Texas STAR+PLUS Medicaid Long-Term Care (2026): Eligibility and How to Apply
STAR+PLUS is Texas Medicaid managed care for adults who have disabilities or are age 65 or older. It can combine medical care with long-term services and supports; Medicaid eligibility comes first. Reviewed July 2026. GlobalBenefits.org is an independent information site, not a government agency.
What this program does
STAR+PLUS delivers Medicaid through health plans. Depending on eligibility and assessed need, a member may receive regular medical benefits and long-term services that help the person remain at home or in a community setting.
- Doctor, hospital, pharmacy, and other Medicaid services through the member’s plan.
- Long-term services and supports may include personal assistance, nursing, therapies, adaptive aids, emergency response, or respite when authorized.
- A service coordinator helps assess needs and coordinate covered care. Coverage is based on authorization, not simply on diagnosis.
Who may be eligible
Eligibility is decided by Texas Health and Human Services Commission (HHSC) or the agency it assigns to review applications. The points below are a practical screening guide, not an eligibility decision.
- Be a Texas resident and meet a Texas Medicaid eligibility group.
- Generally be age 65 or older, or be an adult with a disability in an eligible Medicaid category.
- For STAR+PLUS Home and Community Based Services, meet additional financial and level-of-care rules and have an assessed need for waiver services.
- Some people are excluded or served through another Medicaid delivery system; HHSC makes the assignment.
Do not delay an application only because you are unsure about one rule. Ask the official program to screen the complete facts, and request a written notice if it denies or limits services.
Documents to gather
Exact paperwork varies by applicant and the agency may request more. Start with copies rather than giving away originals unless the agency specifically requires one.
- Identity, Texas residence, Social Security number or immigration documents requested by Medicaid.
- Income and resource records for the Medicaid category being reviewed.
- Insurance information and current Medicaid notices.
- Medical records, functional assessments, medication list, and descriptions of help needed with daily activities.
Record the date submitted, confirmation number, office, and name of anyone who helps you. Use our Benefit Document Checklist to organize the packet.
How to apply
- Apply for Medicaid through YourTexasBenefits, by telephone, mail, or an HHSC benefits office.
- Complete every financial and non-financial eligibility request from HHSC.
- If long-term services are needed, request an assessment and explain daily tasks, safety risks, caregiver limits, and current services.
- After enrollment, review available STAR+PLUS plans and providers, then choose a plan by the deadline or HHSC may assign one.
- Contact the plan’s service coordinator to build and maintain the service plan.
If an online form fails, use the listed telephone, mail, or local-office option. Ask for an accessible format, interpreter, relay service, or other reasonable accommodation when needed. Never pay a third party merely to reach a free government application.
What happens after you apply
HHSC decides Medicaid eligibility; the health plan and assessment process decide covered services and authorized hours.
- Watch for separate notices about Medicaid eligibility, plan enrollment, assessments, and service authorizations.
- Keep Medicaid renewal information current so financial coverage does not lapse.
- Report unmet needs or missed authorized services to the service coordinator and plan.
Processing time is not guaranteed unless the official program gives you a deadline in writing. Respond promptly to requests for proof, but keep a copy of everything. If your address, telephone number, household, health, work, school, or care needs change, report the change through the official channel because it may affect the decision or priority.
If you are denied, delayed, or disagree
The notice should explain whether the dispute concerns Medicaid eligibility, enrollment, or a plan service decision. Those decisions may use different appeal or fair-hearing routes.
Read the notice for the exact deadline and method. Ask for the reason, the rule used, and a copy of the record or assessment when available. Submit an appeal, hearing request, grievance, or reconsideration through the channel named in the notice; calling customer service alone may not preserve appeal rights. For application routing, our Application Status Finder links to official portals.
Important limits and mistakes to avoid
- STAR+PLUS enrollment does not guarantee every requested long-term service.
- Do not confuse regular STAR+PLUS medical coverage with the STAR+PLUS HCBS waiver benefit.
- Provider participation differs by plan and location; verify doctors and long-term-care providers before choosing.
Program names that sound similar can have different financial, medical, service, residency, discharge, or enrollment rules. Confirm that every form and portal belongs to the program on this page. Do not send Social Security numbers, medical records, DD-214s, bank statements, or identity documents to GlobalBenefits.org.
Keep going
GlobalBenefits.org is an independent information website. We are not a government agency and are not affiliated with any federal or state agency. We link to official government sites so you can apply directly and for free. Program amounts and rules change — always confirm on the official page before you apply.
Official sources: Texas HHSC STAR+PLUS; Texas Medicaid for the elderly and people with disabilities. Texas HHSC identifies STAR+PLUS as Medicaid managed care for adults with disabilities or adults age 65 and older and explains that eligible adults typically receive Medicaid services through STAR+PLUS. Rules, forms, funding, provider networks, deadlines, and program capacity can change. The official agency and written eligibility notice control.