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Pangunahing Nilalaman

STAR+PLUS

Medicaid

Not all Texas STAR+PLUS plans are alike. UnitedHealthcare Community Plan provides standard benefits under the STAR+PLUS program for adults who need extra support and care, including services to help with daily activities. We also offer additional services called Value Added Services (VAS). You qualify based on income and health needs. View the list below to see what STAR+PLUS includes.

Need help finding a provider or setting up a visit?

Tumawag sa Mga Serbisyo sa Miyembro sa 1-888-887-9003, TTY 7-1-1, Lunes-Biyernes 8 AM-8 PM o mag-email sa memberservices_uhccp@uhc.com para makakuha ng tulong sa paghahanap ng tagapagbigay ng serbisyo o makapagtakda ng pagbisita.

Mga Benepisyo at Feature

Pangangalaga Habang Walang Sakit at Kapag May Sakit

Get the assistance you need to be at your best — or to get better if you are injured or sick. Kasama rito:

  • Service Coordinator. Specially trained professional to help you receive the services you need based on a person centered plan.
  • Well Visits. Annual checkups can help keep you healthy or reach your potential.
  • Medicines. Fill your prescriptions at local pharmacies.
  • Lab and X-rays. Lab tests, x-rays and diagnostic imaging are covered.
  • Hospital Care. You pay nothing for care in a hospital.

If you have asthma, diabetes or other long-term conditions, you can depend on us. Our STAR+PLUS plan makes sure you get the care, support and services you need. Kabilang sa mga benepisyo ang:

  • Service Coordination. Support from an experienced professional.
  • Disease Management. Individual care to help you manage chronic medical conditions such as diabetes, asthma, COPD, Kidney Failure and Heart Failure.
  • Mental Health Support. Counseling and other treatments are available.

Help protect your sight, hearing and smile with these benefits:

  • Vision. Includes exams and $105 toward frames or contact lenses as a value added service.
  • Hearing. Tests, checkups and hearing services are provided.
  • Dental. Checkups are covered as part of a value added service, and emergency care is covered.

Get the medical equipment, assistance and supplies you need to live safely at home. Kabilang sa mga benepisyo ang:

  • Personal Care. Someone to help with personal care tasks for individuals that qualify based on your primary care physician determination of a functional need and an assessment process.
  • Day Activity Health Services. Supervised care in a group setting with nursing support during the day.
  • Equipment and Supplies. In-home medical and safety equipment are covered as medically necessary.

Kung minsan, maaaring kailanganin mo ng kaunting karagdagang tulong sa paggamit ng iyong planong pangkalusugan. Para sa mga pagkakataong iyon, maaari kang umasa sa:

  • Transportation. Rides to and from medical visits or the pharmacy.
  • Nurse HotlineSMCall our nurses for advice 24/7.
  • Interpreters. As needed for medical appointment or assessments.
  • Member Services. Your benefit questions are answered 24/7.

Read about all the extras you could get when you become a STAR+PLUS member:

  • Vision. Includes exams and $105 toward frames or contact lenses.
  • Adult Dental Services. Includes $500 towards routine exams, cleanings, and x-rays.
  • Diabetic Management. Shoe insoles for members with diabetes.
  • Online Mental Health Resources. Access articles, videos, and other resources at LiveandWorkWell.com
  • Exercise Kit. Includes one pedometer, one pack of resistance bands, and one water bottle for members who want to become more active. 
  • Learn more about Value-added Services Ingles | Español
  • Read all about the extras you could get when you become a STAR+PLUS Nursing Facility Member Ingles | Español

If you're elderly, disabled or living with an illness, your health needs are unique. Our job is to make it as easy as possible for you to meet those needs. The STAR+PLUS HCBS Waiver program provides an array of services and supports for individuals meet the state criteria and have medical necessity for Nursing Facility Level of Care to assist them to live safely in the setting of their choice. Some of the benefits provided in this program include (not an all inclusive list):

  • Specialized Nursing
  • Mga pagkaing inihahatid sa bahay
  • Kaginhawahan
  • Mga serbisyong dental:
  • Adaptive aids
  • Maliliit na pagbabago sa bahay

Pagpili ng Doktor

Magkakaroon ka ng doktor ng pangunahing pangangalaga (primary care physician, PCP) na iyong pangunahing doktor. Gamitin ang tool na Maghanap ng Doktor para makita kung nasa aming network ang iyong doktor.

If you don't have a doctor or if your doctor is not in our network, we can help you find a new one close to you. 

Ang iyong PCP ay ang iyong pangunahing doktor para sa:

  • Preventive care.
  • Paggagamot kung mayroon kang sakit o injury.
  • Mga referral sa mga espesyalista para sa ilang partikular na kondisyon.

Pagkakaospital

This plan pays for all expenses related to a medically necessary hospital stay.

After you leave the hospital, you are not alone. Titiyakin naming makakakuha ka ng follow-up na pangangalaga para maipagpatuloy ang pagpapagaling sa tahanan.

Pangangalagang Pantahanan

Minsan mahirap gawin nang mag-isa ang mga pangunahing kaalaman pagkatapos magkaroon ng sakit o injury. Kung kinakailangan, magpapadala kami ng tao para tumulong sa:

  • Pagbibihis.
  • Pagligo.
  • Pagpapakain.

Mga interpreter

Kailangan magkaunawaan kayo ng iyong doktor. Magiging mahirap ito kung hindi ka magaling magsalita ng Ingles. We can arrange for an interpreter for your appointment.

We have people at our phone centers that speak more than one language. A service lets us connects with others that speak hundreds of languages.

Tulong sa Wika

You can ask to receive information in another language. Then anything we write to you will only be in that language. Ibinibigay ito sa iyo nang walang bayad.

Mga Gamot

We make getting your medicine easy.

There are no copays for covered drugs. You can fill your prescriptions at:

  • Local pharmacies.
  • Services that deliver routinely right to your door.
  • Mail order services.

Mga Serbisyo para sa Miyembro

Minsan kailangan mo ng tulong para maunawaan ang iyong mga opsyon sa pangangalagang pangkalusugan. With us, you have someone you can call 24/7. We’ll answer your questions simply and completely.

Mental Health

Ang mental health ay kasinghalaga ng physical health. Kaya mayroon kaming parehong saklaw para sa dalawang ito.

Ang kinakailangang pangangalaga ay 100% sinasaklaw nang walang copay. Kasama rito ang:

  • Behavioral therapy.
  • Substance use treatment.
  • Mga gamot.

No Copays

Wala kang babayaran para sa mga sinasaklaw na serbisyo.

While your health care is low-cost or free, the care quality is high. Magkakaroon ka ng: 

  • Care from highly skilled and compassionate doctors.
  • Treatments at respected hospitals and clinics.
  • Prescription drugs coverage.

Hotline ng Nars

Dumarating ang mga medikal na tanong at sitwasyon sa mga hindi magandang pagkakataon. When you have questions about your health or your child's health, you can call a trained nurse 24 hours a day, 7 days a week.

Our Nurse Hotline nurses will: 

  • Tutukuyin ang mga sintomas.
  • Gagabayan ka sa pangangalaga sa sarili.
  • Papayuhan ka tungkol sa pagkuha ng pangangalaga sa pagpapatingin sa isang doktor o sa isang center ng agarang pangangalaga.
  • Suggest you go right to the emergency department.

Paghinto sa Paninigarilyo

You know the bad health effects of smoking. You know you need to quit. We will support you while you quit with coaches and supplies. The only thing you won't get from us is a lecture.

Service Coordination - Cornerstone of the STAR+PLUS program

  • Explain medical terms in plain language.
  • Coordinate your doctor appointments and other services or treatments you may need.
  • Connect you with community resources.

Your case manager will stay with you on your medical journey. He or she will:

  • Think beyond just your medical needs.
  • Make sure you have support at home as needed.

Transportasyon

Whether you live in the city or in the country, rides are available. Our plan provides round trips to and from plan locations. This includes trips to and from the pharmacy to fill your prescriptions.

Pangangalaga sa Paningin

You'll get the care, eyeglasses and treatment that let you see life more clearly. Coverage includes $105 each year toward frames or contact lenses.

This benefit is offered by certain stores and retailers.

Mga Resource ng Miyembro

Mga Mapagkukunan ng Miyembro (magbubukas ng modal na window)

Impormasyon sa Enrollment

The Texas STAR+PLUS plan specialists can answer questions and help you enroll.

Tawagan kami:
1-888-887-9003 / TTY: 711

8:00 AM hanggang 8:00 PM lokal na oras, Lunes – Biyernes

Mga Hakbang para Mag-enroll
Kunin ang mga detalye

Visit the Texas CHIP & Medicaid site for more information on eligibility and enrollment.

Texas STAR+PLUS.

For information in alternate formats, like large print, Braille or audio, please call Member Services. Contract information can be found on STAR PLUS Contract Operational (texas.gov)

Impormasyon ng Miyembro

Mayroon kang access sa aming website na para lang sa miyembro. Mag-print ng mga ID card at higit pa. Tingnan ang aming handbook sa ibaba.

Member information is available in paper form, at no cost, upon request, and sent by the health plan within five business days.

Website ng miyembro

Tingnan kung ano ang maiaalok ng UnitedHealthcare.

Kalusugan mo ito. Na iyo ang desisyon.

Karapat-dapat ang lahat sa abot-kayang pangangalagang pangkalusugan, kasama ka.

Seniors and people with disabilities, who qualify for Medicaid’s STAR+PLUS Program, should check out UnitedHealthcare Community Plan of Texas

Mayroon kaming mga benepisyo ng Medicaid at mga extra na maaaring makagawa ng tunay na kaibahan sa iyong buhay. Lahat nang wala kang gastos.

  • Find a Primary Care Physician you trust in our network to be your main doctor.
  • Vision coverage.
  • Transportation to and from doctor appointments.
  • 24/7 Nurse Hotline to answer your health questions.

Kung minsan, maaaring kailanganin mo ng kaunting karagdagang tulong. Kumuha ng mga extra na hindi saklaw ng Medicaid.

  • Receive one fire and waterproof bag per fiscal year to safely store important documents, medications and personal items when experiencing a natural disaster.
  • Receive an exercise kit to help you adopt an active lifestyle or to lose weight.
  • Online mental health services.
  • Help getting a ride when traditional Medicaid transportation is not available.

Nag-aalok din kami ng mga mapagkukunan upang matulungan kang masulit ang iyong plano. Kabilang ang:

  • Mga Advocate na Miyembro
  • Service Coordinators
  • Mga tool sa edukasyong pangkalusugan
  • Pamamahala sa pangangalaga

Visit yourtexasbenefits.com for more information.

Tinutulungan kang mabuhay nang mas malusog. Narito kami para sa iyo, Texas

Remember to choose UnitedHealthcare Community Plan. And get the Plan that gives you more.

To learn more about UnitedHealthcare Community Plan, visit UHCCommunityPlan dot com forward slash TX. 

At UnitedHealthcare we want to make sure you can access all the benefits your plan provides.

If you’ve had a change in your health status and your doctor determines you need a wheelchair, your plan is here for you.

To make sure you get the equipment you need with the coverage you have, follow these simple steps.

You may need a wheelchair evaluation referral from a healthcare provider in your plan’s network for wheelchairs with special features.

Next a Durable Medical Equipment or DME vendor in your health plan network is located.

In many cases, your healthcare provider can help locate an in-network provider and send the referral.

If the health care provider does not complete this step we can help you find an in-network provider and schedule an appointment.

It is important to understand what your insurance does and does not cover, so that you don’t have unexpected expenses.

And we can help you with that.

Once the referral has been sent to the identified provider the evaluation will be performed by a physical therapist, an occupational therapist or a physiatrist who specializes in determining proper seating and positioning.

This evaluation may take place in your home or in the DME provider’s office.

If the assessment takes place at the provider office, be sure to bring your wheelchair with you if you have one.

During the visit you may be asked to provide additional information including your health status and risk factors, transportation needs, and information on your home environment (if the assessment does not take place in your home).

Wheelchairs may take anywhere from 60 to 90 calendar days to be delivered.

Factors such as supply chain issues and availability of parts may cause additional delay.

Your DME provider can assist you with a loaner chair during the waiting period if needed.

When your new wheelchair is delivered be sure to sit in it to ensure proper fit and adjustments.

And even if you have experience with wheelchairs do take the time for the vendor to provide instructions on the use of the chair and its features, care and maintenance.

If any equipment you are requesting is not a covered benefit you may be asked to pay out of pocket for the equipment.

The vendor should provide you with a clear explanation of why it is not part of your benefits.

Generally, a wheelchair should last at least five years, although growing children may need a new chair more often.

If you already use a wheelchair and it’s damaged and unable to be repaired you may also be eligible for a new wheelchair.

Over time your insurance and DME providers may change.

So, be sure and keep all the information about the chair, the DME provider, the coverage and any documentation on any repairs or changes made.

Remember, if you have any questions or need more information visit myuhc.com/CommunityPlan or call member services at the number on the back of your member ID card.

 

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