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STAR+PLUS

Overview

STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 65 or older. People in STAR+PLUS get Medicaid health-care and long-term services and support through a medical plan that they choose.

Long-term services and support 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.

Who can be in STAR+PLUS?

To get services through STAR+PLUS you must: (1) be approved for Medicaid, (2) live in a STAR+PLUS service area, and (3) 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 Waiver Services.
  • Age 21 or older, getting Medicaid through what are called “Social Security Exclusion programs” and meet program rules for income and asset levels.

Children age 20 and younger who have Medicaid and get SSI can be in STAR+PLUS. Or they can keep getting their Medicaid services in traditional Medicaid.
The following people can’t be in the STAR+PLUS program:

  • People living in nursing homes or care centers.
  • STAR+PLUS members who have been in a nursing home or care center for more than 4 months.
  • People who get Medicaid 1915(c) waiver services, other than Community-Based Alternative services.
  • Those who live in facilities for people with Intellectual Developmental Disabilities (IDD).
  • 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.

Important notes for those covered by Medicare:

  • You can get STAR+PLUS even if you get Medicare.
  • 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.

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Where are STAR+PLUS services offered?

Counties where STAR+PLUS is offered include:

Bexar Service Area
Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson counties

Dallas Service Area
Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, and Rockwall counties

El Paso Service Area
El Paso and Hudspeth counties  

Harris Service Area
Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Waller and Wharton  counties

Hidalgo Service Area
Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, and Zapata counties

Jefferson Service Area
Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, and Walker counties

Lubbock Service Area
Carson, Crosby, Deaf Smith, Floyd, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Potter, Randall, Swisher, and Terry counties

Nueces Service Area
Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kenedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio and Victoria counties

Tarrant Service Area
Denton, Hood, Johnson, Parker, Tarrant, and Wise counties

Travis Service Area
Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis and Williamson counties

Map of STAR+PLUS health plans by county

More facts about Medicaid managed care initiatives

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How does STAR+PLUS work for people who get both Medicaid and Medicare?

STAR+PLUS does not change how people get their Medicare services.

They must pick a STAR+PLUS medical plan, but don’t pick a main doctor. They get regular health care from their Medicare doctor and providers. The STAR+PLUS medical plan only gives Medicaid long-term services and supports.

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I was approved for STAR+PLUS. How do I start STAR+PLUS services?

Picking a medical plan and main doctor
If you are approved for STAR+PLUS, you will get a packet in the mail. It will tell you about the program and the medical plans in your area.  

You need to pick one of the medical plans. If you don’t get Medicare, you also will need to pick a main doctor.

You have 15 days pick a medical plan. The 15 days start once you get the packet in the mail. If you don’t pick a medical plan, HHSC will pick a medical plan and main doctor 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 main doctor takes care of basic health-care needs. The main doctor also can refer you to a specialist, if needed.

Regular health care and long-term services and supports are part of a plan of care put together by you, your family, and your doctor and other health-care providers.

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How do I change my STAR+PLUS medical 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 Medical Plans

The following medical plans offer STAR+PLUS services.

STAR+PLUS Service Areas and Medical 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
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 medical plans by county

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
  • Support Consultation
  • Financial Management Services (consumer directed services)

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Extra 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.

STAR+PLUS value-added comparison charts