Along with the medical, behavioral, vision, dental and pharmacy services Molina Healthcare covers, Molina Healthcare also manages certain Long Term Services and Supports (LTSS), or waiver services, for the state of Texas.
What are waiver services?
Waiver services are Long Term Services and Supports (LTSS) available to our members and your patients in a home or community-based setting. It provides assistance with activities of daily living to allow the member to remain in the most integrated setting possible. Texas has seven home and community-based waivers. Each waiver is designed for individuals with similar needs and offers a different set of services. Molina Healthcare manages one of them. You can read more about them here.
Molina Healthcare manages Home and Community-Based Services (HCBS) STAR+PLUS Waiver. This program provides community long-term services and supports to Medicaid eligible members who are elderly and to adults with disabilities as a cost-effective alternative to living in an institutional setting or nursing facility.
Eligibility for waiver services
In order to qualify, the member must meet certain eligibility requirements. Molina Healthcare does not determine eligibility into the waiver or nursing home programs. Members must be age 21 or older, be a Medicaid recipient or be otherwise financially eligible for waiver services. To be eligible for HCBS STAR+PLUS Waiver Services, a member must meet income and resource requirements for Medicaid nursing facilitiy care and receive a determination from HHSC on the medical necessity/level of care for nursing facility care. If a member qualifies for waiver services, the member will be notified.