Medicaid Managed Care Eligibility

The type of Medicaid coverage a person receives depends on where the person lives and what kind of health issues the person has.

• STAR is Medicaid for children, newborns, pregnant women and some families and children. People in STAR get their services through health plans, also called managed care plans.
• STAR+PLUS is a Medicaid program for people who have disabilities or are 65 or older. People in STAR+PLUS get Medicaid basic medical services and long-term services through a health plan, also called a managed care plan.
• STAR Health is a statewide, comprehensive healthcare system that was designed to better coordinate and improve access to health care for:
  • Children in Department of Family and Protective Services (DFPS) conservatorship (under 18).
  • Young adults in CPS extended foster care (18 through 20)
  • Young adults who were previously under DFPS conservatorship and have returned to foster care through voluntary foster care agreements (18 through 20.)
  • Young adults eligible for Medicaid for Former Foster Care Children (FFCC) will continue coverage through the STAR Medicaid Managed Care plan of their choice from age 21 through the month of their 26th birthday.

Pharmacies providers should contact the client's specific MCO for its provider manual and policy materials.