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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. To do that, we start with what our members have told us is most important.
For more information about the pharmacies, hosipitals, specialists and other providers in the UnitedHealthcare Community Plan network, you can call us at 1-888-887-9003, TDD: 711.
We know that health care can be confusing. That’s why our health plans are designed to make things simpler for you.
Employment Assistance and Supported Employment are benefits offered to the STAR+PLUS Waiver members only effective 9/1/2014.
Employment Assistance (EA) services provide assistance to the member to help locate competitive employment or self-employment. EA services include, but are not limited to, the following:
Supported Employment (SE) services provide assistance to the member in order to sustain paid employment, to a member who, because of a disability, requires intensive, ongoing support to be self-employed, work from home, or perform in a work setting at which members without disabilities are employed. SE includes employment adaptations, supervision, and training related to a member's diagnosis.
Competitive employment is work:
Additional Waiver Services
Intellectual and Developmental Disability (IDD)
Effective September 1, 2014, STAR+PLUS services will be expanded to include some individuals who have Intellectual and Developmental Disabilities (IDD) and live in an ICF-IID or who receive services through one of the following IDD waivers: CLASS, DBMD, HCS or TxHmL. Individuals who receive services through one of these five programs and are dual eligible will not be included in this expansion. Children who are SSI eligible and not dual eligible may elect to enroll into STAR+PLUS at this time. Individuals served in these programs that are enrolled into STAR+PLUS will get their ACUTE CARE SERVICES ONLY through managed care and will continue to get their long-term services and supports (LTSS) through the Department of Aging and Disability Services (DADS).
The managed care organizations (MCOs) will provide service coordination activities for these individuals (members), but the MCO will have responsibility only for acute care services.
Every United Healthcare Community Plan member will be assigned a Service Coordinator who will work with families and the DADS waiver staff to arrange and coordinate acute care services for the IDD population for STAR+PLUS members only.
Acute benefits include but are not limited to: all inpatient and outpatient medical and behavioral health services, therapies, durable medical equipment and supplies, early childhood 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 includes:
Nursing Facility Information
Will my STAR+PLUS benefits change if I am in a Nursing Facility?
Starting March 1, 2015, people who have Medicaid and are eligible for STAR+PLUS and live in a nursing facility will get their basic health services (acute care) and long-term care services through STAR+PLUS. People who get both Medicaid and Medicare (dual eligible) will get their basic health services through Medicare and their long-term care services through STAR+PLUS Medicaid.
How will people who live in a nursing facility and their families find out about this change and about which facilities are in the STAR+PLUS network?
HHSC will reach out to nursing facility residents and their legally authorized representatives using a variety of tools including direct letters. HHSC also will provide nursing facilities with information about the upcoming changes.
What is the role of the UnitedHealthcare Community Plan Nursing Facility Service Coordinator?
Service Coordinators represent the health plan at the nursing facility. They are responsible for service coordination and care management for STAR+PLUS program members. All STAR+PLUS members living in a nursing facility will have the same health plan service coordinator. The health plan service coordinator will meet in person with the STAR+PLUS member four times a year.
Health Plan Nursing Facility Service Coordinators are responsible for**:
ADDITIONAL BEHAVIORIAL HEALTH SERVICES
Mental Health Targeted Case Management and Psychosocial Rehabilitation
Mental Health Targeted Case Management and Psychosocial Rehabilitation are for Members with a severe and persistent mental illness (SPMI) or a severe emotional disturbance (SED). The following Mental Health Rehabilitative Services may be provided to individuals with an SPMI or a SED as defined in the DSM-IV-TR and who require rehabilitative services as determined by either the ANSA or the CANS:
Assessment, referral and education are provided. Services include:
Targeted Case Management
Mental Health Rehabilitative Services include
Mental Health Targeted Case Management
The following Mental Health Targeted Case Management services may be provided to individuals with an SPMI or a SED as defined in the DSM-IV-TR and who require the service as determined by either the ANSA or the CANS.
Employment related services that provide training and supports that are not job specific and have as their focus the development of skills to reduce or overcome the symptoms of mental illness that interfere with the individual’s ability to make vocational choices, attain or retain employment can be provided under Skills Training and Development. These services should not be confused with Employment Assistance or Supported Employment allowed under the HCBS STAR+PLUS Waiver.
It's easy to join us. Follow these three steps to sign up for STAR+PLUS:
1. Call Us at 1-800-964-2777.
2. Pick UnitedHealthcare Community Plan as your insurance plan.
3. Pick your doctor.
If you already have Medicaid STAR+PLUS, call 1-800-964-2777 and select UnitedHealthcare Community Plan as your insurance plan.
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