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Medicaid in Texas

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Submitted By fudge710
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Medicaid is the State and Federal joint venture that provides medical coverage to the eligible individuals. The purpose of Medicaid in Texas is to improve the health of people whose income and resources are insufficient to pay for health care. The Texas Health and Human
Services Commission's (HHSC) Medicaid Office is responsible for statewide oversight of Texas
Medicaid. The mission of the Texas Medicaid program is to improve the health of Texans by emphasizing prevention, promoting continuity of care, providing a medical home for Medicaid recipients and ensuring that each recipient can receive high quality, comprehensive health care services within the community. (6) Medicaid serves primarily low- income families, children, caretakers of dependent children, pregnant women, cash assistance recipients, people aged 65 and older, and adults and children with disabilities. Medicaid pays for acute health care
(physician, inpatient, outpatient, pharmacy, lab, and x-ray services), and long-term services and supports (home and community-based services, nursing facility services, and services provided in Intermediate Care Facilities for Individuals with an Intellectual Disability or Related
Conditions (ICFs/IID)) for people age 65 and older and those with disabilities. Texas Medicaid provides major portion of healthcare services through managed care model. (1)
There are basically four Medicaid programs in Texas. The type of coverage an individual gets depends on his/her geographical location and the health condition. The basic
Medicaid programs are Traditional Medicaid, STAR, STAR+PLUS, and STAR Health.
Traditional Medicaid is for those who cannot be in managed care. It is also known as fee for service. STAR is Medicaid for children, newborns, and pregnant women and children with limited income and TANF (Temporary Assistance for Needy Family) clients.

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