What is Star Plus Medicaid

Star Plus Medicaid is a government healthcare program that provides health insurance to people with low income and limited assets. The program is available in all 50 states and the District of Columbia, and it is administered by the Centers for Medicare and Medicaid Services (CMS). Star Plus Medicaid covers a wide range of health care services, including doctor’s visits, hospital stays, prescription drugs, and mental health services. The program is designed to help people get the care they need to stay healthy, and it can also help people save money on their health care costs.

Medicaid Expansion in Texas

In 2022, Texas implemented Medicaid expansion, known as Star Plus Medicaid. Star Plus Medicaid is a managed care program that provides health coverage to low-income adults ages 19-64 who meet certain eligibility requirements. The program is designed to improve access to healthcare for Texans who do not have health insurance and cannot afford to purchase it on their own.

Eligibility for Star Plus Medicaid

  • Adults ages 19-64
  • Residents of Texas
  • Income at or below 138% of the federal poverty level ($18,754 for an individual and $38,295 for a family of four in 2023)
  • Not eligible for Medicare, Medicaid, or other health insurance

Benefits of Star Plus Medicaid

  • Preventive and routine care, such as checkups, screenings, and immunizations
  • Medical care, such as doctor visits, hospital stays, and surgery
  • Behavioral health care, such as mental health and substance abuse treatment
  • Prescription drug coverage
  • Dental and vision care

How to Apply for Star Plus Medicaid

You can apply for Star Plus Medicaid online, by phone, or in person at your local Health and Human Services office. You will need to provide proof of your identity, income, and residency. If you are eligible, you will be enrolled in Star Plus Medicaid within 30 days.

Contact Information for Star Plus Medicaid

If you have questions about Star Plus Medicaid, you can call the Texas Health and Human Services Commission at 1-877-541-7905. You can also find more information about the program online at the Texas Health and Human Services Commission website.

Table Summarizing Star Plus Medicaid Eligibility and Benefits

Adults ages 19-64Preventive and routine care
Residents of TexasMedical care
Income at or below 138% of the federal poverty levelBehavioral health care
Not eligible for Medicare, Medicaid, or other health insurancePrescription drug coverage

Benefits and Coverage of Star Plus Medicaid

Star Plus Medicaid, a managed care program, offers comprehensive healthcare coverage to eligible Medicaid recipients in Texas. It aims to improve health outcomes, provide preventive care, and enhance quality of life. This program provides a wide range of benefits and services, as well as various coverage options to suit individual needs.

Coverage Options

  • Star Plus CHIP: Provides coverage for children and pregnant women.
  • Star Plus Medicare: Combines Medicaid and Medicare benefits for eligible individuals.
  • Star Plus Health: Offers coverage for adults, children, and pregnant women.
  • Star Plus Dual Medicare and Medicaid: Combines Medicare and Medicaid coverage for individuals with disabilities or those who are elderly.

Benefits of Star Plus Medicaid

  • Routine checkups and screenings.
  • Immunizations and preventive care.
  • Hospital and emergency care.
  • Prescription drug coverage.
  • Mental health and substance abuse treatment.
  • Vision and dental care (for children).
  • Physical and occupational therapy.
  • Transportation to medical appointments.

Covered Services

Covered Services under Star Plus Medicaid
MedicalDoctor visits, hospital stays, emergency care, prescription drugs (with co-pays)
Behavioral HealthCounseling, therapy, psychiatric services
DentalCheckups, cleanings, fillings, extractions (for children)
VisionEye exams, glasses or contact lenses (for children)
TransportationNon-emergency medical transportation to appointments

To learn more about Star Plus Medicaid eligibility, enrollment, and the application process, please visit the official website of the Texas Health and Human Services Commission.

Eligibility Requirements for Star Plus Medicaid

Star Plus Medicaid is a health insurance program that provides comprehensive coverage for children, pregnant women, and families with low income and limited assets. To determine eligibility, the following criteria are considered:

Family Income

Eligibility for Star Plus Medicaid is based on a family’s income, which must fall below specific limits. The income limits vary depending on the household size and are updated annually. Families can check their eligibility by comparing their gross monthly income to the current income guidelines set by their state’s Medicaid program.

Age and Pregnancy Status

Children under the age of 19 and pregnant women of any age are eligible for Star Plus Medicaid. There are no age restrictions for children with disabilities or special health needs.


Applicants must be residents of the state in which they are applying for coverage. Proof of residency, such as a driver’s license or utility bill, may be required.

Citizenship and Immigration Status

U.S. citizens, legal residents, and certain non-citizens, including refugees, asylees, and undocumented immigrants who meet specific criteria, are eligible for Star Plus Medicaid. In general, undocumented immigrants are not eligible for Medicaid, but states may choose to cover certain groups, such as children and pregnant women.


Star Plus Medicaid also has asset limits. Assets include cash, bank accounts, stocks, bonds, and other valuables. The asset limits vary by state and are periodically updated. Families with assets above the limits may still be eligible if they meet other criteria, such as having a child with a disability or being pregnant.

To determine eligibility for Star Plus Medicaid, families should contact their state’s Medicaid office or visit the Medicaid website. Applications can be submitted online, by mail, or in person. The application process typically involves providing personal information, income documentation, proof of residency, and information about any health insurance coverage the family currently has.

Alright folks, I hope this brief ramble through Star Plus Medicaid was helpful. I know it can be hard to understand the ins and outs of Medicaid, but hopefully, this article shed some light on the subject. If you’re curious to learn more about other government-sponsored healthcare programs or topics, be sure to swing by again. Until next time, folks!