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
STAR VALUE-ADDED SERVICES
What Value-Added Services do I get as a Member of Community Health Choice?
These services are in effect from September 1, 2017 to August 31, 2018. Call Member Services toll-free at 1.888.760.2600 if you have any questions.
24-Hour Nurse Help line
You can call our Nurse Help line 24 hours a day, seven days a week toll-free at 1.888.332.2730. Call the Nurse Help line before going to the emergency room, unless it is an emergency. A nurse will answer your health care questions and help the Member get the care they need.
Dental Benefits Age 21 and Over
We offer dental benefits for Members 21 and over. These benefits include exams, cleaning, and non-surgical extractions. All other dental services have a 25% discount. Call STARDent toll-free at 1.866.844.4251 to find a network dentist.
Members will receive $100 off the cost of contact lenses instead of glasses, if they choose. The $100 discount only applies if contact lenses are not covered as part of the standard Medicaid benefit. Members get the $100 discount at the time they are eligible for new eyewear. You are eligible for eyewear every 24 months.
We offer free transportation for Medicaid Members to doctors’ appointments when State Medical Transportation is not available and when approved by our case manager. You must call us for approval at least three business days before the Member’s appointment.
Care Management Program
We have care management programs (including services) for asthma and diabetes. We also give educational books on asthma, childbirth, and diabetes to Members in our Care Management Programs.
Classes are offered at multiple sites and at our office. There is no cost. This is available only in the Harris Service Area. Transportation assistance available in the Harris Service Area.
Sports and School Physicals
We will pay our network Providers for sports and school physicals for Medicaid Members age 4 to 19, limited to one per year.
Boys and Girls Club Membership
Children 7–17 years old can join the Boys and Girls Club at no cost! Limitations may apply.
Neighborhood Centers, Inc. (NCI)
Membership We will pay 100% of the membership cost, once per year, to the Neighborhood Centers, Inc. (NCI) of your choice for Medicaid Members in the Harris Service Area. The membership only covers health and wellness classes. Limitations may apply.
Youth Sports League Fee Allowance
We will pay up to $40 annually toward the cost of a Member’s registration fee for a youth sports league.