What Medicaid health plan members need to know about upcoming changes

Beginning Sept. 1, some health plans in the Bexar County area will no longer offer the STAR+PLUS program

A woman with her caregiver. (Community First Health Plans.)

Health plans that offer an important Medicaid program for qualifying residents in San Antonio and surrounding areas are about to change.

STAR+PLUS is a Texas Medicaid managed-care program for adults who have disabilities or are age 65 or older. Adults in STAR+PLUS get Medicaid health care and long-term services and support through the health plan they choose.

STAR+PLUS provides access to necessary care, like habilitation services (learning to do activities of daily living), emergency response services, and nursing and personal care services. This means adults with complex medical needs can live and receive care at home instead of in a nursing facility.

Because STAR+PLUS is vital to so many people, families and caregivers, it is imperative those enrolled are aware of what’s to come.

What’s changing?

Beginning Sept. 1, some health plans in the Bexar County area will no longer offer STAR+PLUS.

If you’re covered by one of these plans, you should expect a packet in the mail soon from the Texas Health and Human Services Commission (HHSC) or an email with information about your new health plan options.

Staying informed during this period of change is very important. Communications from HHSC will explain the transition process and provide clear instructions and resources for understanding and navigating the changes effectively.

Your options

Community First Health Plans (Community First), the only locally owned and operated nonprofit health plan that serves San Antonio and surrounding areas, has been selected by HHSC to administer the Medicaid managed care STAR+PLUS program in seven local counties: Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina and Wilson.

Beginning Sept. 1, Community First will offer STAR+PLUS members all the benefits provided under Medicaid, including long-term services and supports, plus several value-added services, including:

  • Up to eight hours of in-home respite care.
  • Low-cost dental services.
  • Enhanced vision services, including up to $125 for frames or $75 for contact lenses.
  • Prescription savings card approved for use by uninsured family members.
  • Help getting rides to places like the grocery store, health education classes and more.
  • YMCA diabetes prevention and weight loss program with a complimentary YMCA membership.
  • Foot care and insulated cooler bag for members with diabetes.
  • Mask with aerosol chamber and more products for members with asthma.
  • Allowance for a seat attachment that fits on a walker.
  • Home-delivered prepared meals after a hospital stay.
  • Baby shower, baby items and gift card reward program for pregnant members.
  • Zumba classes for members and their families, with fitness giveaways.
  • Smartphone with two plan options.

*Effective Sept. 1. Restrictions and limitations may apply to value-added services.

Community First President and CEO Theresa Rodriguez Scepanski said after nearly 30 years of providing South Texas much-needed health coverage, the nonprofit leaders are eager to offer its services to this vulnerable and important population.

“We hope to close gaps in health care for these members by anticipating their unique health needs and meeting those needs through experience and compassion, and by putting the members first, helping them to meet their health goals and maintain their independence,” she said.

Community First will also guide new STAR+PLUS members who transition from other health plans that will no longer serve residents of the Bexar County area.

In addition to checking your mail for information from HHSC and responding accordingly, current STAR+PLUS members should also:

  • Visit CommunityFirstSTARPLUS.com for more information or call Community First Member Services at 844-832-2347, Monday through Friday, 8 a.m. to 5 p.m.
  • Update any address or phone number change with HHSC by calling 2-1-1 or visiting YourTexasBenefits.com.

Though change may bring apprehension, it also presents opportunities for enhancement. Individuals who choose to switch plans to Community First can depend on service coordination, continuity of care and compassion, experience and support throughout the process. Community First will assist individuals navigating these transitions.

If your current STAR+PLUS health plan has notified you that they will no longer serve STAR+PLUS members, you must choose a new plan by July 31. If you do not, HHSC will select one for you. This is why it’s important to be proactive in the decision-making process.

Click or tap here or call 844-382-2347 to learn more about Community First STAR+PLUS, including how to switch plans and how to apply.

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