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Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) in 2025, please refer to our full plan details page.
Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) is a Medicare-Medicaid Plan plan offered by Centene Corporation available for enrollment in 2025 to people living in Dallas and Hidalgo Counties. The overall rating for this plan is not yet available for 2025.
It's important to know that Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Important:
Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan)is a Medicare-Medicaide (MMP) plan. This means you can only enroll in this plan if you meet specific criteria for both medicare and medicaid. See our full plan details page for more information.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
We don't have information on the Maximum Out-Of-Pocket cost for this plan. You can call our licensed insurance specialists by clicking "Call to Enroll" below for more information.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan) has a $0 deductible for prescription drugs. If you qualify for the low-income subsidy (LIS), you will pay $0.00 for Part D drugs. During the initial coverage phase, you will pay the costs for drugs in each tier until your total drug costs reach $2000. After your yearly out-of-pocket drug costs reach $2000, you pay nothing for Medicare Part D covered drugs.
Additional Benefits
The Superior HealthPlan STAR+PLUS Medicare-Medicaid plan offers a range of benefits with varying cost-sharing structures. Many services, including primary care, preventive services, hearing and vision exams, and home health services, are available with no copay. Additionally, the plan provides coverage for dental services, medical equipment, and other services like OTC items, meal benefits, and home modifications. However, the plan has limitations. Some services such as outpatient substance abuse, worldwide emergency services, and certain vision and dental services are not covered. Prior authorization is required for some services, and there are annual maximums for certain benefits like dental and other services.
Inpatient Hospital See details
Inpatient Hospital benefits, including acute and psychiatric services, are covered. Additional days for inpatient hospital-acute and psychiatric are also covered, with 30 additional days for acute and unlimited days for psychiatric, and non-Medicare-covered stays and upgrades for inpatient hospital-acute are not covered.
Outpatient Services See details
Outpatient Services are covered, including outpatient hospital services, observation services, and ambulatory surgical center (ASC) services. Outpatient substance abuse services and outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered with prior authorization.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Superior HealthPlan STAR+PLUS Medicare-Medicaid plan. All ambulance services are covered with prior authorization and no copay or coinsurance, but ground and air ambulance services are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan), with no copay or coinsurance for Emergency Services and Urgently Needed Services. Worldwide Emergency Services is not covered, including Worldwide Emergency Coverage, Worldwide Urgent Coverage, and Worldwide Emergency Transportation.
Primary Care See details
The Superior HealthPlan STAR+PLUS Medicare-Medicaid plan covers primary care physician services, occupational therapy services, physician specialist services, podiatry services, other health care professional services, physical therapy and speech-language pathology services, additional telehealth benefits, and opioid treatment program services with no copay and no coinsurance. Chiropractic services, mental health specialty services, and psychiatric services are partially covered, and routine chiropractic care, individual sessions for mental health specialty services, group sessions for mental health specialty services, individual sessions for psychiatric services, and group sessions for psychiatric services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered preventive services with no copay, and additional services such as Personal Emergency Response Systems (PERS), Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, Kidney Disease Education Services, Glaucoma Screenings, Diabetes Self-Management Training, Barium Enemas, Digital Rectal Exams, and EKGs following a Welcome Visit. However, the plan does not cover Annual Physical Exams, Health Education, In-Home Safety Assessments, Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Fitness Benefits, and Home and Bathroom Safety Devices and Modifications. Counseling Services are covered with a limit of 30 sessions.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids, with no copay or coinsurance. Prescription hearing aids (all types) are covered, with one hearing aid allowed every 5 years, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams, contact lenses, and eyeglasses (lenses and frames), each covered once per year, and eyeglasses (lenses and frames) are not subject to a deductible. Eyeglass lenses, eyeglass frames, and upgrades are not covered.
Dental Services See details
Dental services are covered, with a maximum of $750 per year for other dental services and orthodontic services. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), fluoride treatment, other preventive dental services, restorative services, endodontics, periodontics, prosthodontics (removable and fixed), and oral and maxillofacial surgery are covered. Adjunctive general services, maxillofacial prosthetics, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan), including Medicare Part B Insulin Drugs, but Medicare Part B Chemotherapy/Radiation Drugs are not covered. Prior authorization is required for Home Infusion bundled Services.
Dialysis Services See details
Dialysis Services are covered under the Superior HealthPlan STAR+PLUS Medicare-Medicaid (Medicare-Medicaid Plan). There is no copay or coinsurance for this benefit.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) and Prosthetics/Medical Supplies - Non-Medicare benefit, both with no copay and no coinsurance. Durable Medical Equipment for use outside the home, Prosthetic Devices, Medical Supplies, Diabetic Supplies, and Diabetic Therapeutic Shoes/Inserts are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, but Diagnostic Procedures/Tests, Lab Services, Diagnostic Radiological Services, Therapeutic Radiological Services, and Outpatient X-Ray Services are not covered. There is no copay for the covered services.
Home Health Services See details
Home Health Services are covered by the Superior HealthPlan STAR+PLUS Medicare-Medicaid plan, with no copay or coinsurance. Additional hours of care and personal care services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are technically covered, but none of the listed sub-services are covered. Specifically, the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Superior HealthPlan STAR+PLUS Medicare-Medicaid plan, with prior authorization required. Additional days beyond Medicare-covered SNF stays are covered, and the plan does not cover non-Medicare-covered SNF stays.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items with a $35 monthly maximum, Meal Benefits requiring a doctor's referral, and Other Services including Nursing Services, Minor Home Modifications up to $7,500 per lifetime, Emergency Response Services, Assisted Living Services, Adult Foster Care, Transitional Assistance Services up to $2,500 per lifetime, Respite Care with a limit of 30 visits per year, Behavioral Health Services, Employment Assistance, Supported Employment, Cognitive Rehabilitation Therapy, Adaptive Aids and Medical Supplies up to $10,000 per year, Home-Delivered Meals, Personal Assistance Services, Dental Services up to $5,000 per year, Occupational Therapy, Speech, Hearing and Language Therapy, Support Consultation, Habilitation Services, Smoking and Tobacco Use Cessation Counseling limited to 8 sessions per visit, Home Visits, Nonemergency Medical Transportation (NEMT) Services, Cologuard, Cytogenomic Constitutional Microarray with a lifetime limit of 1 visit, Case Management for Children and Pregnant Women limited to 1 session per day, and Emergency Triage, Treat, and Transport Benefits. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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