Critical Medicaid Health Plan Changes Impacting Seniors and Adults with Disabilities in 2024
Changes are coming to Medicaid health plans that will significantly impact the lives of 53,000 seniors and adults with disabilities in and around San Antonio. These individuals, who are currently enrolled in Medicaid’s STAR+PLUS plan, will need to select a new plan provider by July 10, 2024, due to a shift in plan providers. This transition is crucial for ensuring continuity of care and maintaining access to necessary medical and support services.
Understanding STAR+PLUS
STAR+PLUS is a Medicaid-managed care program designed to provide health care and long-term care services to adults with disabilities or those aged 65 and older. This program includes services such as respite care, transportation, home-delivered meals, and other vital supports that help individuals live more independently.
Why Change Is Necessary
Several large health plans that currently offer STAR+PLUS will no longer provide coverage starting September 1, 2024. *”Eligibility restrictions may apply.” As a result, affected individuals must select a new health plan provider. If a new provider is not chosen by the deadline, the government will automatically select one for them, potentially disrupting their care.
Importance of Choosing the Right Plan
“It’s hard when change happens, especially for families with older adults and adults with disabilities,” said Melanie R. Cawthon, Co-founder and CEO of disABILITYsa. “In light of the significant changes in STAR+PLUS health plan providers this year, it’s critical for these populations to actively choose the provider that aligns best with their unique needs rather than having the government make that decision for them. This decision impacts not only their healthcare but can also affect their financial well-being, access to transportation, and overall quality of life.”
Theresa Rodriguez Scepanski, President & CEO of Community First Health Plans, emphasized the importance of selecting a plan that fits individual needs. “Health plans offer different value-added services such as respite care, vision, dental, transportation, home-delivered meals, and even gift card rewards,” she said. “This is why choosing the plan that fits your individual needs is critical. It puts the power back into your hands.”
Community First Health Plans: A Local Resource
Community First Health Plans, as the only local, non-profit health plan option, aims to support this transition by providing education and service. “At Community First, we want to close gaps in health care for seniors and disabled adults, helping them meet their health goals and maintain independence,” added Scepanski. “The addition of STAR+PLUS is going to allow us to provide this continuity of care.”
Community First offers various value-added services to its STAR+PLUS members, effective September 1, 2024. These services include:
- In-home respite care
- Gift card rewards
- Diabetes Prevention and Weight Loss Programs with complimentary YMCA memberships
- Foot care and insulated cooler bags for Members with diabetes
- Enhanced vision services
- Low-cost dental services
- Home-delivered prepared meals after a hospital stay
- Zumba classes for members and their families
Steps to Take
To ensure uninterrupted care, individuals enrolled in STAR+PLUS should:
- Check their mail for information from Health and Human Services and respond promptly.
- Visit CommunityFirstSTARPLUS.com for updates or call 1-844-382-2347 for assistance in English or Spanish.
- Report any changes to phone numbers or addresses by calling 2-1-1 or online at YourTexasBenefits.com.
For those needing in-person assistance, support is available in English and Spanish at the Avenida Guadalupe Community Office located at 1410 Guadalupe Street, Suite 222, San Antonio, TX.
If you have questions, you can attend an enrollment event in your area. Search events by county at TXMedicaidEvents.com. Representatives from Maximus, the enrollment broker vendor for your area, will be in attendance and available to help and make plan and primary care provider selections. You can also contact Maximus by phone at 800-964-2777.
This transition may seem overwhelming, but with the right information and resources, seniors and adults with disabilities can navigate the changes effectively. disABILITYsa and Community First Health Plans are committed to ensuring that this vulnerable population continues to receive the care and support they need.
By actively engaging with these resources and making informed choices, residents can maintain their healthcare, financial well-being, and overall quality of life during this period of change.
