Texas STAR+PLUS Benefits

STAR+PLUS is a Medicaid-managed care program serving low-income individuals who have disabilities or are age 65 or older living in the El Paso and Hudspeth areas. This program has been designed to meet the unique needs of these specialized individuals.

El Paso Health is a local health plan
with local understanding.

How does STAR+PLUS work?

If you qualify for STAR+PLUS, you will need to choose a health plan. You may also need to choose a main doctor for all your care.

What are my health care benefits? You get benefits from El Paso Health for acute care such as doctor visits, hospitalizations, prescriptions, and behavioral health services. You can also get long-term services and supports. Long-term services and supports benefits help you live in your home instead of in a long-term care facility.

Long-term services and supports can include help with light housekeeping, fixing meals, bathing, and dressing. To learn more about specific long-term services and supports you can get, our Service Coordinators can assist you.

Learn about the additional healthy rewards you will receive by being a part of El Paso Health.

Call the STAR+PLUS Help Line at 1-833-742-3127, and ask to join El Paso Health today!

STAR+PLUS Nursing Facility Members

If you live in a Nursing Facility, most of your care will come from the Nursing Facility. Your Service Plan helps you stay connected with your service coordinator. You can access your Service Plan online, or have the materials mailed to you. You can also talk to your service coordinator about your services. Services include:

Daily care services such as:

  • Room and Board
  • Medical supplies and equipment
  • Personal needs items
  • Social Services
  • Over-the-Counter drugs

Nursing Facility add-on services, which include:

  • Emergency dental services
  • Physician-ordered rehabilitative services
  • Augmentative communication devices
  • Customized power wheelchairs

You pay nothing for STAR+PLUS benefits except the monthly applied income amount you pay to the Nursing Facility.

If you have Medicare, we pay your percentage of the costs for a Medicare-covered stay for Nursing Facility daily care services. Your Medicare plan or Texas Medicaid pays your percentage of the costs for Nursing Facility add-on services.

Prior Authorizations

Authorizations

An authorization is when your doctor needs to ask us to approve a service before you receive it. Your provider will work with us to get the authorization you need. Please refer to the Prior Authorization page.

Referrals

You may need to visit a specialist or another provider for care or services your primary care provider can’t give you. You don’t need a referral from your primary care provider to get care from other providers in our plan. This includes behavioral health services, OB/GYN care, and family planning. It’s a good idea to talk to your main doctor first about other types of care you may need. He or she can tell you about other providers in our plan and help you find the care that’s right for you.

The Member Handbook:
Everything you need to know!

Your Member Handbook is your guide for health services. Read about:

  • How to use your benefits.
  • How to choose a primary care provider.
  • How to get help if your doctor's is closed.
  • How to reach Member Services if you have questions.
  • Your Rights and Responsibilities as an El Paso Health Member.

Member Handbooks and Downloadable Directories

Document
Last Updated
Size
STAR+PLUS Member Handbook
Feb 2024
3.4 MB
STAR+PLUS Nursing Facility Member Handbook
Feb 2024
3.7 MB
STAR+PLUS Provider Directory
Feb 22, 2024
10.7 MB

Need a Handbook mailed to you?

Just message us your mailing address to have a STAR+PLUS Member Handbook mailed to you at no cost, contact Member Services. The Handbook will be mailed within five business days of your request.
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