People in STAR+PLUS get Medicaid basic medical services and long-term care services through a health plan, also called a managed care plan. For example, if you live in Texas, the federal government requires that inpatient and outpatient hospital services must be covered, among many other mandatory benefits. Medicaid is a program for low-income persons whose income and/or resources are below certain levels. STAR+PLUS — STAR+PLUS is a Medicaid program for people who have disabilities or are age 65 or older. This website and its contents are for informational purposes only. Eligibility was primarily for individuals falling into particular categories, such as low-income children, pregnant women, the elderly, individuals with disabilities, and parents meeting specific income thresholds. Medicaid and the Children's Health Insurance Program (CHIP) provide health coverage for low-income children, families, seniors and people with disabilities. Young adults who are in the Former Foster Care in Higher Education program also get services through STAR Health. If you are a biller, provider, or partner: visit our Billers, providers, and partners webpage . In total, 12 million people are "dually eligible" and enrolled in both Medicaid and Medicare, composing more than 15% of all Medicaid enrollees. The program is funded jointly by states and the federal government. Medicaid also covers long-term care costs, both in a nursing home and at-home care. The CMHW HCBS program provides services to youth, ages 6-17, who have a diagnosis of a serious emotional disturbance (SED). However, many adults still receive benefits under the Interim coverage. An official website of the United States government. Find someone to talk to. Because Medicaid is administered through the state and states determine eligibility, you will need to visit your state's Medicaid office or website to apply. All rights reserved. Generally, household composition and pregnancy status do not require formal verification. Your year begins on April 1st and ends March 31st each year. Some states choose to offer optional benefits but at a limited cost to the customer, so Medicaid recipients may be expected to pay a co-payment or pay a portion of the total cost. Our mission is simple: help people quickly and easily understand which programs they might be eligible for—all in one place. It is administered by state governments, and each one has broad leeway in determining how Medicaid is implemented. Return to search results. The state currently contracts with ten plans to manage care for beneficiaries, including three national, for profit plans (Aetna Better Health, UnitedHealthcare Community Plan, and Coventry Cares Health Plan), and three national, not-for- profit plans (AmeriHealth Caritas Pennsylvania, AmeriHealth Northeast, and Keystone First). The state also contracts with five Behavioral Health Organizations (Magellan Behavioral Health; Community Care Behavioral Health Organization; Community Behavioral Health; PerformCare; and Value Behavioral Health of Pennsylvania) to manage the behavioral health component of HealthChoices. What coverage do pregnant women get under Medicaid? This means that Medicaid helps people with low incomes cover their health care costs. Center for Disease Control’s response to COVID-19. We may earn money when you click on our links. Clinic Visits (Hospital-Based and Free Standing Article 28 Health Department-certified facilities) - $3.00; Laboratory Tests performed by an independent clinical laboratory or any hospital-based/free standing clinic laboratory - $0.50 per procedure; Medical Supplies including syringes, bandages, gloves, sterile irrigation solutions, incontinence pads, ostomy bags, heating pads, hearing aid batteries, nutritional supplements, etc. And, if you live in New York, you will be covered for all required federal benefits. The New York State Medicaid State Plan is administered by the NY Department of Health. Under STAR Kids, you will get basic medical and long-term care services and supports through the health plan's provider network. And low-income families this what does medicaid cover is limited to $ 200 in a co-pay year, item or service ’. S. Related resources Medicaid benefits that states much offer qualified participants covers … Medicaid administered! 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