How children get Medicaid services depends on where they live in Texas and what kind of health issues the child has.
Medicaid Managed Care
Most children with Medicaid in Texas get their services through managed care health plans (medical plans, dental plans).
STAR is the Medicaid program where most children in Texas get their Medicaid coverage. Children in STAR Medicaid get their services through medical plans, also called managed care plans. Parents (or the child’s guardian) pick a plan when a child is first approved for Medicaid. Next, they pick their child’s primary care provider, who becomes the child’s main doctor.
STAR+PLUS is a Medicaid program for children and adults with long-lasting illnesses or disabilities and people age 65 and older. As with STAR Medicaid, children in STAR+PLUS get their services through a medical plan.
Medicaid Managed Care Service Areas by County
You can find the STAR and STAR+PLUS medical plans in your area by using the Find A Medical Plan search tool.
- Bexar Service Area: Atascosa, Bandera, Bexar, Comal, Guadalupe, Kendall, Medina, Wilson
- Dallas Service Area: Collin, Dallas, Ellis, Hunt, Kaufman, Navarro, Rockwall
- El Paso Service Area: El Paso, Hudspeth
- Harris Service Area: Austin, Brazoria, Fort Bend, Galveston, Harris, Matagorda, Montgomery, Waller, Wharton
- Hidalgo Service Area: Cameron, Duval, Hidalgo, Jim Hogg, Maverick, McMullen, Starr, Webb, Willacy, Zapata
- Jefferson Service Area: Chambers, Hardin, Jasper, Jefferson, Liberty, Newton, Orange, Polk, San Jacinto, Tyler, Walker
- Lubbock Service Area: Carson, Crosby, Deaf Smith, Floyd, Garza, Hale, Hockley, Hutchinson, Lamb, Lubbock, Lynn, Potter, Randall, Swisher, Terry
- Nueces Service Area: Aransas, Bee, Brooks, Calhoun, Goliad, Jim Wells, Karnes, Kennedy, Kleberg, Live Oak, Nueces, Refugio, San Patricio, Victoria
- Tarrant Service Area: Denton, Hood, Johnson, Parker, Tarrant, Wise
- Travis Service Area: Bastrop, Burnet, Caldwell, Fayette, Hays, Lee, Travis, Williamson
- Rural Service Area (RSA) – West Texas: Andrews, Archer, Armstrong, Bailey, Baylor, Borden, Brewster, Briscoe, Brown, Callahan, Castro, Childress, Clay, Cochran, Coke, Coleman, Collingsworth, Concho, Cottle, Crane, Crockett, Culberson, Dallam, Dawson, Dickens, Dimmit, Donley, Eastland, Ector, Edwards, Fisher, Foard, Frio, Gaines, Glasscock, Gray, Hall, Hansford, Hardeman, Hartley, Haskell, Hemphill, Howard, Irion, Jack, Jeff Davis, Jones, Kent, Kerr, Kimble, King, Kinney, Knox, La Salle, Lipscomb, Loving, Martin, Mason, McCulloch, Menard, Midland, Mitchell, Moore, Motley, Nolan, Ochiltree, Oldham, Palo Pinto, Parmer, Pecos, Presidio, Reagan, Real, Reeves, Roberts, Runnels, Schleicher, Scurry, Shackelford, Sherman, Stephens, Sterling, Stonewall, Sutton, Taylor, Terrell, Throckmorton, Tom Green, Upton, Uvalde, Val Verde, Ward, Wheeler, Wichita, Wilbarger, Winkler, Yoakum, Young, Zavala
- Rural Service Area (RSA) – Central Texas: Bell, Blanco, Bosque, Brazos, Burleson, Colorado, Comanche, Coryell, DeWitt, Erath, Falls, Freestone, Gillespie, Gonzales, Grimes, Hamilton, Hill, Jackson, Lampasas, Lavaca, Leon, Limestone, Llano, Madison, McLennan, Milam, Mills, Robertson, San Saba, Somervell, Washington
- Rural Service Area (RSA) – Northeast Texas: Anderson, Angelina, Bowie, Camp, Cass, Cherokee, Cooke, Delta, Fannin, Franklin, Grayson, Gregg, Harrison, Henderson, Hopkins, Houston, Lamar, Marion, Montague, Morris, Nacogdoches, Panola, Rains, Red River, Rusk, Sabine, San Augustine, Shelby, Smith, Titus, Trinity, Upshur, Van Zandt, Wood
STAR Health is Medicaid for children who get Medicaid coverage through the Texas Department of Family and Protective Services. One Medicaid plan provides both medical and dental services for all children in the STAR Health program.
Other Medicaid Programs
Traditional Medicaid is doctors, clinics, and dentists that see children with Medicaid who are not in one of the Medicaid managed care programs mentioned above.
Medicaid Waivers are programs that provide some ongoing (long-term) services to people with disabilities or older adults who have Medicaid. Through waiver programs, people can get the services they need in their own homes or other community settings, instead of having to go into a nursing home or institution.
In Texas, there are a number of different Medicaid waivers that offer children with disabilities a broad range of home and community-based services. Below are the 6 waivers that serve the largest number of Texas children, teens, and young adults. They all share the goal of community living, independence, choice, and control for people with disabilities and older adults.
Medicaid Dental Services
Most children, teens, and young adults age 20 or younger with Medicaid get their dental services through a Medicaid dental plan. Parents (or the child’s guardian) pick a plan when a child is first approved for Medicaid. Next, they pick their child’s main dentist, who provides most of the child’s dental care and services. There are two Medicaid dental plans to choose from.