STAR Kids will be the first Medicaid managed care program specifically serving youth and children who get disability-related Medicaid.

Beginning Nov.1, 2016, children and youth age 20 or younger who either receive Supplemental Security Income (SSI) Medicaid or are enrolled in the Medically Dependent Children Program (MDCP) will receive all of their services through a STAR Kids health plan. Children and youth who receive services through other 1915(c) waiver programs will receive their basic health services (acute care) through STAR Kids.

STAR Kids will be tailored to the needs of youth and children with disabilities. The program will provide benefits such as prescription drugs, hospital care, primary and specialty care, preventive care, personal care services, private duty nursing, and durable medical equipment and supplies. Children and youth who get additional services through MDCP will receive additional long-term services and support through STAR Kids.

STAR Kids Benefits

Non-exhaustive, high-level listing of Covered Services under the STAR Kids Medicaid Managed Care Program.

  • Ambulance services
  • Audiology services, including hearing aids
  • Behavioral Health Services, including:
    • Inpatient mental health services for adults and children. The Managed Care Organization (MCO) may provide these services in a free-standing psychiatric hospital in lieu of an acute care inpatient hospital setting.
    • Outpatient mental health services for adults and children
    • Psychiatric services
    • Substance use disorder treatment services
    • Outpatient services, such as:
      • Assessment
      • Detoxification services
      • Counseling treatment
      • Medication assisted therapy
  • Residential services, which may be provided in a chemical dependency treatment facility in lieu of an acute care inpatient hospital setting, including detoxification services
  • Prenatal care provided by a physician, certified nurse midwife (CNM), nurse practitioner (NP), clinical nurse specialist (CNS) and physician assistant (PA) in a licensed birthing center
  • Birthing services provided by a physician or CNM in a licensed birthing center
  • Birthing services provided by a licensed birthing center
  • Cancer screening, diagnostic and treatment service
  • Chiropractic services
  • Dialysis
  • Drugs and biologicals provided in an inpatient setting
  • Durable medical equipment and supplies
  • Early Childhood Intervention (ECI) services
  • Emergency services
  • Family planning services
  • Home health care services
  • Hospital services, inpatient and outpatient
  • Laboratory services         
  • Mastectomy, breast reconstruction, and related follow-up procedures, including:
    • Inpatient services
    • Outpatient services provided at an outpatient hospital and ambulatory health care center as clinically appropriate
    • Physician and professional services provided in an office, inpatient, or outpatient setting for:
      • All stages of reconstruction on the breast(s) on which medically necessary mastectomy procedure(s) have been performed
      • Surgery and reconstruction on the other breast to produce symmetrical appearance
      • Treatment of physical complications from the mastectomy
      • Treatment of lymphedemas
      • Prophylactic mastectomy to prevent the development of breast cancer
      • External breast prosthesis for the breast(s) on which medically necessary mastectomy procedure(s) have been performed
  • Medical checkups and Comprehensive Care Program (CCP) services through the Texas Health Steps EPSDT program
  • Mental health rehabilitation services
  • Mental health targeted case management
  • Oral evaluation and fluoride varnish in the Medical Home in conjunction with Texas Health Steps medical checkup for children 6 months through 35 months of age
  • Optometry, glasses and contact lenses, if medically necessary
  • Outpatient drugs and biologicals, including pharmacy-dispensed and provider-administered outpatient drugs and biologicals
  • Personal Care Services (PCS)
  • Podiatry
  • Prenatal care
  • Prescribed pediatric extended care center (PPECC) services
  • Primary care services
  • Private Duty Nursing (PDN) services
  • Radiology, imaging and X-rays
  • Specialty physician services
  • Telemonitoring
  • Therapies – physical, occupational and speech
  • Transplantation of organs and tissues
  • Vision services 

MDCP STAR Kids Services 

The following is a non-exhaustive list of Covered Services for Members who qualify for MDCP STAR Kids services. 

  • Respite care 
  • Supported employment 
  • Financial management services 
  • Adaptive aids
  • Employment assistance 
  • Flexible family support services 
  • Minor home modifications 
  • Transition assistance services 

For more information regarding STAR Kids program and its benefits, please Click Here 

${loading}