TX STAR+PLUS Program Explained

The STAR+PLUS program is a Texas Medicaid managed care initiative that provides health care and long-term services to adults with disabilities or aged 65 and older, with a focus on empowering family caregivers through compensation for their valuable support.
Published on
August 24, 2023
Written by
Katie Wilkinson
Reviewed by
Max Mayblum
Certified Senior Advisor (CSA)®
Presented by Givers
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The TX STAR+PLUS Program is available in:

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The STAR+PLUS program caters to adults with disabilities and those aged 65 and older. It goes beyond conventional care, offering a choice for individuals with complex medical needs to receive support within a home setting rather than residing in nursing facilities. But the program's significance extends further, advocating for the recognition and compensation of family caregivers, an integral but underpaid workforce in the US healthcare system.

Overview of STAR+PLUS Program

The STAR+PLUS program, a Medicaid managed care initiative in Texas, is designed to provide comprehensive health care and long-term services and supports to adults with disabilities or individuals aged 65 and above. It offers a person-centered approach, allowing beneficiaries to select a health plan that best suits their needs from various options.

The primary purpose of the STAR+PLUS program is to enhance the quality of life and independence of eligible participants while ensuring they receive the necessary medical care and community-based services. By offering choices and flexibility, the program aims to empower individuals with complex medical needs to live and receive care in a home setting, fostering a sense of dignity and autonomy.

Through the STAR+PLUS program, eligible participants gain access to various services, including medical, behavioral health, and long-term care services. This comprehensive approach intends to address the unique needs of each individual, improving health outcomes and overall well-being.

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Can you get paid caring for your loved one?
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Eligibility Requirements for STAR+PLUS Program

Individuals must meet specific eligibility criteria to access services through the STAR+PLUS program. To be eligible, the individual must first be approved for Medicaid. Additionally, they must fall into one of the following categories:

  1. Age 21 or older, receiving Supplemental Security Income (SSI) benefits, and eligible for Medicaid due to low income.
  2. Not receiving SSI but eligible for STAR+PLUS Home and Community-Based Services.
  3. Age 21 or older, receiving Medicaid through "Social Security Exclusion programs," and meeting program rules for income and asset levels.
  4. Age 21 or older, living in a nursing home, and receiving Medicaid while there.
  5. Enrolled in the Medicaid for Breast and Cervical Cancer program.

However, specific individuals are NOT eligible for the STAR+PLUS program, including:

  1. People over 21 who receive Medicaid 1915(c) waiver services or live in community homes for individuals with Intellectual Developmental Disabilities (IDD) and also receive Medicare.
  2. Individuals not eligible for complete Medicaid benefits like Frail Elderly program members, Qualified Medicare Beneficiaries, Specified Low-Income Medicare Beneficiaries, or Qualified Disabled Working Individuals.
  3. Those who are not eligible for Medicaid.
  4. Children in state foster care.
  5. Individuals aged 20 or younger who are not part of the Medicaid for Breast and Cervical Cancer program.

Individuals who are "dual eligible," meaning covered by Medicare and Medicaid, can still enroll in the STAR+PLUS program as long as they are not receiving Medicaid 1915(c) waiver services or living in facilities for those with Intellectual Developmental Disabilities (IDD). In such cases, STAR+PLUS does not affect the regular healthcare services received through Medicare.

Services and Supports Offered by STAR+PLUS Program

The STAR+PLUS program offers a comprehensive array of services and supports to meet its beneficiaries' diverse needs. Upon enrolling in the program, members are visited by a service coordinator within 30 days, who assesses their specific requirements and devises a personalized care plan.

The long-term services and supports available through STAR+PLUS encompass various options, including:

  1. Day Activity and Health Services (DAHS): Providing opportunities for social engagement and health-related activities during the day.
  2. Primary Home Care (PHC): Offering personal assistance services for activities of daily living within the home setting.

Other services included under the STAR+PLUS Home and Community-Based Services Waiver are:

  1. Personal Assistance Services: Assisting with daily tasks and activities, ensuring a safe and comfortable environment.
  2. Adaptive Aids: Providing aids and equipment to enhance independence and mobility.
  3. Adult Foster Care Home Services: Offering support and care within a foster home setting.
  4. Assisted Living: Providing residential care and support services for those needing additional assistance.
  5. Emergency Response Services: Ensuring prompt assistance during emergencies or urgent situations.
  6. Home Delivered Meals: Providing nutritious meals to individuals who cannot prepare themselves.
  7. Medical Supplies: Offering necessary medical equipment and supplies.
  8. Minor Home Modifications: Making essential changes to the home environment to enhance accessibility and safety.
  9. Nursing Services: Delivering skilled nursing care and medical support.
  10. Respite Care: Furnishing short-term care to give caregivers much-needed breaks.
  11. Therapies: Offering occupational, physical, and speech-language therapies to improve overall functioning.
  12. Transitional Assistance Services: Assisting with transitioning from one care setting to another.

These services collectively promote the well-being and independence of STAR+PLUS participants, ensuring they receive the necessary care and support to lead fulfilling lives in their chosen home settings.

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Earn up to $20/hr for the care you give.
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Compensation for Family Caregivers

The STAR+PLUS program recognizes the vital role of family caregivers and has taken steps to compensate them for their dedicated services. Through the self-directed option available under this Medicaid waiver, eligible participants can hire and pay their family members, including adult children, for caregiving services. This innovative approach empowers individuals with disabilities or those aged 65 and above to choose their preferred caregivers, often family members, and offers financial compensation for their invaluable support. The self-directed option fosters a more personalized and compassionate caregiving experience while recognizing and addressing the financial burden often faced by family caregivers, making it a crucial aspect of the STAR+PLUS program's commitment to advocating for the rights and welfare of caregivers.

A note from Givers

If you are a caregiver in Texas, find out if you're eligible for compensation by filling out this form and take the first step towards recognizing the invaluable contributions of caregivers in our society.

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