Texas Medicaid Managed Care Plans: Compare the 7 STAR+PLUS MCOs

Texas Medicaid managed care plans for seniors run through STAR+PLUS. Seven managed care organizations (MCOs) serve the program, Texas Medicaid managed care is organized into 13 service delivery areas, and every area gives you at least two STAR+PLUS plans to choose from.1 The Texas Health and Human Services Commission (HHSC) decides which MCOs serve which area, so the plans you can pick depend on where you live.2

In This Guide

• Key Takeaways
• What Is a Managed Care Plan?
• The Seven STAR+PLUS MCOs
• Which Texas Medicaid Managed Care Plans Serve Your Area
• How to Compare Texas Medicaid Managed Care Plans
• What Happens If You Don't Choose
• How to Switch Your MCO
• Your Rights as a Member
• What to Do If You Have a Problem
• Frequently Asked Questions
• Next Steps

What Is a Managed Care Plan?

Texas covers Medicaid for adults age 65 or older and adults who have disabilities through STAR+PLUS, its Medicaid managed care program for that group. Members get their Medicaid health care and long-term services and supports through providers contracted by the managed care organization (MCO) they choose.7 Your MCO is the health plan that sits between you and those providers: it keeps its own list of doctors and clinics, and it is the first place to call with a question about your care.5

Texas HHS describes the STAR+PLUS covered services for the program as a whole, and the health plans are how members get them. It lists regular checkups, medicine and vaccines, hospital care, x-rays and lab tests, vision and hearing care, access to medical specialists and mental health care, and nonemergency medical transportation, plus long-term services and supports (personal assistance services, Day Activity and Health Services, habilitation, emergency response) for members who qualify for them.4 If you have both Medicare and Medicaid, the picture is different: you keep getting your regular health care through your Medicare doctor, STAR+PLUS does not change how you get Medicare services, and HHSC says dual-eligible members get only their long-term services and supports through STAR+PLUS.8 Where the plans do differ is in their provider lists5 and in the extra "value-added" benefits they may offer on top, which vary from plan to plan.8

The Seven STAR+PLUS MCOs

Under the STAR+PLUS contracts that took effect September 1, 2024, seven MCOs serve the program, and three of them were new to STAR+PLUS.1 Some service areas got new plans as a result, so the choices a member had before September 2024 are not necessarily the ones they have now.2 HHSC's service-area map of the plans serving members as of September 2026 names these seven on its STAR+PLUS lines, and its MCO contact list labels a few of them slightly differently.1

If an older letter or plan document says Amerigroup, it means Wellpoint: HHSC states that Amerigroup rebranded its Texas health plans to Wellpoint on January 1, 2024.1

Which Texas Medicaid Managed Care Plans Serve Your Area

Texas Medicaid managed care is organized into 13 service delivery areas, and STAR+PLUS members can choose from at least two MCOs in each one.1 Which MCOs serve which area is set by HHSC and published in its "STAR+PLUS Health Plans by Service Areas" document, which the Texas Medicaid & Healthcare Partnership (TMHP) points members to for the complete list. Take your lineup from the current version of that document, not from a list someone remembers or one that predates the September 2024 contracts.2

If you already have a plan and want a different one, the Texas Enrollment Broker Helpline at 1-800-964-2777 is the line for changing a STAR+PLUS health plan.3

If you have both Medicare and Medicaid, note one recent change: Texas ended its STAR+PLUS Medicare-Medicaid Plan (MMP) dual demonstration on December 31, 2025, and the MCOs that ran those plans began offering aligned Integrated Dual Eligible Special Needs Plans (D-SNPs) on January 1, 2026 in Bexar, Dallas, El Paso, Harris, and Hidalgo counties.2

How to Compare Texas Medicaid Managed Care Plans

Texas HHS describes the STAR+PLUS covered services for the program as a whole, while each plan keeps its own provider list and may add its own value-added extras.4 Compare your options in this order.

What Happens If You Don't Choose

If you do not pick an MCO when you enroll, HHSC assigns one for you.3 An active choice beats an automatic assignment: even a quick check of whether your current doctor is in-network puts you in a stronger position than a default plan.

How to Switch Your MCO

You are not locked into your plan.

• Call the Texas Enrollment Broker at 1-800-964-2777.3
• You can change your STAR+PLUS plan at any time. Texas does not limit Medicaid plan changes to a set enrollment window.3
• A change takes 15 to 45 days to take effect.3

You can also make the change by logging into Your Texas Benefits instead of calling.3 Because a change can take up to 45 days, if your parent's doctor leaves the plan's network, call before the next appointment rather than after it, and ask the current plan how it will handle care while the switch goes through.3

Your Rights as a Member

Whichever MCO you choose, your plan's STAR+PLUS member handbook is where your rights are written out in full, so read it when it arrives. A few points are worth knowing before then:

• You choose a main doctor. Each plan has its own list of providers, and members choose a primary care provider (PCP) from it.5 Check the handbook for how to change your PCP and when you need a referral to see a specialist.
• You can change plans. You can switch MCOs at any time through the Enrollment Broker or Your Texas Benefits.3
• You can take a complaint outside the plan. The HHS Ombudsman Managed Care Help line handles questions and complaints about a Medicaid managed-care plan, including problems getting access to care.3
• You can appeal a denial. If your MCO denies, reduces, or ends a service, you can appeal to the plan and, if it upholds its decision, request a State Fair Hearing.11

Check your own handbook for the plan's rules on emergency and out-of-network care, interpreter services, and translated materials.

What to Do If You Have a Problem

Start with your MCO, then escalate to the state if the plan does not fix it.

File a Complaint with Your MCO

Call your health plan using the phone number listed on your health plan ID, explain the problem, and ask to file a complaint.5 If the plan does not resolve it, call the HHS Ombudsman Managed Care Help line at 1-866-566-8989, 8 a.m. to 5 p.m. Monday through Friday, which handles complaints about a Medicaid managed-care plan.3

Request a State Fair Hearing

If your MCO denies, reduces, or terminates a service, you have 60 calendar days from the date on the denial notice to file an internal appeal with the health plan, and the plan's standard resolution timeframe may be no longer than 30 calendar days from the day it receives your appeal, though the plan can extend it by up to 14 calendar days if you ask or if it shows the state it needs more information and the delay is in your interest. You can request the appeal orally or in writing, and the MCO must treat any oral or written expression of dissatisfaction as a request to appeal.11 Once you get notice that the plan has upheld its denial, you can request a State Fair Hearing, and if the plan fails to meet the federal notice and timing rules for your appeal, you can go straight to a hearing. Federal rules count the hearing window from the date of the plan's notice resolving your appeal, and Texas allows 120 days for actions taken by a managed care organization. The HHSC hearings officer has 60 to 90 days from the appeal request date to issue a written decision. Most appeal requests can be made in writing, by calling 2-1-1, or by visiting a local HHSC office, and hearings are typically conducted by conference call.11

Watch the deadline for keeping services running. Continuation applies only when the plan is ending, suspending, or reducing a service you were already authorized to receive, so a first-time denial does not qualify. Federal rules count a continuation request as on time if it is filed by the later of 10 calendar days after the plan sends its notice or the date the change is set to take effect. HHSC's STAR+PLUS handbook states the requirement more strictly, as an appeal filed by the effective date of the action, so file before the change takes effect rather than counting on the later date. A second short clock follows: if the plan upholds its decision, continued services stop unless you request the State Fair Hearing and continuation within 10 calendar days after the plan sends its notice, even though you have 120 days to request the hearing itself. One trade-off to know before you ask: if the final decision upholds the plan, it may recover the cost of services furnished while the appeal and hearing were pending, to the extent they were furnished only because of the continuation rules.11 That exposure is bounded rather than open-ended. Under 42 CFR 431.230(b), recovery reaches only the services furnished solely by reason of the continuation, meaning the care that kept flowing because you asked for it, not every service you received during those months.12

If your MCO does not resolve your issue, these Texas agencies can help.3

The HHS Ombudsman Managed Care Help page also takes questions and complaints about your plan online.

Next Steps

Once you know which MCOs serve your area, confirm your doctor is in-network, and switch through the Enrollment Broker or Your Texas Benefits if a different plan fits better.3

Learn More

Find personalized help comparing Texas Medicaid managed care plans at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.