STAR+PLUS

STAR+PLUS is designed to meet the unique needs of adults who have disabilities or are age 65 or older.

Community First Health Plans provides Service Coordination for our STAR+PLUS Members. Service Coordination helps identify needs and connects Members to services and providers.

Community First Service Coordinators:

• Review each Member’s specific needs.
• Help the family and health plan create a unique individual service plan for each Member.
• Assist the member to get the medical and long-term services and support they need as they relate to health and independent living.

 STAR+PLUS Dual Members (Members who have Medicare) are not required to choose a Primary Care Provider (PCP) because dual-eligible Members receive acute care from their Medicare providers. Under the STAR+PLUS program, Community First provides Medicaid Long Term Services & Supports (LTSS) to dual-eligible Members. Community First recommends choosing a PCP to assist Members in coordinating care. No PCP information will appear on the STAR+PLUS Dual member ID card.

To qualify for STAR+PLUS, you must be approved for Medicaid and meet at least one of the following:

• Age 21 or older, getting Supplemental Security Income (SSI) benefits and able to get Medicaid due to low income.
• Not getting SSI and need the type of services in STAR+PLUS HOME and Community-Based Services.
• Age 21 or older, getting Medicaid through what are called “Social Security Exclusion programs” and meet program rules for income and asset levels.
• Age 21 or over residing in a nursing home and receiving Medicaid while in the nursing home.
• In the Medicaid for Breast and Cervical Cancer program.

Dedicated to the health and well-being of our Members, Community First Health Plans has developed guidelines to ensure your safety and protect your rights. Learn more about our processes and policies below.