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 STAR+PLUS MMP depends on contract renewal.
If one or more of the following situations happens, Medicare or Texas Medicaid must end your membership with Superior 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.
If we learn from Medicare and/or Texas Medicaid that one or more of the following has occurred, we will disenroll you from our plan with permission from Medicare and Texas Medicaid:
- 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.