Texas STAR Plan
What is Medicaid?
It is the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). Community provides both Children’s Medicaid and Medicaid for Pregnant Women. These programs are at no cost to U.S. residents who cannot afford health insurance.
How does Medicaid work?
Members choose an HMO and a Primary Care Provider to give them all their primary care services. This includes coordinating referrals for all medically necessary specialty services.
Income determines eligibility. That income level is different based on age and Medicaid program. Children’s Medicaid covers a child up through the month of his or her 21st birthday.
Medicaid for Pregnant Women
Medicaid for Pregnant Women covers a childbearing woman of any age. Members must be at 185% or lower of the Federal Poverty Level (FPL). Members must recertify every year.
What Services Does Medicaid Cover?
Medicaid Members get medical care that includes:
- Hospital care
- Physical/speech/occupational therapies
- Prescription drugs
- Emergency services
- Regular health checkups and immunizations
Service Area Maps
For our Pregnant Members - Extra Benefits
- Adults get one physical exam per year, not covered in regular Medicaid
- Dental services for Members age 21 and over
- Vision benefits, including contact lenses
- Fun Member events at Moody Gardens, the Houston Zoo, the Children’s Museum, and games in Harris Service Area
- Fun Member events at Moody Gardens, the Children’s Museum, Sports Connection, South Texas Fair, and holiday events with Santa in Jefferson Service Area
- Children's Wellness Gift Program up to age 21
- Kids Club contests
- Memberships to Boys & Girls Club or Neighborhood Centers, Inc. in your area
- Web Site Baby Showers and Childbirth Classes for pregnant Members
- 24-Hour Nurse Help Line
- Transportation assistance
- Care Management Program for asthma, diabetes, and high-risk pregnancies
- School sports physicals
- Discount up to $40 for sports recreation programs
- Help with Medicaid recertification