Client Information
Who Qualifies for STAR+PLUS?
What is STAR+PLUS?
Where are STAR+PLUS Services Offered?
STAR+PLUS Health Plan Comparison Charts
STAR+PLUS Community Events
Who Qualifies for STAR+PLUS?
Enrollment in STAR+PLUS is required for Medicaid recipients who live in STAR+PLUS service area and are one or more of the following:
- People who have a physical or mental disability and qualify for supplemental security income (SSI) benefits or for Medicaid due to low income.
- People who qualify for Community-Based Alternatives (CBA) 1915(c) waiver services.
- People age 21 or older who can receive Medicaid because they are in a Social Security Exclusion program and meet financial criteria for 1915(c) waiver services.
- People age 21 or older who are receiving SSI.
Enrollment in STAR+PLUS is voluntary for:
- Children under age 21 receiving SSI can join STAR+PLUS or can continue to receive benefits through traditional Medicaid.
The following people cannot participate in the STAR+PLUS program:
- Residents of nursing facilities.
- STAR+PLUS HMO members who have been in a nursing facility for more than 120 days.
- Clients of Medicaid 1915(c) waiver services other than Community-Based Alternatives services.
- Residents of Intermediate Care Facilities for the Mentally Retarded (ICF-MR).
- Clients not eligible for full Medicaid benefits, such as Frail Elderly program members, Qualified Medicare Beneficiaries, Specified Low-Income Medicare Beneficiaries, Qualified Disabled Working Individuals and undocumented aliens.
- People not eligible for Medicaid.
- Children in state foster care.
Important notes for those in Medicare:
Important notes for those in Medicare:
- Enrollment in Medicare does not affect eligibility for STAR+PLUS.
- People who qualify for both Medicare and Medicaid (also known as “dual eligibles”) and participate in STAR+PLUS will continue to receive acute care services through their Medicare doctor. STAR+PLUS does not change the way they receive Medicare services.
What is STAR+PLUS?
The STAR+PLUS program combines health and long-term services and supports, such as helping in your home with daily activities, home modifications, respite (short-term supervision) and personal assistance. These services are delivered by health plans operating as Health Maintenance Organizations (HMOs).
Service coordination is the main feature of STAR+PLUS. It is a specialized case management service for program members who need or request it. Service coordination means that health plan members, their family members, and their providers can work together to help members get health, long-term, and other community support services.
Where are STAR+PLUS Services Offered?
STAR+PLUS currently serves Medicaid recipients in 29 counties in the Travis, Bexar, Nueces, and Harris/Harris Expansion Service Areas.
Current STAR+PLUS Service Areas and Counties: |
Bexar Service Area
Atascosa, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson Counties |
Harris Service Area
Harris |
Harris Expansion Service Area
Brazoria, Fort Bend, Galveston, Montgomery and Waller Counties |
Nueces Service Area
Aransas, Bee, Calhoun, Jim Wells, Kleberg, Nueces, Refugio, San Patricio and Victoria Counties |
Travis Service Area
Bastrop, Burnet, Caldwell, Hays, Lee, Travis and Williamson Counties |
In 2011, HHSC will expand STAR+PLUS to 13 counties in the Dallas and Tarrant Service Areas.
Dallas Service Area
Dallas, Collin, Ellis, Hunt, Kaufman, Navarro and Rockwall Counties |
Tarrant Service Area
Tarrant, Denton, Hood, Johnson, Parker, and Wise Counties |
Additional information on the 2011 STAR+PLUS Expansion
Map of STAR+PLUS Service Areas
Back to STAR+PLUS home |
