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Texas STAR+PLUS Medicaid Waiver
What are Medicaid Waivers?
Medicaid pays for long term care services in nursing homes. For nursing home qualified persons that choose to live at home or in a residential community, Medicaid will pay for those services if they can be obtained at a lower cost. These are called Home and Community Based Services, Waiver Funded Services, Medicaid Waivers or simply Waivers.
Texas STAR+PLUS Waiver Overview
This Texas Medicaid waiver allows elderly persons who are aged 65 or older and require a nursing facility level of care, to reside at home or in assisted living residences and receive care services in those locations. Services are provided by managed care organizations, which participants select from a local provider.
The STAR+PLUS waiver is offered in certain areas of Texas as an alternative to the Community Based Alternatives (CBA) Waiver. In this program, acute care and long term care services are integrated and provided by managed care organizations. Unlike the CDA Waiver, STAR+PLUS does not offer individuals a consumer directed option.
http://www.payingforseniorcare.com/medicaid-waivers/tx-community-based-alternatives.html
Other programs in Texas that may be relevant to the reader include the Community Attendant Services Program, Primary Home Care Program and Day Activity and Health Services Program.
The STAR+PLUS waiver is offered in certain areas of Texas as an alternative to the Community Based Alternatives (CBA) Waiver. In this program, acute care and long term care services are integrated and provided by managed care organizations. Unlike the CDA Waiver, STAR+PLUS does not offer individuals a consumer directed option.
http://www.payingforseniorcare.com/medicaid-waivers/tx-community-based-alternatives.html
Other programs in Texas that may be relevant to the reader include the Community Attendant Services Program, Primary Home Care Program and Day Activity and Health Services Program.
Qualifications for the STAR+PLUS Waiver
In addition to requiring nursing home level care, Texas residents must be financially qualified for Medicaid.
Qualifying for Medicaid is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years. The rules change in each state but typically monthly income cannot exceed $2,000 and one's countable assets must be valued at less $1,000 - $8,000. IMPORTANT* Even though, one's income or assets may exceed these limits, most individuals can still qualify for Medicaid.
Many families find themselves in an awkward position where their loved one has enough income and assets that they do not qualify for Medicaid but not enough so that they can afford to pay for their care. Fortunately, there are many exceptions to what is considered income and countable assets. For example, one's car and home can be considered exempt from their countable assets. Income in excess of the limit can be allocated to a pooled income trust thereby enabling the individual to meet the Medicaid limit and qualify for assistance.
Creating a funeral trust is another simple and common technique used to help qualify for Medicaid. Given the expense of funerals and the fact that everyone will eventually require one, it makes sense to allocate money in advance to cover the funeral and associated expenses. A funeral trust is considered an exempt asset from Medicaid, therefore by creating one, a family can prepare for an inevitable need without having to plan the details and lower their countable assets to help qualify for Medicaid. Learn more about establishing a funeral trust.
Not qualifying for Medicaid can be devastating to the comfort of an individual, their family’s finances and even their health. For these reasons, Medicaid planners exist to ensure families have the best chance of acceptance into the program. With care costing $1000’s / month, there is a strong incentive to use a Medicaid Planner. Find assistance applying for Medicaid.
Qualifying for Medicaid is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years. The rules change in each state but typically monthly income cannot exceed $2,000 and one's countable assets must be valued at less $1,000 - $8,000. IMPORTANT* Even though, one's income or assets may exceed these limits, most individuals can still qualify for Medicaid.
Many families find themselves in an awkward position where their loved one has enough income and assets that they do not qualify for Medicaid but not enough so that they can afford to pay for their care. Fortunately, there are many exceptions to what is considered income and countable assets. For example, one's car and home can be considered exempt from their countable assets. Income in excess of the limit can be allocated to a pooled income trust thereby enabling the individual to meet the Medicaid limit and qualify for assistance.
Creating a funeral trust is another simple and common technique used to help qualify for Medicaid. Given the expense of funerals and the fact that everyone will eventually require one, it makes sense to allocate money in advance to cover the funeral and associated expenses. A funeral trust is considered an exempt asset from Medicaid, therefore by creating one, a family can prepare for an inevitable need without having to plan the details and lower their countable assets to help qualify for Medicaid. Learn more about establishing a funeral trust.
Not qualifying for Medicaid can be devastating to the comfort of an individual, their family’s finances and even their health. For these reasons, Medicaid planners exist to ensure families have the best chance of acceptance into the program. With care costing $1000’s / month, there is a strong incentive to use a Medicaid Planner. Find assistance applying for Medicaid.
Services Provided under the STAR+PLUS Waiver
Under STAR+PLUS traditional health care and long-term care support are integrated and accordingly a broad range of services can be paid for including:
-Medical Care
-Personal Care (assistance with the activities of daily living)
-Respite Care
-Home Modifications
-Environmental Adaptive Aids
-Medical Care
-Personal Care (assistance with the activities of daily living)
-Respite Care
-Home Modifications
-Environmental Adaptive Aids
Availability of the STAR+PLUS Waiver / How to Apply
At the time of writing, the STAR+PLUS program was not available statewide however its service area is continuing to expand. See a map of which Texas counties are currently participating. One can learn more about the program on the STAR+PLUS website.
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