Can I have STAR+PLUS and a Medicare Advantage plan?

Your Medicare choices with STAR+PLUS

STAR+PLUS is your Medicaid coverage. Medicare is separate, and HHSC lists three ways to get it while you're in STAR+PLUS, available statewide:

• Original Medicare, with a separate Part D drug plan.
• A Medicare Advantage plan, a private plan that covers Part A and Part B services and usually drugs.
• A D-SNP, a Medicare Advantage plan only for people with both Medicare and Medicaid.

Whichever you choose, STAR+PLUS still covers Medicaid services such as long-term services and supports, and Texas Medicaid can pay Medicare costs you'd otherwise owe.

Integrated D-SNPs in five Texas counties

Since January 1, 2026, integrated D-SNPs have been available to full dual eligible adults in Bexar, Dallas, El Paso, Harris and Hidalgo counties. HHSC describes how they work:

• When you choose an integrated D-SNP for Medicare, you're automatically enrolled in that company's related STAR+PLUS plan for Medicaid.
• You get one ID card and one member handbook for both programs.
• You get one phone number and one appeals and grievances letter for both.

Starting January 1, 2027, more STAR+PLUS health plans in those five counties will offer integrated D-SNPs, so you may have more choices. If you're happy with your current plans, you don't have to change.

When can I change?

• Fall open enrollment, October 15 to December 7, for coverage starting January 1.
• A monthly Special Enrollment Period for people with Medicaid or Extra Help. Medicare.gov says you can switch Part D plans, or leave a Medicare Advantage plan with drug coverage for Original Medicare and a Part D plan, once a month.
• The Medicare Advantage Open Enrollment Period, January 1 to March 31, if you're already in a Medicare Advantage plan.

Changing your STAR+PLUS health plan is a separate step with HHSC.

Get help

A licensed insurance agent with Benefits Life can explain D-SNPs and other Medicare plans available to dual eligibles in your county, from the companies they work with, at no cost to you, at (512) 265-6565, TTY 711. You can also see plans in your ZIP code. See dual eligible special needs plans in Texas.

Related questions

Sources

• Texas HHSC — Options for Medicare and Medicaid dual coverage
• Texas HHSC — Dual Integration Project Phase II, effective January 1, 2027
• Texas HHSC — STAR+PLUS
• Medicare.gov — Special Enrollment Periods
• 42 CFR §422.62 — Election of coverage under an MA plan

Frequently asked questions

What is a D-SNP?

A dual eligible special needs plan is a Medicare Advantage plan only for people who have both Medicare and Medicaid. HHSC says it helps coordinate Medicare and Medicaid services, even when different health plans provide them. Texas has 173 special needs plans in 2027, and the choices differ by county.

What happened to the Texas Dual Demonstration plans?

HHSC ended the Dual Demonstration, which used Medicare-Medicaid Plans, on December 31, 2025, as a federal rule required. The companies that ran those plans began operating integrated D-SNPs on January 1, 2026.

What changes on January 1, 2027?

HHSC says the remaining STAR+PLUS health plans in Bexar, Dallas, El Paso, Harris and Hidalgo counties begin operating integrated D-SNPs on January 1, 2027. Dual eligible members may move to a different STAR+PLUS plan that offers one, but they don't have to.

Can I change my Medicare plan if I have Medicaid?

Yes, more often than most people. Medicare.gov says people with Medicaid or Extra Help can change their Part D coverage once a month, with the change starting the first of the next month. You can also change during the fall open enrollment period.

Medicare in your Texas county

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