Texas Famous Person+plus Waiver Programs

Persons on Texas Stars ank”>Texas Stars isex-ultra-cotton-tee/” target=”_blank”>Texas Stars Texas Stars the HCBS waivers CLASS, HCS, TxHML, DBMD Texas Stars and in ICF-IID facilitiesThe individual Texas Stars care you want. The help you need.

If you are elderly, disabled or dwelling with an infection, your fitness desires are unique. Our task is to make it as clean as viable for you to meet the ones wishes. To try this, we start with what our individuals have instructed us is maximum critical.A health practitioner you understand and accept as true with, who’s close to you. You can pick from lots of physicians and hospitals throughout Texas.Support for individuals who assist you. We get to realize your family, your caregivers and those who assist you inside the community.Help with coordinating your care. Your Service Coordinator allow you to get the maximum from your blessings.

For greater statistics approximately the pharmacies, hosipitals, specialists and other vendors in the UnitedHealthcare Community Plan community, you may call us at 1-888-887-9003, TDD: 711.All your Medicaid benefits and more*

We recognize that health care may be difficult. That’s why our health plans are designed to make things simpler for you.You can pick out your personal health practitioner. Find a number one doctor for your neighborhood. Your doctor can ship you to lots of professionals, too.24/7 NurseLineSM You or a caregiver can call our nurses for recommendation, day or night.Prescription tablets. Get the drugs you want at a pharmacy close to you.Vision and dental. Have ordinary eye and dental exams. We cover glasses and call lenses too.Mental health. Counseling and other remedies are Texas Stars included.A Service Coordinator. If you need extra help dealing with your circumstance, certainly one of our Service Coordinators will work with you to get the care you want.Transportation. If you want help attending to the health practitioner, we can pick out you up. Even prevent at the pharmacy on the manner domestic.Value-delivered benefits. Earn free gift playing cards whilst you are taking healthful steps. You’ll get rewards if you have your every year health exam or whole a weight loss plan. * Please Note: Some advantages won’t practice to all individuals or service areas.

Employment Assistance and Supported Employment are blessings offered to the STAR+PLUS Waiver members most effective effective 9/1/2014.

Employment Assistance (EA) services offer help to the member to assist discover aggressive employment or self-employment. EA offerings include, but are not limited to, the subsequent:Identifying an member’s employment alternatives, task capabilities, and necessities for a work putting and paintings conditions;Locating potential employers presenting employment compatible with an member’s diagnosed alternatives, skills, and requirements; andContacting a prospective organization on behalf of an member and negotiating the member’s employment.

Supported Employment (SE) services provide help to the member on the way to sustain paid employment, to a member who, due to a incapacity, calls for in depth, ongoing guide to be self-employed, work at home, or perform in a work placing at which members without disabilities are hired. SE consists of employment adaptations, supervision, and education related to a member’s diagnosis.

Competitive employment is paintings:In the aggressive exertions marketplace, in which each person may additionally compete for employment, that is carried out on a full-time or component-time foundation in an included setting; andIn which a member is compensated at or above the minimum wage, however not much less than the commonplace salary and degree of advantages paid by the organization for the identical or comparable paintings accomplished via individuals with out disabilities.

Additional Waiver Services

Intellectual and Developmental Disability (IDD)

Effective September 1, 2014, STAR+PLUS offerings can be improved to encompass some people who have Intellectual and Developmental Disabilities (IDD) and stay in an ICF-IID or who get hold of services through one of the following IDD waivers: CLASS, DBMD, HCS or TxHmL.  Individuals who receive offerings via this kind of five programs and are dual eligible will not be covered on this enlargement.  Children who are SSI eligible and no longer twin eligible may also select to sign up into STAR+PLUS at this time.  Individuals served in those Texas Stars applications which can be enrolled into STAR+PLUS will get their ACUTE CARE SERVICES ONLY through managed care and could hold to get their long-time period services and helps (LTSS) through the Department of Aging and Disability Services (Texas Stars DADS).

The controlled care agencies (MCOs) will provide service coordination sports for those individuals (members), however the MCO could have responsibility best for acute care services. 

Every United Healthcare Community Plan member could be assigned a Service Coordinator who will work with households and the DADS waiver workforce to arrange and coordinate acute care offerings for the IDD populace for STAR+PLUS contributors handiest.

Acute blessings encompass but are not constrained to: all inpatient and outpatient medical and behavioral fitness services, therapies, long lasting clinical device and components, early early life intervention, family planning services, home health care services and prescription medications.

STAR+PLUS HCBS Waiver Services Provided Through CBA in Traditional Medicaid

The list of services consists of:Adaptive aids and scientific suppliesAdult foster careAssisted residingDentalEmergency response Texas Stars servicesFinancial management servicesHome delivered foodMinor domestic modificationsNursingOccupational therapyPersonal assistance offeringsPhysical therapyPrescription capsules, except the man or woman is eligible for both Medicare and MedicaidRespiteSpeech, listening to and language therapySupport consultationTransition help services

FAQs for Acute Care Benefits for HCBS Waiver Members

Nursing Facility Information

Will my STAR+PLUS benefits trade if I am in a Nursing Facility?

Starting March 1, 2015, human beings who’ve Medicaid and are eligible for STAR+PLUS and live in a nursing facility gets their primary health offerings (acute care) and lengthy-time period care offerings through STAR+PLUS. People who get both Medicaid and Medicare (dual eligible) gets their Texas Stars fundamental fitness offerings via Medicare and their lengthy-term care services via STAR+PLUS Medicaid.

How will folks that stay in a nursing facility and their families discover approximately this alteration and approximately which facilities are within the STAR+PLUS network?

HHSC will attain out to nursing facility citizens and their legally legal representatives using loads of gear including direct letters. HHSC will also offer nursing centers with records about the upcoming modifications.

What is the role of the UnitedHealthcare Community Plan Nursing Facility Service Coordinator?

Service Coordinators represent the health plan on the nursing facility. They are liable for service coordination and care management for STAR+PLUS program members. All STAR+PLUS members residing in a nursing facility may have the same fitness plan provider coordinator. The health plan carrier coordinator will meet in character with the STAR+PLUS member four instances a year.

Health Plan Nursing Facility Service Coordinators are responsible for**:Working with the member, own family, nursing facility care coordinator and body of workers, and others to make a provider plan. A provider plan includes offerings given thru the nursing facility, upload-on services, acute scientific services, behavioral health offerings, and primary or uniqueness care.Participating in nursing facility care planning conferences with the aid of phone or in man or woman, with the member’s permission.Reviewing the member’s carrier plan which include the nursing facility plan of care, as a minimum once a yr or when there’s a alternate in fitness.Visiting individuals dwelling in nursing facilities in person at least 4 instances a yr.Helping to acquire carried out income whilst a nursing facility has not been a hit.Meeting necessities of the Texas Promoting Independence Initiative (PII). The quarterly in-person visits can include exams required under the PII. The provider coordinator can serve as the contact person for a member who moves returned to the community under PII.Working with discharge making plans team of workers to devise discharge and transition from the nursing facility.

** Please notice: The following populations are excluded:Children and teenagers below age 21.Truman W. Smith Children’s Care Center Residents.State Veteran’s home residents.


Mental Health Targeted Case Management and Psychosocial Rehabilitation

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