Texas STAR+PLUS benefits

 

STAR+PLUS is a Texas Medicaid managed care program for adults who have disabilities or are ages 65 or older.

Medical care is just the beginning

 

With Wellpoint, you’ll also have access to a wide range of services including long-term services and supports, vision care, and extra benefits like our Healthy Rewards program.

Not sure of your service area?

 

Visit our Know Your Service Area page.

STAR+PLUS nursing facility members

 

If you live in a nursing facility, most of your care will come from the nursing facility. Your Service Plan helps you stay connected with your service coordinator. You can access your Service Plan online, or have the materials mailed to you. You can also talk to your service coordinator about your services. Services include:

 

Daily care services such as:

  • Room and board
  • Medical supplies and equipment
  • Personal needs items
  • Social services
  • Over-the-counter drugs

 

Nursing facility add-on services, which include:

  • Emergency dental services
  • Physician-ordered rehabilitative services
  • Augmentative communication devices
  • Customized power wheelchairs

 

You pay nothing for STAR+PLUS benefits except the monthly applied income amount you pay to the nursing facility.

 

If you have Medicare, we pay your percentage of the costs for a Medicare-covered stay for nursing facility daily care services. Your Medicare plan or Texas Medicaid pays your percentage of the costs for nursing facility add-on services.

Texas Star Plus. Texas Health and Human Services.

Preapprovals and referrals

 

Preapprovals

A preapproval is when your doctor needs to ask us to approve a service before you receive it. Your provider will work with us to get the preapprovals you need. Please refer to the Referrals and Preapprovals page.

 

Referrals

You may need to visit a specialist or another provider for care or services your primary care provider can’t give you. You don’t need a referral from your primary care provider to get care from other providers in our plan. This includes behavioral health services, OB/GYN care, and family planning. It’s a good idea to talk to your main doctor first about other types of care you may need. He or she can tell you about other providers in our plan and help you find the care that’s right for you.

Need a handbook mailed to you?

 

Request a handbook via live chat with Member Services. To have a STAR+PLUS member handbook mailed to you at no cost, contact Member Services. The handbook will be mailed within five business days of your request.