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STAR Medicaid

What is Medicaid?

It is the State of Texas Access Reform (STAR) Managed Care Program (Medicaid). Community provides both Children’s Medicaid and Medicaid for Pregnant Women. These programs are at no cost to U.S. residents who cannot afford health insurance.

How does Medicaid work?

Members choose an HMO and a Primary Care Provider to give them all their primary care services. This includes coordinating referrals for all medically necessary specialty services.

Children’s Medicaid

Income determines eligibility. That income level is different based on age and Medicaid program. Children’s Medicaid covers a child up through the month of his or her 21st birthday.

Medicaid for Pregnant Women

Medicaid for Pregnant Women covers a childbearing woman of any age. Members must be at 185% or lower of the Federal Poverty Level (FPL). Members must recertify every year.

What Services Does Medicaid Cover?

Medicaid Members get medical care that includes:

  • Hospital care
  • Surgery
  • X-rays
  • Physical/speech/occupational therapies
  • Prescription drugs
  • Emergency services
  • Transplants
  • Regular health checkups and immunizations

Help Me Apply

Keep Your STAR Benefits!

Families must renew their CHIP or Children’s Medicaid coverage every year. In the months before a child’s coverage is due to end, HHSC will send the family a renewal packet in the mail. The renewal packet contains an application. It also includes a letter asking for an update on the family’s income and cost deductions. The family needs to:

• Look over the information on the renewal application.
• Fix any information that is not correct.
• Sign and date the application.
• Look at the health plan options, if Medicaid health plans are available.
• Return the renewal application and documents of proof by the due date.

Once HHSC receives the renewal application and documents of proof, staff checks to see if the children in the family still qualify for their current program or if they qualify for a different program. If a child is referred to another program (Medicaid or CHIP), HHSC sends the family a letter telling them about the referral and then looks to see if the child can get benefits in the other program. If the child qualifies, the coverage in the new program (Medicaid or CHIP) begins the month following the last month of the other program’s coverage. During renewal, the family can pick new medical and dental plans by calling the CHIP/Children’s Medicaid call center at 1.800.964.2777.

Community Members enjoy...

  • More than 10,000 Providers and hospitals from which to choose,
  • Memberships to Neighborhood Centers, Inc. (NCI) and Boys and Girls Club,
  • Youth sports league allowance up to $40,
  • No cost, fun Member events such as Family Fun Night, Rockets and Astros games, and other neighborhood events at Moody Gardens, The Children's Museum, Sports Connection, and
  • Much more!