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Medicare-Medicaid Plan by Superior STAR+PLUS MMP

Important Notifications

Due to flooding in the State of Texas, Governor Greg Abbott declared a state of emergency in the following Counties: Bastrop, Burnet, Colorado, Fayette, Hood, Jim Wells, Kerr, Kimble, La Salle, Live Oak, Liano, Mason, McMullen, Nueces, Real,

San Patricio, Travis, and Williamson Counties.

Your health and safety are our primary concerns and if you leave your home to avoid this emergency, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional.   

For our members who live in one of these impacted areas, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers.  You must still use Medicare certified facilities and providers.

Prior authorization for medical services or medication may still be needed for medical necessity. This change is in effect until the emergency notice is closed or 15 October 2018 whichever is earlier. 

For public health emergencies, the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first.

Due to flooding in the State of TX, Governor Abbott declared a state of emergency in the following Counties: Aransas, Cameron, Hidalgo, Nueces, San Patricio, and Willacy.

Your health and safety are our primary concerns and if you leave your home to avoid this emergency, we do not want any undue barriers to keep you from getting your medication or to seeing a medical professional.   

For our members who live in one of these impacted areas, we have removed the refill too soon edits for your Part D Prescription Drugs, and removed the out-of-network authorization requirements for out-of-network providers.  You must still use Medicare certified facilities and providers.

Prior authorization for medical services or medication may still be needed for medical necessity. This change is in effect until the <emergency or disaster> notice is closed or <date 30 days from declaration>, whichever is earlier. 

For public health emergencies, the lift for your Part D prescription drugs refill too soon edit will remain in effect until the emergency no longer exists or upon the expiration of the 90-day period beginning from the initial declaration, whichever occurs first.

In its first such rating measuring member satisfaction, Superior HealthPlan finished in the top five nationally for its STAR+PLUS Medicare-Medicaid Plan (MMP). The company earned a score of 89 out of 100 in an annual member survey, the fifth highest score in the country and only two points away from the top-place finisher.

“We are proud of the work we do each day to support all of our members,” said Cindy Adams, Plan Product President of Complex Care Programs. “This is especially true for those with complex care needs. This rating, which is based on overall member satisfaction, confirms our commitment to providing quality, holistic healthcare to those who need it most.”

The rating is based on the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, which is part of the Centers for Medicare and Medicaid Services (CMS) annual measurement of consumer experience. A portion of Superior’s roughly 10,000 STAR+PLUS MMP members participated in the survey.

Superior STAR+PLUS MMP is a product for members who qualify for both Medicare and Medicaid. The product is offered in three counties in Texas: Bexar, Dallas and Hidalgo. Superior first began offering the product on March 1, 2015.

“This is a direct reflection on the role our employees play in ensuring our members receive the healthcare they deserve,” explained Anna Velasquez, Vice President of STAR+PLUS MMP. “Each one of our members in this program works directly with a Service Coordinator at Superior, who can help them navigate the complex healthcare system. We believe this demonstrates our dedication to recognizing that each member has a very distinct set of needs that require individualized attention.”

For more details about the CAHPS survey, visit https://www.ma-pdpcahps.org/.

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Before January 1, 2018, all Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) members will receive a new member ID card. The drug information on the front of the card will be updated. Your benefits will not change. Please show this card to your pharmacist so they can update your records.

Use your current member ID card until the last day of 2017. On January 1, 2018, please destroy your old Superior STAR+PLUS MMP ID card and use this new card.

You can get your drugs filled at most pharmacies in Texas. You can also find a pharmacy by using the Find a Doctor or Pharmacy tool on this website.  

If you need help finding a pharmacy or have questions about your health plan benefits, please call Member Services at 1-866-896-1844. TTY users should call 711. You can call 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on holidays, you may be asked to leave a message. Your call will be returned within the next business day. The call is free. This number can also be found on the back of your new ID card.

Superior HealthPlan (Superior) STAR+PLUS Medicare-Medicaid Plan (MMP)

Superior HealthPlan STAR+PLUS Medicare-Medicaid Plan (MMP) is a Medicare-Medicaid Plan made up of doctors, hospitals, pharmacies, providers of long-term services and supports, and other providers.  It also has service coordinators and service coordination teams to help you manage all your providers and services.  They all work together to provide the care you need. 

  • Getting all of your covered Medicare and Medicaid services from Superior STAR+PLUS MMP plan.  You won’t pay extra to join our health plan.
  • Having both an individual service coordinator and service coordination team who will work with you, and with your care providers, to come up with a Plan of Care specifically designed to meet your health needs. Your service coordinator will be responsible for coordinating the services you need such as informing your doctors about the medicines you take and ensuring that your test results are shared with you.
  • Be age 21 or older, and
  • Live in either the Bexar, Dallas or Hidalgo service delivery area, and
  • Have both Medicare Part A and Medicare Part B, and
  • Are a United States Citizen or are lawfully present in the US, and
  • You are eligible for Medicaid and at least one of the following:
    • Have a physical disability or a mental disability and quality for Supplemental Security Income (SSI), or
    • Qualify for Medicaid because you receive Home and Community Based Services (HCBS) waiver services; and
  • You are NOT enrolled in one of the following 1915(c) waiver programs:
    • Community Living Assistance and Support Services (CLASS)
    • Deaf Blind with Multiple Disabilities Program (DBMD)
    • Home and Community-based Services (HCS)
    • Texas Home Living Program (TxHmL)

This information is available for free in other languages. For more information, call Member Services at 1-866-896-1844. Hours are 8 a.m. to 8 p.m., Monday through Friday. After hours, on weekends and on holidays, you may be asked to leave a message.  Your call will be returned the next business day. TTY users call 711.

We are here to help you get the healthcare you need, when you need it and to keep you healthy.

Now is the time to think about what you want to get out of your health care plan. It is your choice!

More information on Medicare benefits and services can be found 24 hours a day, seven days a week at www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227), TTY users call: 1-877-486-2048. Calls to this number are free, 24 hours a day, 7 days a week.

 

 

Last Updated: 04/19/2018
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