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.

Map of STAR+PLUS health plans by county

Map of STAR+PLUS Health Plans by Rural Service Area (PDF)

More facts about Medicaid managed care initiatives

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.

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.

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.

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

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

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.