Health Insurance for Low-Income
Originally authorized in 1965, Medicaid provides health care programs to millions of American individuals, families, pregnant women, children, adults without children, those with disabilities, and seniors. In 2013, soon after the signing of the Affordable Care Act, Texas opted to expand their Medicaid programs. As of July 2016, there were over 4.7 million individuals enrolled in Medicaid and CHIP – up 6% since Obamacare was signed and Medicaid was expanded in October 2013.
Texas’ Medicaid and CHIP coverage is handled through managed care organizations that have been contracted by the United States Health and Human Services department. Each individual organization creates a network of clinicians that work together to provide care to their qualified members. With the introduction of Obamacare, the Affordable Care Act, Texas opted to expand their Medicaid programs in 2013. If you were denied Medicaid coverage in Texas previous to this expansion, you may now qualify.
Texas Medicaid Programs
STAR
STAR is the Texas Medicaid option for pregnant women, newborns, and children offered through managed care programs. Most plans have regional specifications, so once you obtain eligibility for STAR you can narrow down available plans based on the county in which you reside. This is the program that provides the majority of the coverage for Texans that qualify for Medicaid.
Texas health insurance plans that have been contracted by STAR Medicaid include:
- Aetna Better Health of Texas
- AmeriGroup RealSolutions
- BlueCross BlueShield of Texas
- CHRISTUS Health Plan
- Community First HealthPlans
- Community Health Choice
- Cook Children’s Health Plan
- Driscoll Children’s Health plan
- El Paso First Premier Plan
- FirstCare STAR
- Molina Healthcare of Texas
- Parkland HEALTHfirst
- Right Care from Scott and White Health Plans
- Sendero Health Plans
- Seton Health Plan
- Superior HealthPlan
- Texas Children’s Health Plan
- UnitedHealthcare Community Plan
STAR Kids
STAR Kids is a brand new Texas Medicaid program that will begin November 2016 to provide coverage for children and adults who are under 21 with disabilities. It will be a managed care program that will require a plan to be picked along with a primary care physician who will provide most of the medical services and if needed, referrals.
Texas health insurance plans that have been contracted by STAR Kids Medicaid include:
- Amerigroup
- Blue Cross and Blue Shield of Texas
- Children’s Medical Center
- Community First Health Plans
- Cook’s Children Health Plans
- Driscoll Health
- Superior Health Plan
- Texas Children’s Health Plan
- UnitedHealthcare
STAR+PLUS
STAR+PLUS offers coverage that provides longer-term healthcare services and support for Texas adults with disabilities or adults over 65 years old. There have been many expansions to this program in the last year for cognitive rehabilitation therapy, improved nursing facilities, intellectual disabilities, and an expansion of the geographic region in which it services the rural areas.
Texas health insurance plans that have been contracted by STAR+PLUS Medicaid:
- Amerigroup
- Cigna-HealthSpring
- Molina Healthcare of Texas
- Superior HealthPlan
- UnitedHealthcare Community Plan
STAR Health
STAR Health was designed for the kids that get their coverage through the Texas Department of Family and Protective Services. It was developed to allow better access and coordination of care for medical and behavioral health services. Those that are covered under STAR Health can get the services they need no matter where they are in the state. Texas’ STAR Health program also extends care to young adults that are participating in the Former Foster Care in Higher Education program.
CHIP
CHIP is a Texas program that supports children in families that cannot afford private health insurance, but whose household income is too high to qualify for Medicaid.
Texas health insurance plans that have been contracted by CHIP include:
- Aetna Better Health
- Amerigroup
- BlueCross BlueShield of Texas
- CHRISTUS Health Plan
- Community First Health Plans
- Community Health Choice
- Cook Children’s Health Plan
- Driscoll Children’s Health Plan
- El Paso First CHIP
- FirstCare CHIP
- Molina Healthcare of Texas
- Parkland KIDSfirst
- Sendero Health Plans
- Seton Health Plan
- Superior HealthPlan
- Texas Children’s Health Plan
- UnitedHealthcare Community Plan
Medicare-Medicaid Plans
Currently, there are six counties in Texas participating in a pilot Medicare-Medicaid program that offers dual coverage to individuals in order to combine long-term services with basic healthcare needs. The six counties are Bexar, Dallas, El Paso, Harris, Hidalgo, and Tarrant county.
Texas health insurance plans that have been contracted by Medicare-Medicaid include:
- Amerigroup Molina Superior
- Molina Superior
- Amerigroup Molina
- Amerigroup Molina UnitedHealthcare
- Cigna-HealthSpring Molina Superior
- Amerigroup
HIPP (Health Insurance Premium Payment) Program
Texas’ Health Insurance Premium Payment (HIPP) Program provides financial assistance to families that qualify for healthcare support despite having insurance through their employer. This program allows the family to begin to increase their long-term health support system while being able to take advantage of Medicaid’s coverage options. To qualify for this program, one person in the family must be qualified for or currently using Medicaid.
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