about this transition for STAR+PLUS providers and members:
HHSC will make further updates to this webpage to reflect this change, including to the map of STAR+PLUS health plans.
Service Area | Medical Plans |
---|---|
Bexar Service Area Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson counties | Amerigroup, Molina Healthcare of Texas, Superior HealthPlan |
Dallas Service Area Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall counties | Molina Healthcare of Texas, Superior HealthPlan |
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, UnitedHealthcare Community Plan |
Hidalgo Service Area Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and Zapata counties | HealthSpring, Molina Healthcare of Texas, Superior HealthPlan |
Jefferson Service Area Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, and Walker counties | Amerigroup, Molina Healthcare of Texas, UnitedHealthcare Community Plan |
Lubbock Service Area | Amerigroup, Superior HealthPlan |
MRSA Central Texas Bell, Blanco, Bosque, Brazos,Burleson, Colorado, Comanche, Coryell, DeWitt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Somervell, Washington | Superior HealthCare, UnitedHealthcare |
MRSA 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 | Molina Healthcare of Texas, UnitedHealthcare |
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, McCulloch, 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 HealthPlan |
Nueces Service Area Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio and Victoria counties | Superior HealthPlan, UnitedHealthcare Community Plan |
Tarrant Service Area Denton, Hood, Johnson, Parker, Tarrant, and Wise counties | Amerigroup, HealthSpring |
Travis Service Area Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis and Williamson counties | Amerigroup, UnitedHealthcare Community Plan |
Client Information
STAR+PLUS is a Texas Medicaid managed care program for adults who have disabilities or are age 65 or older. Adults in STAR+PLUS get Medicaid health-care and long-term services and support through a health plan that they choose.
Long-term services and supports includes things like:
- Help in your home with basic daily activities.
- Help in making changes to your home so you can safely move around.
- Short-term care to provide a break for caregivers.
- Help with things that need to get done.
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.
STAR+PLUS Client FAQs
Who can be in STAR+PLUS?
To get services through STAR+PLUS you must: (1) be approved for Medicaid, (2) be one or more of the following:
- Age 21 or older, getting 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 Services.
- Age 21 or older, getting Medicaid through what are called "Social Security Exclusion programs" and meet program rules for income and asset levels.
- Age 21 or over residing in a nursing home and receiving Medicaid while in the nursing home.
- In the Medicaid for Breast and Cervical Cancer program.
The following people can't be in the STAR+PLUS program:
- People over 21 who get Medicaid 1915(c) waiver services or who live in community homes for people with Intellectual Developmental Disabilities (IDD), and get Medicare.
- 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.
- Age 20 or younger and not in the Medicaid for Breast and Cervical Cancer program.
Important notes for those covered by Medicare:
- You can get STAR+PLUS even if you get Medicare unless you get Medicaid 1915 (c) waiver services or live in facilities for people with 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.
Where are STAR+PLUS services offered?
Service Area | Medical Plans |
---|---|
Bexar Service Area Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson counties | Amerigroup, Molina Healthcare of Texas, Superior HealthPlan |
Dallas Service Area Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall counties | Molina Healthcare of Texas, Superior HealthPlan |
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, UnitedHealthcare Community Plan |
Hidalgo Service Area Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and Zapata counties | HealthSpring, Molina Healthcare of Texas, Superior HealthPlan |
Jefferson Service Area Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, and Walker counties | Amerigroup, Molina Healthcare of Texas, UnitedHealthcare Community Plan |
Lubbock Service Area | Amerigroup, Superior HealthPlan |
MRSA Central Texas Bell, Blanco, Bosque, Brazos,Burleson, Colorado, Comanche, Coryell, DeWitt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Somervell, Washington | Superior HealthPlan, UnitedHealthcare |
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-HealthSpring, UnitedHealthcare |
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, McCulloch, 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 HealthPlan |
Nueces Service Area Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio and Victoria counties | Superior HealthPlan, UnitedHealthcare Community Plan |
Tarrant Service Area Denton, Hood, Johnson, Parker, Tarrant, and Wise counties | Amerigroup, HealthSpring |
Travis Service Area Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis and Williamson counties | Amerigroup, UnitedHealthcare Community Plan |
Map of STAR+PLUS health plans by county
How does STAR+PLUS work for adults who get both Medicaid and Medicare?
STAR+PLUS does not change how people get their Medicare services. You can continue to get regular medical care from your Medicare doctor and providers.
When you join STAR+PLUS, you will pick a STAR+PLUS health plan and start getting Medicaid long-term services and supports through your health plan.
How do I sign up for STAR+PLUS?
STAR+PLUS is a Texas Medicaid program. To get services through STAR+PLUS, you must first be enrolled in Medicaid.
To enroll in Medicaid, visit yourtexasbenefits.com or call 2-1-1.
Once you are approved for STAR+PLUS, you will get a packet in the mail that tells you about the program and how to choose a health plan. If you don't have Medicare, you will also need to select a primary care doctor.
After receiving the STAR+PLUS enrollment packet, you have 15 days to choose a health plan. If you don't choose a health plan and primary care doctor, HHSC will choose for you.
You can tell us your choices by phone, mail, or by filling out a form at an enrollment event or presentation. Enrollment event calendar.
Getting services
Your health plan will assist in setting up services.
Your primary care doctor takes care of your basic medical needs and can refer you to a specialist, if needed.
Regular health care and long-term services and supports are part of a plan of care created by you, your family, your doctor, and other health-care providers.
How do I change my STAR+PLUS health plan or main doctor?
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.
STAR+PLUS services
The following is an overview of the services STAR+PLUS offers.
Medical plans must have a service coordinator visit with the member within 30 days of enrolling in the program. 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
Extra Services (Value-Added Services)
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.
What is the Home and Community Based Services program?
The STAR+PLUS Home and Community Based Services program (sometimes referred to as “STAR+PLUS Waiver”) provides services that help people live at home who would otherwise need to be in a nursing facility. HHSC assesses a person’s need for this program when they apply for Medicaid.
For more information, email Managed Care Initiatives.