STAR Kids is a new Texas Medicaid managed care program that will provide Medicaid beneﬁts, beginning November 1, 2016, to children and adults 20 and younger who have disabilities. Participation in the STAR Kids program is required for those who are 20 or younger, covered by Medicaid, and meet at least one of the following:
STAR Kids is designed to meet the unique needs of youth and children with disabilities. The program will provide beneﬁts such as prescription drugs, hospital care, primary and specialty care, preventive care, personal care services, private duty nursing, and durable medical equipment and supplies. Children and youth who get additional services through MDCP will receive their MDCP services through STAR Kids.
If you or your child lives in a community-based intermediate care facility for individuals with an intellectual disability or related condition (ICF/IID) or nursing facility, your long term services will be provided the same way they are now.
If you or your child receives services from any of the following programs, they will be provided the same way they are now:
If you or your child receives Medicare, your Medicare beneﬁts won’t change. You will keep using Medicare for basic health services and medicine ordered by your doctor. Through STAR Kids, families will also receive help with coordinating care. Each health plan will provide service coordination, which will help identify needs and connect members to services and qualiﬁed providers. STAR Kids MCOs will assess each member's service needs, which will be used to help the family and the MCO create an individual service plan.
Maximus, the state's managed care enrollment broker, will mail introductory STAR Kids letters to individuals affected by this change in July 2016, followed by enrollment letters with instructions in August 2016. Individuals will need to choose a health plan or one will be assigned. Texas HHSC has directed MAXIMUS to host 30 community education sessions. in addition to 60 enrollment events. MAXIMUS is working with provider organizations and local authorities across the state to coordinate community education sessions. Events will be posted to www.TXMedicaidEvents.com.
|July 2016||Introduction Letters|
|August 2016||Enrollment Packets|
|September 2016||Reminder Letters|
|October 15, 2016||Deadline to select an MCO|
|November 1, 2016||Implementation|
The Texas Health and Human Services Commission (HHSC) conducted information sessions regarding the STAR Kids managed care program earlier this year. Training material from those events, dates and locations of future information sessions (including some which may be held in Spanish), as well as more information on the STAR Kids managed care program may be found at: www.hhsc.state.tx.us/starkids.
Managed care means that you will pick health plan that will provide the health services you need through a network of doctors, specialists and other providers. Those enrolling in the STAR Kids program will choose a health plan, as well as a primary care physician or clinic who will provide basic medical services, like check-ups, and provide referrals to a specialist when needed.