Are You Able to Get STAR+PLUS?*

 
There are mandatory groups of people that are able to get Medicaid no matter where they live. These mandatory groups include low income people with a physical or mental disability, low income families with dependent children, and women who are pregnant and have children and are below the federal poverty level.


You must join STAR+PLUS if you live in a STAR+PLUS service area and fit one of the requirements below
:
 
  • People age 21 or older who can receive Medicaid because they are in Social Security Exclusion program and meet financial criteria for waiver services.


  • People age 21 or older who are receiving Supplemental Security Income (SSI)


  • People who have a physical or mental disability and qualify for supplemental security income (SSI) benefits or for Medicaid due to low income.


  • People who are able to get Community-Based Alternatives (CBD) waiver services.


  • People who receive services in community-based Intermediate Care Facilities for people with Intellectual Disabilities or Related Conditions (ICF-IID)


  • People who receive services in certain DADS 1915(c) programs:

    • Home and Community-Based Services (HCS)
    • Community Living Assistance and Support Services (CLASS)
    • Texas Home Living (TxHml)
    • Deaf Blind Multiple Disabilities (DBMD)
  • Nursing Facility

    • Adults age 21 and older who are in a nursing facility
    • Determined able to get Medicaid, and who meet STAR+PLUS criteria will be mandatory
    • Nursing Facility Dual and Nursing Facility Medicaid Only
    • Members will no longer be dis-enrolled from STAR+PLUS when residing in a Nursing Facility
    • Exclusions:
      • Children and young adults under age 21
      • Truman W. Smith Children's Care Center residents
      • State veteran's home residents
 
*Individuals not able to get Medicaid and children in state foster; clients not able to get full Medicaid benefits, such as: 1) Qualified Medicare beneficiaries, 2) Specified low-income Medicare beneficiaries, 3) Qualified disabled working individuals and undocumented immigrants cannot participate in the STAR+PLUS program.
 
Enrollment in STAR+PLUS is voluntary for children under age 21 receiving (SSI) or (SSI) related benefits.
 
 
To find out if you are able to get STAR+PLUS Medicaid, call 2-1-1.
 
To switch to Cigna-HealthSpring STAR+PLUS, call the STAR+PLUS Help Line at 1-800-964-2777, Monday to Friday, 8:00 a.m. to 8:00 p.m. Central Time.
 
 
Service Area List
 

Medicaid Rural Service Area (MRSA) / Northeast Texas Service Delivery Area:

Anderson, Angelina, Bowie, Camp, Cass, Cherokee, Cooke, Delta, Fannin, Franklin, Grayson, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Montague, Morris, Nacogdoches, Panola, Rains, Red River, Rusk, Sabine, San Augustine, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt, Wood
 

Hidalgo Service Delivery Area:

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

Tarrant Service Delivery Area:

Tarrant, Denton, Hood, Johnson, Parker, and Wise