Superior Health Plan strives to remove barriers that prevent members from receiving quality healthcare, such as improving disability access data in its Find a Provider tool.
Superior is proud to announce that their Medicaid health plan, STAR+PLUS MMP, has earned a rating of 3.5 or above on a five-point scale from the National Committee for Quality Assurance’s (NCQA) Medicaid health insurance plan ratings for Texas for three consecutive years – making Superior the only Texas provider to do so!
STAR Health
If you are searching for an all-inclusive health insurance plan to cover hospitalization expenses, STAR Health could be an option. With benefits such as maternity coverage, non-medical fees, outpatient department costs, and bariatric surgery costs covered, as well as free medical tests and copayment coverage available, it is also essential to know its limitations before purchasing this policy.
STAR Health was India’s inaugural standalone health insurer when it was established in 2006. Offering personal accident, travel, corporate, and healthcare insurance products and convenient cashless claim settlement has quickly become an affordable insurance plan among many Indians. Furthermore, customers gain access to over 14,000 network hospitals nationwide, making STAR Health an appealing choice.
STAR Health’s Comprehensive Plan covers pre- and post-hospitalisation expenses beyond hospitalization charges. The former includes costs related to the condition you were admitted to; post-hospitalization includes expenses such as follow-up visits, physiotherapy sessions, and medication costs.
With its comprehensive coverage and cost-effective monthly premium payment option, this mediclaim plan is ideal for families seeking to protect themselves against health risks. Furthermore, its Buy-Back of Preexisting Diseases feature can reduce the pre-hospitalization waiting period from 36 months to 12 months by paying an additional premium.
STAR+PLUS
STAR+PLUS is a Medicaid-managed care program offering long-term home and community-based services for individuals in Dallas, Hidalgo, and El Paso Counties of Texas. The aim is to prevent institutional placement while helping individuals remain safely within the community. Individuals considering applying must meet specific eligibility requirements before being eligible.
Eligible individuals must demonstrate a need for nursing home-style care services, usually provided in nursing homes. The MCO will complete and sign off on a medical necessity and level of care assessment; additionally, the individual cannot manage their care needs in an outpatient community setting without significant assistance.
A vital component of the STAR+PLUS program is its self-directed option for home and community-based services, which enables participants to hire family members as caregivers at financial compensation – an ingenious and innovative way to support family caregivers, who often play an essential role in maintaining one’s health and well-being.
STAR+PLUS differs from traditional Medicare because it combines medical and long-term care benefits in one plan. It offers a member portal to view plan details, access tools, and more from your smartphone, tablet, or computer.
Ambetter
Ambetter Health Insurance Company of Texas provides HMO and EPO plans on the federal Health Insurance Marketplace. Their plans can be found in 138 Texas counties, offering benefits such as prescription drug coverage, maternity care, and hospitalization coverage; some plans even feature telehealth services to connect users directly to doctors via video chat; mail-order pharmacy service, mobile apps, and nurse advice lines are among its other offerings; in addition, each plan comes equipped with its own rewards program.
Ambetter provides several cost-effective healthcare plans, from Bronze to Silver and Gold, at competitive rates. Each program features different monthly premiums and out-of-pocket maximums; all meet Health Insurance Marketplace requirements. Silver and Gold plans may offer cost-sharing reductions that could lower their premiums.
Each plan offers its benefits, yet most provide primary coverage. The Bronze plan boasts lower monthly premiums and out-of-pocket costs; Silver and Gold plans offer higher monthly premiums but higher out-of-pocket limits; the Gold plan provides the ideal combination of dividends, out-of-pocket costs, telehealth visits, and telemedicine visits with no cost share required – making it an excellent option.
Ambetter Health Insurance of Georgia operates nationwide. Their parent company, Centene, provides quality healthcare solutions to millions of people across the U.S. Its products have also been certified as Qualified Health Plan issuers on the Health Insurance Marketplace.
Children’s Health Insurance Program (CHIP)
Children’s Health Insurance Program (CHIP) is a joint federal-state effort designed to offer coverage for children who do not meet eligibility for Medicaid but cannot afford private health insurance policies. Financing of this program comes from both levels of government, with at least 65 percent federal matching funds allocated towards CHIP funding; thanks to the Affordable Care Act 2010 and MACRA 2015 amendments, this figure increased to an average 82 percent national match rate.
States have considerable freedom in designing their CHIP programs within federal guidelines, allowing them to select an integrated or separate CHIP plan to cover all children living within their borders or offer different programs explicitly tailored for various groups of children. Furthermore, states may impose cost-sharing or premiums for some enrolled children within certain limits, though any increase would diminish enrollment and undercut the effectiveness of their program.
CHIP has significantly reduced the number of uninsured children since its implementation, cutting by more than half. Renewing CHIP ensures millions of low-income families will continue to access high-quality, affordable health care. Here, you will find resources that will assist in making your case for funding this critical public investment in children’s health; fact sheets, infographics, and tools to encourage enrolling their children or grandchildren into CHIP are available here.
Medicare
Medicare is a national health insurance program for people over 65 administered by the Centers for Medicare and Medicaid Services (CMS). Medicare offers traditional medical benefits and prescription drug coverage through various prescription plans, plus special enrollment periods (SEP) whereby beneficiaries covered by an EGHP through employment are often entitled to switch back into original Medicare without incurring premium surcharges.
