El Paso and Lubbock Service Areas STAR+PLUS Expansion

Notice:  On Feb. 17, 2012, HHSC issued an advisory to long-term services and supports (LTSS) providers related to authorization and billing issues under Section 8.2.1 of the STAR+PLUS Expansion Contract (Continuity of Care and Out-Of-Network Providers).  [View advisory (DOC)]

Announcement: Claims testing opportunities are available for contracted STAR+PLUS Long-term Services and Supports (LTSS) providers in the Hidalgo, El Paso, and Lubbock service areas prior to the March 1, 2012, Medicaid managed care expansion.  More about claims testing.

Starting March 1, 2012, the STAR+PLUS program will expand to serve these counties:

• El Paso Service Area: El Paso, Hudspeth
  
• Lubbock Service Area: Carson, Crosby, Deaf Smith, Floyd, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Potter, Randall, Swisher, Terry

Medicaid clients must enroll in STAR+PLUS if they meet one or more of the following:

• Have SSI and are age 21 or older.
  
• Get Community Based Alternative (CBA) services.
  
• Get Medicaid through Social Security exclusion programs.

The following may choose between STAR+PLUS and traditional Medicaid:

• Children age 20 and younger with Supplemental Security Income (SSI).

People who have both Medicaid and Medicare will:

• Continue to get health care from their Medicare doctors.
  Continue to get medications through Medicare.
  Get long-term services and supports from STAR+PLUS.

The following will continue to get Medicaid services the same way they do now:

• People who live in an institution—such as a nursing home, Intermediate Care Facility for Persons with Mental Retardation (ICF-MR) or state school.
  
• People who get home and community-based services through a Medicaid waiver other than the CBA program.
  Children in state foster care.

Community Outreach Meeting Calendar

Client Resource Materials

• El Paso STAR+PLUS enrollment packet for clients with Medicaid only
• El Paso STAR+PLUS enrollment packet for clients with Medicaid only and long-term services and supports
• El Paso STAR+PLUS enrollment packet for clients with Medicaid and Medicare
• El Paso STAR+PLUS enrollment packet for clients with Medicaid and Medicare and long-term services and supports
• Lubbock STAR+PLUS enrollment packet for clients with Medicaid only
• Lubbock STAR+PLUS enrollment packet for clients with Medicaid only and long-term services and supports
• Lubbock STAR+PLUS enrollment packet for clients with Medicaid and Medicare
• Lubbock STAR+PLUS enrollment packet for clients with Medicaid and Medicare and long-term services and supports
• STAR+PLUS Introduction Letter and Frequently Asked Questions (English and Spanish)
  
• STAR+PLUS Introduction Letter and Frequently Asked Questions for people who have Medicaid and Medicare (English and Spanish)
  
• STAR+PLUS Voluntary Introduction Letter and Frequently Asked Questions (English and Spanish)
  
• STAR+PLUS Voluntary Introduction Letter and Frequently Asked Questions for people who have Medicaid and Medicare (English and Spanish)