How many MCOs participate in Texas STAR+PLUS?

As of July 2026, seven managed care organizations participate in STAR+PLUS: UnitedHealthcare Community Plan of Texas, Molina Healthcare of Texas, Superior HealthPlan, Wellpoint (formerly Amerigroup Texas), Community First Health Plans, El Paso Health, and Community Health Choice. Not all seven operate in every service delivery area — Community First serves Bexar County only, El Paso Health serves El Paso only, and Community Health Choice primarily serves the Greater Houston area.

Do I have to credential with every MCO in my service delivery area?

You don't have to, but you should — eventually. Each MCO credentialing is independent, and each one unlocks a separate member pool. In areas like Dallas (Molina + Superior) or Houston (Molina, UnitedHealthcare, Wellpoint, Community Health Choice), a home care agency credentialed with only one MCO is invisible to members of the other three. New agencies typically start with 2–3 MCOs and add the rest within 12 months.

What is a Texas STAR+PLUS service delivery area?

Texas divides the state into 13 STAR+PLUS service delivery areas (SDAs) for administrative purposes. Each SDA has 2–4 MCOs offering STAR+PLUS plans to eligible members. Your SDA is determined by the county in which your clients live — not where your agency office is located. Members choose their MCO when enrolling in STAR+PLUS; you must be credentialed with that MCO to serve them.

How long does MCO credentialing take for a new STAR+PLUS provider?

Credentialing timelines vary by MCO and current application volume, but most take 30 to 90 days from complete application submission to active network status. Plan for 90 days as your baseline. Incomplete applications — missing TMHP enrollment confirmation, missing insurance certificates, missing HCSSA license documentation — are the most common cause of delays. Submit complete packets and respond within 48 hours to any MCO information requests.

Can I serve STAR+PLUS clients before MCO credentialing is complete?

No. You must be actively credentialed and in-network with a member's MCO before rendering services. Providing services before credentialing is complete and attempting to bill creates a denial — and potentially a compliance issue. Some MCOs offer provisional credentialing that allows billing to begin while the full credentialing review continues, but this is not universal. Ask each MCO about their specific policy at the start of the application.

Texas STAR+PLUS MCO Guide 2026: Which Managed Care Organization Should Your Home Care Agency Join?

Most new Texas home care agencies focus on getting their HCSSA license first — and that's right. But the question that follows immediately is: which STAR+PLUS MCO should you join, and in what order?

The answer is less about which MCO is "better" and more about which MCOs operate in your service delivery area and how to sequence credentialing so you can start serving clients as efficiently as possible. This guide breaks down all seven STAR+PLUS MCOs, their coverage footprints, what the credentialing process requires, and a practical strategy for new agencies.

All information reflects the STAR+PLUS program as of July 2026, including the January 2026 transition of former Medicare-Medicaid Plan (MMP) members into STAR+PLUS.

What STAR+PLUS Is and Why Credentialing Decisions Matter

STAR+PLUS is Texas's Medicaid managed care program for adults age 21 and older who are aged, blind, or have disabilities and qualify for both Medicaid and long-term services and supports (LTSS). For home care agencies, STAR+PLUS is the primary Medicaid pathway for personal attendant services — the same population that needs help with bathing, dressing, meal preparation, and mobility support.

Unlike fee-for-service Medicaid, STAR+PLUS delivers services through managed care organizations (MCOs) — private health plans contracted with HHSC to coordinate and pay for member care. The MCO is the payer, not the state directly. As a result:

Your TMHP provider enrollment gets you into the Medicaid system, but it does not make you billable to any MCO
You must credential and contract with each MCO separately
A member enrolled in Molina Healthcare's STAR+PLUS plan can only receive services from Molina-credentialed providers
Being credentialed with Superior HealthPlan does not give you access to any other MCO's members

This is the decision that shapes your client pipeline: which MCOs you credential with, and in what order, determines which STAR+PLUS clients can legally choose your agency.

Texas Has 13 Service Delivery Areas — Find Yours First

Before you decide which MCO to credential with, you need to know which service delivery area (SDA) you operate in. Texas divides the state into 13 SDAs for STAR+PLUS. Your SDA is determined by the county where the client lives, not your agency's office location.

Each SDA has between two and four MCOs offering STAR+PLUS plans to members. When a member enrolls in STAR+PLUS, the state enrollment broker (reachable at 1-800-964-2777) helps them choose from the MCOs available in their SDA.

For providers, the SDA determines your credentialing target list. An agency in the Dallas SDA needs to credential with Molina and Superior. An agency in San Antonio (Bexar SDA) needs to credential with Molina, Superior, Wellpoint, and Community First Health Plans. Getting this wrong — credentialing with MCOs that don't serve your area — wastes months.

To confirm your SDA: Check the official HHSC STAR+PLUS Health Plans by Service Areas document at hhs.texas.gov before submitting any credentialing applications. The document is updated when service area assignments change, which has happened in recent contract cycles.

The Seven STAR+PLUS MCOs

1. Superior HealthPlan

Superior HealthPlan is one of the two statewide MCOs with the broadest footprint — it operates in approximately 9 of the 13 STAR+PLUS SDAs. For most new Texas home care agencies outside of El Paso and a few smaller service areas, Superior is likely in your credentialing list.

Superior is a Centene Corporation subsidiary and one of the largest Medicaid managed care plans in Texas. For new PAS providers, Superior is typically the recommended first credentialing target in SDAs where it operates, given its member volume.

Provider relations: Contact Superior HealthPlan's provider enrollment team directly at superiorhealthplan.com. You will need your TMHP-assigned Texas Medicaid provider ID and your HCSSA license documentation.

2. Molina Healthcare of Texas

Molina is the second statewide MCO with broad coverage across approximately 9 SDAs. Like Superior, Molina operates in most STAR+PLUS service delivery areas and has a large membership base.

For agencies in multi-MCO SDAs, Molina and Superior are almost always the first two credentialing applications you'll submit, because they collectively cover the largest member population in your area.

Provider relations: molinahealthcare.com/providers or call Molina's Texas provider services line.

3. UnitedHealthcare Community Plan of Texas

UnitedHealthcare participates in several STAR+PLUS SDAs, with confirmed presence in the Harris County (Greater Houston) SDA where it is one of the primary options alongside Molina and Wellpoint.

Provider relations: UnitedHealthcare provides LTSS-specific provider relations support at 888-787-4107. For general Texas STAR+PLUS provider inquiries: 888-303-6162.

4. Wellpoint (formerly Amerigroup Texas)

Wellpoint — which rebranded from Amerigroup Texas — currently participates in approximately 4 STAR+PLUS SDAs, including Lubbock, Nueces (Corpus Christi), Jefferson (Beaumont), and the Greater Houston area (Harris SDA).

Important note for San Antonio agencies: Wellpoint also serves the Bexar SDA, making it one of four MCOs to credential with in San Antonio (alongside Molina, Superior, and Community First).

January 2026 change: Former Medicare-Medicaid Plan (MMP) members in Bexar, Dallas, El Paso, Harris, and Hidalgo counties transitioned into STAR+PLUS effective January 1, 2026. Wellpoint is one of the MCOs that absorbed MMP members — meaning its STAR+PLUS member count in relevant SDAs grew in early 2026.

Provider relations: wellpoint.com/tx/provider or providernews.wellpoint.com/tx for provider bulletins.

5. Community First Health Plans

Community First Health Plans is a San Antonio regional MCO — it serves the Bexar SDA only. If you do not operate in San Antonio or serve Bexar County clients, you do not need to credential with Community First.

For agencies in San Antonio, Community First is the fourth credentialing application after Molina, Superior, and Wellpoint — and it matters because it's a deeply community-embedded plan with strong provider relationships in the Bexar market.

Provider relations: ProviderRelations@CFHP.com | 210-358-6407 (Provider Relation Engagement Manager).

6. El Paso Health

El Paso Health serves the El Paso SDA only. Alongside Molina Healthcare, El Paso Health is one of two MCOs available to STAR+PLUS members in El Paso County.

For agencies serving El Paso clients, El Paso Health credentialing is essential. For agencies outside El Paso, it is not applicable.

Provider relations: Contact El Paso Health directly at elpasonm.org or the provider relations line.

7. Community Health Choice

Community Health Choice operates primarily in the Greater Houston area (Harris SDA). It serves a significant population in the Houston metro alongside Molina, UnitedHealthcare, and Wellpoint.

For agencies in the Houston metro, Community Health Choice rounds out the credentialing picture after the three larger statewide MCOs.

Provider relations: communityhealthchoice.org/providers.

Decision Framework: Which MCO to Credential With First

Step 1 — Identify your service delivery area

Confirm which SDA covers the primary county where you will serve clients. Use the HHSC official SDA map. If you plan to serve clients in multiple counties that cross SDA boundaries, identify both SDAs.

Step 2 — List the MCOs in your SDA

Each SDA has 2–4 MCOs. Get the current list from HHSC — do not rely on a list more than 12 months old, since MCO contracts have changed in recent cycles (most recently with the September 2024 contract cycle that reorganized several SDA assignments).

Step 3 — Prioritize by member volume

Within your SDA, submit credentialing applications to the MCOs with the largest member populations first. In most areas, this means Molina and Superior first, followed by any additional MCOs in your SDA. In Houston, add UnitedHealthcare. In San Antonio, add Community First. In El Paso, add El Paso Health.

Step 4 — Submit applications simultaneously, not sequentially

Because credentialing takes 30–90 days per MCO, submitting applications to your two or three priority MCOs simultaneously — not one at a time — shaves months off your timeline to first client.

A common mistake: agencies wait for Molina's credentialing to complete before submitting to Superior. That approach means your first eligible client from Superior comes 3–6 months later than it had to.

Step 5 — Credential with all SDAs where you plan to serve clients

Being credentialed in the Dallas SDA does not give you network access in the adjacent Tarrant/Fort Worth SDA. If you plan to expand geographically, you must credential with the MCOs in each additional SDA separately — and you must have a physical service territory that covers those counties.

The Credentialing Process: What to Prepare

Before submitting to any MCO, you must have your TMHP Medicaid provider enrollment completed. MCOs require your Texas Medicaid provider ID as part of their credentialing packet — do not contact MCOs for credentialing before TMHP enrollment is finalized.

Standard credentialing documents (verify requirements with each MCO before submitting):

Texas Medicaid provider ID (from TMHP PEMS enrollment)
Current HCSSA license (from HHSC)
Proof of general liability insurance and professional liability insurance
Federal tax ID / W-9
NPI (National Provider Identifier) — if not already obtained, apply through nppes.cms.hhs.gov
Agency organizational documents (articles of incorporation or equivalent)
List of service locations / service areas the agency will cover
Background check documentation for principals and administrators (varies by MCO)

Some MCOs also require:

Sample service agreement or client care plan template
Written policies and procedures for care delivery
References from existing Medicaid or managed care relationships

What Happens After Credentialing

Being credentialed does not mean clients automatically appear. The STAR+PLUS referral pipeline works through MCO service coordinators: staff members employed by the MCO who manage each member's care plan and make referrals to home care providers.

Getting your first client depends on:

Being listed in the MCO's provider directory — confirm your listing is active and accurate after credentialing completes
Making outreach to MCO service coordinator teams — service coordinators are the gatekeepers; new providers who introduce themselves proactively get referrals faster than those who wait passively
Having EVV in place before the first authorized visit — STAR+PLUS services require EVV-compliant visit capture. All MCOs require EVV for authorized PAS visits as a condition of billing

For a full walkthrough of what happens between credentialing and your first client arrival, see our guide: How to Get Your First STAR+PLUS Client.

Key Change: January 2026 MMP Transition

Effective January 1, 2026, Texas ended its Medicare-Medicaid Plan (MMP) demonstration program. Former MMP members in Bexar, Dallas, El Paso, Harris, and Hidalgo counties were transitioned into standard STAR+PLUS MCO plans.

For providers already credentialed with STAR+PLUS MCOs: you likely received new member assignments from MCOs that absorbed MMP membership. Check with each MCO for updated plan codes and member ID formats if you experienced billing issues in early 2026.

For new providers: the MMP transition expanded STAR+PLUS membership in several high-population areas. The timing is favorable — these five counties are also where most Texas home care agencies concentrate their operations.

Software and MCO Billing: What to Set Up

Each MCO has its own billing portal and claim submission requirements. However, most Texas MCOs accept ANSI X12 5010 EDI claims routed through TMHP's claims processing infrastructure — so your billing workflow may route through TMHP even for MCO-covered services.

Beyond billing, STAR+PLUS MCO services require:

EVV-compliant visit capture for all PAS visits (HHAeXchange aggregator, required by HHSC)
Authorization tracking — each visit must fall within an active ISP (Individual Service Plan) authorization; software that tracks approved hours against visits rendered prevents billing denials
MCO-specific documentation — some MCOs require home care agencies to submit visit notes or service logs in specific formats

These are the operational setup requirements that distinguish STAR+PLUS billing from private pay. See our STAR+PLUS Billing Guide for a full walkthrough of the post-credentialing billing lifecycle.

STAR+PLUS MCO Credentialing Checklist

Before contacting MCOs:

TMHP PEMS enrollment complete — Texas Medicaid provider ID in hand
HCSSA license issued and current
NPI obtained for the agency entity
Liability insurance certificates ready (confirm MCO-specific coverage requirements)
Service delivery area confirmed (check current HHSC SDA map)
MCO list for your SDA identified and verified

Submitting credentialing applications:

Applications submitted to all MCOs in your SDA simultaneously (not sequentially)
TMHP provider ID included in every application
Tracked: date submitted, reference/case number per MCO
Policy and procedures documents attached (if required by MCO)

After approval:

Provider directory listing verified as active and accurate
MCO service coordinator team introduction completed
EVV system in place and tested before first authorized visit
Billing workflow confirmed (EDI / portal) with each MCO

Additional Resources

HHSC Enrollment Broker (member questions): 1-800-964-2777
HHSC STAR+PLUS Health Plans by Service Area: hhs.texas.gov (search "STAR+PLUS health plans by service area" — PDF updated by HHSC as contracts change)
MCO Provider Relations Contacts (HHSC): hhs.texas.gov/sites/default/files/documents/mco-provider-relations-contacts.pdf — revised January 2026
TMHP provider enrollment: tmhp.com/topics/provider-enrollment
HHAeXchange EVV provider onboarding: hhaexchange.com/resources/texas-evv

Related Guides

Texas HCSSA License Requirements 2026 — what to do before STAR+PLUS credentialing starts
How to Get Your First STAR+PLUS Client — the referral pipeline after credentialing
STAR+PLUS Billing for Texas Home Care Agencies — billing lifecycle after your first authorization
Texas EVV Requirements 2026 — EVV compliance for STAR+PLUS services
AtlasCare vs HHAeXchange — the difference between HHAeXchange as a required state EVV aggregator and as a commercial software product
Home Care Software for Small Texas Agencies — software built for STAR+PLUS operations

All MCO coverage information reflects publicly available HHSC and MCO sources as of July 2026. STAR+PLUS MCO service area assignments are governed by HHSC contracts that change at contract cycle renewal. Verify current SDA assignments with HHSC before submitting credentialing applications.