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MCO’s have received communication from HHSC that as of January 2023 some types of assessments will require a face-to-face visit. This means a United Healthcare staff member will need to visit with you in your place of residency.
Please be advised that missing your assessment could impact your services or eligibility. If you have questions, please contact your Service Coordinator or Member Services.
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.
This plan is available in the following counties:
Anderson, Angelina, Aransas, Austin, Bastrop, Bee, Bell, Blanco, Bosque, Bowie, Brazoria, Brazos, Brooks, Burleson, Burnet, Caldwell, Calhoun, Camp, Cass, Chambers, Cherokee, Colorado, Comanche, Cooke, Coryell, DeWitt, Delta, Erath, Falls, Fannin, Fayette, Fort Bend, Franklin, Freestone, Galveston, Gillespie, Goliad, Gonzales, Grayson, Gregg, Grimes, Hamilton, Hardin, Harris, Harrison, Hays, Henderson, Hill, Hopkins, Houston, Jackson, Jasper, Jefferson, Jim Wells, Karnes, Kenedy, Kleberg, Lamar, Lampasas, Lee, Leon, Liberty, Limestone, Live Oak, Llano, Madison, Marion, Matagorda, McLennan, Milam, Mills, Montague, Montgomery, Morris, Nacogdoches, Newton, Nueces, Orange, Panola, Polk, Rains, Red River, Refugio, Robertson, Rusk, Sabine, San Augustine, San Jacinto, San Patricio, San Saba, Shelby, Smith, Somervell, Titus, Travis, Trinity, Tyler, Upshur, Van Zandt, Victoria, Walker, Waller, Washington, Wharton, Williamson, and Wood.
The STAR+PLUS program serves SSI (Supplemental Security Income) and SSI-related clients. SSI and SSI-related adults are required to participate in the program, while SSI and SSI-related children may choose to participate. These people usually need care and services to help with day-to-day activities.
Texas members who have questions about Coronavirus (COVID-19), can visit the Texas Health & Human Services at https://www.dshs.texas.gov/coronavirus/
Medicaid benefits are extended until further notice, and Texas HHS will continue to provide updates to the public during the coming months. Texans in need can apply for benefits, including SNAP and Medicaid, at YourTexasBenefits.com or use the Your Texas Benefits mobile app to manage their benefits. Read the news release in English or English or Español.
Find providers and coverage for this plan.
Search for doctors, hospitals and specialists.
Find medications covered by this plan.
Find a pharmacy near you.
Benefits & Features
Choice of Doctor
You get a primary care physician (PCP) who is your main doctor. Use the Doctor Lookup tool to see if your doctor is in our network.
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.
Your PCP is your main doctor for:
- Preventive care.
- Treatment if you are sick or injured.
- Referrals to specialists for certain conditions.
This plan pays for all expenses related to a medically necessary hospital stay.
After you leave the hospital, you are not alone. We make sure you get follow-up care to continue healing at home.
Sometimes the basics are hard to do yourself after an illness or injury. If needed, we provide someone to help with:
Your doctor and you need to understand each other. Not speaking English well makes this difficult. 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.
You can ask to receive information in another language. Then anything we write to you will only be in that language. This is provided at no cost to you.
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.
Sometimes you might need a little help understanding your health care options. With us, you have someone you can call 24/7. We’ll answer your questions simply and completely.
Mental health is as important as physical health. That's why we have the same coverage for both.
Required care is 100% covered with no copay. This includes:
- Behavioral therapy.
- Substance use treatment.
You pay nothing for covered services.
While your health care is low-cost or free, the care quality is high. You get:
- Care from highly skilled and compassionate doctors.
- Treatments at respected hospitals and clinics.
- Prescription drugs coverage.
Medical questions and situations come at inconvenient times. 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:
- Listen to the symptoms.
- Guide you on self-care.
- Advise you about getting care at a doctor visit or an urgent care center.
- Suggest you go right to the emergency department.
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.
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.
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.
Toll Free Numbers
Information and Interpreters are available in many languages from 8 a.m. to 8 p.m. Monday through Friday. After hours, please contact Nurse Hotline. Se habla Español.
TDD/TTY (for hearing impaired).........711
Service Coordination.........1-800-349-0550 (8 a.m. to 8 p.m., Monday through Friday)
Nurse Hotline (available 24 hours a day, 7 days a week).........1-877-839-5407
For Dental Services, Call Your Medicaid Dental Plan
For Eye Care Appointments, Call Member Services.........1-888-887-9003
Mental Health and Substance Abuse Services...........1-888-887-9003
Optum Behavioral Health; available 24 hours a day, 7 days a week. Information and Interpreters are available in many languages. For a crisis and you have trouble with the phone line, call 911 or go to the nearest emergency room.
Non-Emergent Transportation Service, Call LogistiCare.........1-866-528-0441
What to Do in an Emergency
Call 911 or go to the nearest hospital/emergency facility if you think you need emergency care. You can call 911 for help in getting to the hospital emergency room. If you receive emergency services, call your doctor to schedule a follow up visit as soon as possible. Please call us and let us know of the emergency care you received. An emergency is a condition in which you think you have a serious medical condition, or not getting medical care right away will be a threat to your life, limb or sight.
What to Do in a Behavioral Health Emergency
You should call 911 if you are having a life-threatening behavioral health emergency. You can also go to a crisis center or the nearest emergency room.
Optum Behavioral Health
- Available 24 hours, 7 days a week.
- Interpreter services avavilable.
- Se Habla Español.
External Medical Review
Fill out the ‘State Fair Hearing and External Medical Review Request Form’ that came with the Member Notice of MCO Internal Appeal Decision letter and mail or fax it to
UnitedHealthcare Community Plan
Attn: Fair Hearings Coordinator
14141 Southwest Freeway, Suite 500
Sugar Land, TX 77478
- Call UnitedHealthcare at 1-800-288-2160
- Email UnitedHealthcare at firstname.lastname@example.org
State Fair Hearing Contact Information
To ask for a State Fair Hearing, you or your representative should call UnitedHealthcare Community Plan at 1-888-887-9003 or send a letter to the health plan at:
UnitedHealthcare Community Plan Attn: Sate Fair Hearings Coordinator 14141 Southwest Freeway, Suite 800 Sugar Land, TX 77478
Disaster Prep Pharmacy Guide
Transition of Care Education
National Flu Campaign Questions & Answers
Form 1718 Electronic Visit Verification Rights and Responsibilities
How to Submit a Complaint
File a Complaint, Report Suspected Fraud, Waste or Abuse
If you get benefits through Medicaid’s STAR, STAR+PLUS, STAR Kids or STAR Health program, call your medical or dental plan first. If you don’t get the help you need there, you should do one of the following:
a. Call Medicaid Managed Care Helpline at 1-866-566-8989 (toll free)
b. Online: Send your complaint in an email to HPM_Complaints@hhsc.state.tx.us
c. Mail: Texas Health and Human Services Commission
Office of the Ombudsman, MC H-700
P.O. Box 13247
Austin, TX 78711-3247
d. Fax: 1-888-780-8099 (Toll-Free)
To report suspected fraud, waste, or abuse by a member and/or provider: https://oig.hhsc.texas.gov/
How to Submit a Complaint
STAR+PLUS Member Handbook
STAR+PLUS Nursing Facility Member Handbook
- With respect to a member who is hospitalized at the time of the request UHC will issue a coverage determination within 1 business day. For members who are not hospitalized at the time of a routine prior authorization request, within 3 business days or up to 72 hours for expedited authorization requests.
- UHC will send a request for additional information if a decision cannot be made based on the information submitted within the initial request. The request will include a list of documents that are needed. For members under the age of 21, UMCM 3.22 is followed and the authorization decision can be pended for up to 7 days from the request date before a coverage determination will be issued to allow additional time for the necessary information to be submitted.
- Our current prior authorization lists are broken out by when they went into effect and are located here.
- UHC’s telephone, fax and provider portal link are listed at the top of each of our Prior Authorization documents so we can be easily contacted with any questions.
- Eligibility and benefits information on UHC’s website can be found here.
- Medicaid MCOs are responsible for providing all services and benefits available to clients of the Medicaid Fee-for-Service (FFS) Program to the MCO’s Medicaid Members, in the same amount, duration, and scope as is available through FFS as reflected in the state plan under Title XIX of the Social Security Act Medical Assistance Program and detailed in the Texas Medicaid Provider Procedures Manual (TMPPM).
Member Newsletters 2016 - Current
Member Newsletters Prior to 2016
Toll-Free Phone Numbers for Texas Health Care Information
For policy and benefit information.
TMHP Medicaid Hotline
Texas Medicaid & Healthcare Partnership
For information about the Medically Needy Program or Medicaid billing questions.
Texas Health Steps (THSteps) and Case Management for Children and Pregnant Women
For information about the Texas Health Steps Program and case management for children under 21 years of age.
1-877-847-8377 (TDD 1-800-735-2989)
Texas Health and Human Services Commission Ombudsman Office
For information about qualifying for Medicaid, ID forms, and address changes, programs for elders and persons with disabilities offered, or to locate the local Texas Health and Human Services Commission office nearest you.
1-877-787-8999 (TDD 1-888-425-6889)
Member Advisory Committee Meetings
Member Advisory Council Flyer
National Prescription Drug Take Back Day
The Drug Enforcement Administration’s National Prescription Drug Take Back Day is Saturday, October 27. This a safe, convenient, and responsible way to dispose of unused or expired prescription drugs. A list of drug collection sites is available here.
Download the DEA National Take Back Brochure.
Time to See Your Doctor?
It’s important to get medical care when you need it. Call your doctor’s office to make an appointment. Tell them the reason for the visit. This will help them make the appointment within the right time frame.
Download our Access to Care document.
Learn more about Housing Support.
Housing Resource List by County.
Annual Care Checklist
Annual Care Checklist for kids
Annual Care Checklist for Women
Annual Care Checklist for Men
See what UnitedHealthcare has to offer.
It’s your health. It’s your choice.
Everyone deserves affordable health care, including you.
Seniors and people with disabilities, who qualify for Medicaid’s STAR+PLUS Program, should check out UnitedHealthcare Community Plan of Texas
We have the Medicaid benefits and extras that can make a real difference in your life. All at no cost to you.
- 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.
Sometimes, you might need a little extra help. Get extras not covered by 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.
We also offer resources to help you make the most of your plan. Including:
- Member Advocates
- Service Coordinators
- Health Education Tools
- Care Management
Visit yourtexasbenefits.com for more information.
Helping you live a healthier life. We are here for you, 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.
This link is being made available so that you may obtain information from a third-party website. This link is provided solely as a convenience and is not an endorsement of the content of the third-party website or any products or services offered on that website. We are not responsible for the products or services offered or the content on any linked website or any link contained in a linked website. We do not make any representations regarding the quality of products or services offered, or the content or accuracy of the materials on such websites.