Whether or not a person has health care coverage throughout their life can impact their health and related expenses as they age.
Most older adults receive health care coverage through Medicare when they become eligible. However, people who were uninsured before their Medicare eligibility can have higher health care costs and more frequent hospital and doctor visits than those with coverage before Medicare. Medicaid, a jointly funded health care program administered by states, provides health care coverage to vulnerable Texans, including low-income adults, children and people with disabilities.
In Texas, managed care health plans contract with the state to deliver Medicaid to beneficiaries. Managed care is a health care delivery system designed to manage quality of care, performance and costs.
STAR+PLUS is a Medicaid managed care program that offers basic health and long-term services and supports for adults 21 and older who meet the following criteria:
- Have a disability and qualify for Medicaid because of low income.
- Qualify for Supplemental Security Income benefits; or
- Qualify for Medicaid because they meet a nursing facility-level of care andneed STAR+PLUS Home and Community Based waiver services because they have an intellectual and developmental disability or related condition.
Benefits and services
STAR+PLUS provides traditional Medicaid benefits as well as non-medical benefits, such as personal assistance services, day activity and health services, and service coordination.
Other benefits include:
- Access to a primary care provider.
- Unlimited prescriptions.
- Value-added services or extra benefits offered through the managed care organization.
- Nursing facility services.
To apply for Medicaid benefits, visit the Your Texas Benefits website or contact your local HHS benefits office. To connect with your local benefits office, call the 2-1-1 information and referral hotline. You can apply in person or mail a completed paper application to HHSC, P.O. Box 149027, Austin, TX 78714-0927.
Your local Area Agency on Aging can help you apply and determine if you are eligible for benefits. To find your local AAA, call 800-252-9240 or visit the Area Agencies on Aging Directory.
Olivia Burns is Aging Texas Well coordinator for the state’s Health and Human Services Commission.