Welcome to the STAR+PLUS provider page! Enjoy easy access to key resources for STAR+PLUS providers.
The STAR+PLUS program provides an integrated approach to healthcare delivery that addresses those services members may require in the acute, behavioral, functional, social and environmental areas.
The program administers acute and long-term services and supports (LTSS) to the eligible populations through a managed-care system. Service coordination is a major feature of STAR+PLUS and involves specialized, person-centered thinking for members.
Service coordinators provide assistance to members, their families, member representatives and providers to develop a detailed service plan and administer assistance according to the member’s needs. Including:
- Acute care
- Behavioral health
- Environmental care
- Functional care
- Home- and community-based care
Nursing facility resources
Nursing facilities are required to notify Wellpoint within one business day of:
- New admission for an existing member
- Discharge of a member due to:
- Emergency care
- Extended leave from the facility
- Significant change in condition
Medicare-Medicaid Plan program
Wellpoint STAR+PLUS MMP is a Texas plan contracted with CMS and Texas Health and Human Services Commission (HHSC).
Wellpoint STAR+PLUS MMP integrates care and reimbursement for Texas members who have Medicare Part A, Medicare Part B, Medicare Part D and Medicaid benefits (dual-eligible members) and consolidates their care through one Medicare-Medicaid Plan for full access to both their Medicaid and Medicare benefits.
By consolidating the responsibility for all the covered services into a single plan, we see improved quality of care for the members; maximize the member’s ability to remain safely in their homes and communities; and improve continuity of care across acute care, long-term care, behavioral health and home- and community-based services using a patient-centered approach.
Wellpoint STAR+PLUS MMP offers this plan for dual-eligible members who reside in one of four counties: Bexar, El Paso, Harris and Tarrant.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub
- Learn about Availity
- Precertification Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Member Eligibility & Pharmacy Overview
- Provider Manuals and Guides
- Training Academy
- Pharmacy Information
- Electronic Data Interchange (EDI)