Paul Sanchez
STAR is a Medicaid managed care program that provides health insurance coverage for low-income children, pregnant women, and families. STAR members can choose their own health plan and receive benefits such as regular check-ups, prescription drugs, hospital care, and specialist treatment. STAR+PLUS is an extension of the STAR program, providing long-term care and support services for adults with disabilities or those aged 65 and over. Both programs are available in Texas and are provided by insurance companies such as Community Health Choice and Superior HealthPlan. These programs are offered at no cost to US residents who cannot afford health insurance.
| Characteristics | Values |
|---|---|
| Insurance company | Superior HealthPlan |
| Insurance plan | STAR |
| Who it serves | Low-income families, low-income children, pregnant women |
| Cost | No cost to members |
| Benefits | Choice of doctors, regular checkups, prescription drugs, medical supplies, dental and vision services, behavioral health care, hospital coverage, value-added services (e.g. extra vision care, online resources, transportation assistance) |
| Insurance company | Community Health Choice |
| Insurance plan | STAR |
| Who it serves | Children, pregnant women |
| Cost | No cost to members |
| Benefits | Regular checkups, prescription drugs, hospital care, X-rays and lab tests, vision and hearing care, access to medical specialists and mental health care, treatment of special health needs and pre-existing conditions, value-added services |
| Insurance company | N/A |
| Insurance plan | STAR+PLUS |
| Who it serves | Adults with disabilities or aged 65 or older |
| Cost | N/A |
| Benefits | Basic healthcare services (e.g. doctor visits), long-term services and support (e.g. help with daily activities, home modifications), value-added services |
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Community Health Choice
In addition to Medicaid, Community Health Choice participates in the Children's Health Insurance Program (CHIP) and CHIP Perinatal (CHIP-P). CHIP provides health insurance for children under the age of 19 in families who do not qualify for Texas Medicaid but cannot afford private insurance. CHIP-P offers prenatal care for the unborn children of low-income women who do not qualify for Medicaid.
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Superior HealthPlan
Medicaid is a health insurance program for people who cannot afford health insurance. Superior HealthPlan offers STAR Medicaid to its members in Texas, which covers low-income children, pregnant women, and families. STAR members can choose a health plan from the ones available in their service area and receive benefits such as regular check-ups, prescription drugs, hospital care, x-rays, lab tests, vision and hearing care, access to medical specialists, and mental health care.
In addition to their regular Medicaid benefits, Superior HealthPlan offers Value-Added Services (VAS) to its members. These include extra vision care, online resources, help with transportation, home-delivered meals, and more. For example, pregnant members can receive a diaper bag, diapers, and educational materials by completing the Notification of Pregnancy form and attending Superior's educational baby shower. Superior also offers weight loss support through Weight Watchers® for members 18 and older with a BMI value of 30 or higher.
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STAR+PLUS
- Be 21 or older, receive Supplemental Security Income (SSI) benefits, and be eligible for Medicaid due to low income.
- Do not receive SSI but require the type of services provided by STAR+PLUS Home and Community-Based Services.
- Be 21 or older, receive Medicaid through "Social Security Exclusion programs", and meet the program rules for income and asset levels.
- Be 21 or older, reside in a nursing home, and receive Medicaid while in the nursing home.
- Be enrolled in the Medicaid for Breast and Cervical Cancer program.
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STAR benefits
STAR is a Medicaid managed care program that provides coverage for low-income children, pregnant women, and families. It is available to Texas residents who meet the income eligibility requirements. STAR members can choose their health plan and receive services such as regular check-ups, prescription drugs, hospital care, x-rays, vision and hearing care, and access to medical specialists.
One of the key benefits of the STAR program is the inclusion of value-added services, which are extra services provided in addition to the standard Medicaid benefits. These value-added services vary by plan and area and may include extra vision care, online resources, transportation assistance, and more.
For pregnant members, STAR offers benefits such as dental coverage, rewards for completing prenatal and postpartum visits, home visits, and educational resources through programs like Start Smart® For Your Baby.
STAR also provides Medicaid Applied Behavior Analysis (ABA) Services for children and youth with autism. This service encourages positive and adaptive behaviors and helps improve their health, safety, and independence.
It is important to note that Medicaid coverage through the STAR program is typically limited to the service area. If members are outside of their designated service area, benefits may be restricted to emergency care only. Additionally, Medicaid does not provide coverage for individuals outside of the country.
Overall, the STAR program under Medicaid offers a comprehensive range of benefits and services to eligible individuals and families in Texas, ensuring access to necessary healthcare and additional support.
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STAR eligibility
STAR is a managed care program that provides Medicaid services in Texas. STAR covers low-income children, pregnant women, and families. Members in the STAR program can access Medicaid benefits such as regular check-ups, prescription drugs, hospital care, x-rays, vision and hearing care, and mental health services.
Community Health Choice is a managed care organization that offers Texas Medicaid STAR coverage. It provides Children's Medicaid and Medicaid for Pregnant Women at no cost to eligible US residents. Children's Medicaid covers children up to their 21st birthday, with income eligibility varying based on age and program. Medicaid for Pregnant Women is available to women of any age with an income at or below 185% of the Federal Poverty Level (FPL). Members must recertify annually.
In the context of New York State, STAR refers to the School Tax Relief Program. The STAR and Enhanced STAR (E-STAR) benefits offer property tax relief to eligible New York homeowners. To be eligible for Basic STAR, an individual's income must be $250,000 or less. For Enhanced STAR, the total income of all owners and resident spouses or partners must not exceed $107,300, and at least one spouse or partner must be 65 or older.
The STAR exemption program is closed to new applicants, but current recipients can apply to have it restored if they previously lost the benefit. New York State homeowners can view and update their property tax benefit registrations and enroll in direct deposit for their STAR credit through the Homeowner Benefit Portal.
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Frequently asked questions
STAR is a managed care program that provides Medicaid services to low-income families, pregnant women, and children at no cost. STAR members can choose a health plan from the ones available in their service area and receive benefits like regular checkups, prescription drugs, hospital care, and more.
Superior HealthPlan and Community Health Choice are two examples of insurance companies that offer STAR Medicaid plans in Texas.
STAR Medicaid plans typically include benefits such as doctor visits, prescription drugs, dental and vision services, behavioural healthcare, hospital coverage, and value-added services like extra vision care or transportation assistance.
To enrol in a STAR Medicaid plan, you must first be enrolled in Medicaid. You can enrol in Medicaid through Your Texas Benefits or by calling 2-1-1. Once enrolled in Medicaid, you can choose a STAR plan that meets your needs based on your location and specific requirements.
