ADRC Agency-Referral Tool

Provides counseling and advocacy regarding public benefits such as Medicare, Medicaid, QMB, and other government benefits.

Amerigroup is a health plan in the Texas STAR+PLUS Program. Amerigroup helps you manage your SSI health care benefits if you are: an elderly person, blind person, or a person with disabilities. Service planning, answer questions, provide guidance through the system. Benefits also include: Activities of Daily Living (ADLs). Day activity and health service; Personal attendant services; Consumer directed attendant care; Respite care; Transportation assistance; Adaptive aids; Adult foster care/personal care home; Assisted living/residential care; Emergency response system; Medical supplies; Minor home modifications; Pest control (quarterly, such as for bedbugs), Transition assistance services; Nursing services; Physical therapy; Speech/language therapy; Dietitian/nutritional services; Home delivered meals; Primary home care. Amerigroup will send a service coordinator to your home to see what you need. With your agreement, your service coordinator will talk to your doctors, see what help you need, and get the services started.

CLASS provides home and community-based services to people with related conditions as a cost-effective alternative to placement in an intermediate care facility for persons with developmental disabilities or a related condition (ICF-MR/RC). Program provides home and community-based services to people with physical disabilities that were present before 22 years of age. Some examples of services provided by CLASS include physical therapy, respite care, nursing services, psychological services, and job training. There is currently a waitlist for this program.

Enrollment assistance or more information from the center by calling (832) 393-5423 or toll-free 1-855-892-8082. They can also go online to visit the Marketplace at HealthCare.gov or its Spanish version at CuidadoDeSalud.gov or the collaborative’s site EnrollGulfCoast.com.

The Health Insurance Marketplace (CMS) is the way to find health coverage that fits your budget and meets your needs. With one application, you can see all your options and enroll. When you use the Health Insurance Marketplace, you’ll fill out an application and find out if you can get lower costs on your monthly premiums for private insurance plans. You'll find out if you qualify for lower out-of-pocket costs. The Marketplace will also tell you if you qualify for free or low-cost coverage available through Medicaid or the Children's Health Insurance Program (CHIP). Open enrollment starts October 1, 2013. Coverage starts as soon as January 1, 2014. Insurance plans in the Marketplace are offered by private companies, and they cover the same core set of benefits called essential health benefits. No plan can turn you away or charge you more because you have an illness or medical condition. Plans can't charge women more than men. While all insurance plans are offered by private companies, the Marketplace in Texas is run by the federal government. It simplifies your search for health coverage by gathering the options available in your area in one place. With one application you can compare plans based on price, benefits, quality, and other features important to you before you make a choice. You can also get help online, by phone, by chat, or in person. Find a plan that fits your needs and budget: In the Marketplace information about prices and benefits is written in simple language. You get a clear picture of what premiums you'd pay and what benefits and protections you'd get before you enroll. Compare plans based on what is important to you, and choose the combination of price and coverage that fits your needs and budget. Website also in Spanish. Other languages available upon request.

Replacement Medicaid cards can be obtained by calling or by going to the website.

Medicaid planning for seniors with financial complications. We provide complete nursing home Medicaid planning, Medicaid application filing, and full Medicaid representation.

The Health and Human Services Commission's Office of the Ombudsman helps people with Medicaid managed care coverage.

Superior HealthPlan believes every person deserves access to quality, affordable health coverage. The company is proud to offer STAR+PLUS Medicare-Medicaid Plan (MMP), a program that provides members access to a large provider network, including hospitals, pharmacies, doctors, and specialists. Superior HealthPlan’s Service Coordinators are here to help you find the coverage that’s right for you, navigate your coverage plan, and manage your services and providers to ensure you receive the care you need.

Texas Medicaid managed care program for people who have disabilities or are age 65 or older.

Under this program, the state may file a claim against the estate of a deceased Medicaid recipient, age 55 and older, who applied for certain long-term care services on or after March 1, 2005. Claims include the cost of services, hospital care and prescription drugs supported by Medicaid under the following programs: * Nursing facility; * Intermediate care facility for persons with intellectual disability, which includes state supported living centers; * Medicaid waiver programs including: * Community Living Assistance and Support Services, * Deaf Blind with Multiple Disabilities, * Home and Community-based Services, * Texas Home Living Program, * Consolidated Waiver Programs, * Community Based Alternatives, * STAR+PLUS; and * Community Attendant Services. Exceptions to filing claims: MERP claims will only be filed when it is cost-effective. Claims that are considered not cost-effective are those where: •the value of the estate is $10,000 or less; •the recoverable amount of Medicaid costs is $3,000 or less; or •the cost of selling the property would be equal to or greater than the property’s value. In addition, a claim will not be filed should one or more of the following conditions exist: •there is a surviving spouse; •there is a surviving child or children under 21 years of age; •there is a surviving child or children of any age who is blind, has a visual impairment or who has low vision and is totally disabled under Social Security requirements; or •there is an unmarried adult child residing continuously in the Medicaid recipient’s homestead for at least one year before the time of the Medicaid recipient’s death. An undue hardship waiver may be filed when: •The estate property -- has been the site of a family business, farm or ranch for at least 12 months prior to the death of the Medicaid recipient; -- is the primary income producing asset of the heirs; -- produces at least 50 percent of their livelihood; and -- recovery by the state would affect the property and result in heirs losing their primary source of income. •The estate’s beneficiaries would be eligible for public or medical assistance if a recovery claim is collected. •Allowing one or more heirs to receive the estate enables them to discontinue eligibility for public or medical assistance. •The Medicaid recipient received medical assistance as the result of being a crime victim. •Other compelling reasons exist.

Provides a variety of services that allow individuals under age 21 to live at home and avoid nursing facility placement. Provides respite care, adjunct support services, minor home modifications, adaptive aids and transition assistance services. Individuals eligible for MDCP also receive services through the State Medicaid Program. There is an interest list.

Children in Texas without health insurance may be able to get low cost or free health coverage from the Children’s Health Insurance Program (CHIP) or Children’s Medicaid.

STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 65 or older.

Provides institutional nursing care to Medicaid recipients whose medical condition requires the skills of a licensed nurse on a regular basis.