Potential for Contract Termination

Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) is a health plan that contracts with both Medicare and Texas Medicaid to offer benefits of both programs to enrollees. Enrollment in Superior (MMP) depends on contract renewal.

Your membership will end for any of the reasons below:

These are the cases when Medicare or Texas Medicaid must end your membership with Superior HealthPlan STAR+PLUS MMP:

  • There is a break in your Medicare Part A and Part B coverage.
  • You no longer qualify for Texas Medicaid. Our plan is for people who qualify for both Medicare and Texas Medicaid.
  • You do not pay the amount needed for you to qualify for benefits (medical spend down).
  • You move out of our service area.
  • You go to jail.
  • You lie about or do not tell us information about other insurance you have for drugs.

We can make you leave our plan if we get permission from Medicare and Texas Medicaid first if:

  • You give us incorrect information on purpose when you are enrolling in our plan and that information made you eligible for our plan.
  • You always behave in a way that bothers others and makes it difficult for us to provide medical care for you and other members of our plan.
  • You let someone else use your ID card to get medical care.
    •  If we end your membership because of this reason, Medicare may turn your case over to the Inspector General.

Last Updated: 10/01/2016