Many families have what we know as traditional Medicaid. Families who have children that receive Supplemental Security Income (SSI) benefits get traditional Medicaid if they want it. Families that have children under one of the Medicaid Waiver programs would also be in traditional Medicaid.
This will all change in November of this year with the arrival of the STAR Kids program.
A new program, STAR Kids, will benefit children and families by providing services that are designed to meet the needs of children and youth with disabilities. The STAR Kids official website says this:
STAR Kids will be the first Medicaid managed care program specifically serving youth and children who get disability-related Medicaid.
Beginning Fall 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.
More details can be found here.
Families will have access to personal care services, private duty nursing, and habilitation services. These are considered long-term services and supports, meaning families need these services to keep their child at home and not in a nursing home or other facility. Without these services, there is a risk that children could be placed outside of the home in order to receive necessary care. This is why it is so important that families can access these services.
Another benefit of STAR Kids will be access to care coordination services. Care coordination will help families find doctors, specialists, and medical supplies. Care coordination will also make sure that children are caught up with their annual check-ups and vaccines. Prevention is a huge focus of the managed care model––i.e., when caught early, most illnesses have a greater chance for recovery.
In the El Paso area, two managed care plans will be offered, Amerigroup and Superior. Families will have to select one of these two health plans. Look very carefully before selecting, ask questions, and find out if your child’s doctors are accepting either of the plans before you make any decisions.
Plans will offer the same services, so choose the plan that is best for your child. The major differences between the two plans are benefits and their network of doctors. If you are not happy with one organization, you will be able to switch to the other one.