On Sept. 1, the STAR+PLUS Medicaid managed care program expanded to 164 rural counties not currently participating in the model. The expansion requires elderly patients eligible for Medicaid long-term care services and supports (LTCSS) and adult patients with disabilities to enroll in a STAR+PLUS plan. Children with disabilities may enroll voluntarily.
For patients eligible for all Medicaid services, STAR+PLUS HMOs cover all traditional Medicaid visits, such as doctor visits, emergency care, and hospital services, as well as long-term care services. For patients dually eligible for both Medicare and Medicaid, Medicare will continue to provide acute care services, while the STAR+PLUS HMO will provide LTCSS.
Patients throughout the state with intellectual and developmental disabilities, including those living in an intermediate care facility or those eligible for certain long-term care services, also are enrolled in STAR+PLUS for their acute care services, such as doctor visits and hospital care. They may live in a community-based intermediate care facility for individuals with intellectual disabilities or related conditions (ICF-IID) or receive services through one of the following ICF-IID waiver programs:
- Home and Community-based Services (HCS),
- Community Living Assistance and Support Services (CLASS),
- Texas Home Living (TxHmL), or
- Deaf Blind with Multiple Disabilities (DBMD).
Nursing facility services were originally scheduled to transition to STAR+PLUS Sept. 1. The Texas Health and Human Services Commission (HHSC) has postponed moving nursing facility residents into STAR+PLUS Medicaid managed care until March 1, 2015.
For more information, visit HHSC's Medicaid Managed Care Initiatives page.
Action, Sept. 2, 2014
Last Updated On
May 13, 2016