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December 2016 Texas Medicaid Provider Procedures Manual

Medicaid Managed Care Handbook : 7 STAR Health Program : 7.1 STAR Health Program Clients

All Medicaid clients in foster care are placed in this program with the following exceptions:
Children from other states who are placed in Texas Children in Medicaid-paid facilities such as children in nursing homes, ICF-IIDs, or State-Supported Living Centers
Clients who participate in the Medicaid for Transitioning Foster Care Youth (MTFCY) program and the Former Foster Care in Higher Education (FFCHE) program are eligible for the STAR Health program.
The following table shows the age ranges for clients who may be eligible for the STAR Health program:
DFPS can retain conservatorship through the month of the client’s 18th birthday. (Eligibility ends the month conservatorship ends.)
Clients who voluntarily continue in a foster care placement after DFPS conservatorship ends
STAR Health members can gain eligibility on any day of the month. To ensure the accurate confirmation of STAR Health eligibility, it is essential that all health-care providers verify eligibility by contacting the STAR Health MCO. The STAR Health MCO receives updated eligibility information on a daily basis, so it will have the most current eligibility information.
The Department of Family and Protective Services (DFPS) Form 2085 as well as the Your Texas Benefits Medicaid card may also be used to verify eligibility in the STAR Health Program.
Newborns born to a mother who is enrolled in the STAR Health program are automatically enrolled in STAR Health.
Newborns born to a mother who is enrolled in STAR Health through the Former Foster Care in Higher Education (FFCHE) Program are not eligible to be enrolled in STAR Health.
Newborns that are taken into State conservatorship while still in the hospital will be enrolled in STAR Health on the date the State takes conservatorship.

Texas Medicaid & Healthcare Partnership
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