| (a) Enrollment in the Dual Demonstration is optional
for dual eligible individuals who live in the designated counties
and meet the following criteria:
(1) eligible for STAR+PLUS, including those eligible
for STAR+PLUS home and community-based waiver services;
(2) enrolled in Medicare Parts A, B, and D; and
(3) age 21 or older.
(b) The following dual eligible individuals cannot
participate in the Dual Demonstration:
(1) under age 21;
(2) individuals not eligible for STAR+PLUS, including
individuals:
(A) residing in an intermediate care facility for individuals
with an intellectual disability or related conditions;
(B) receiving services under the following Medicaid
1915(c) waivers:
(i) Home and Community-based Services (HCS);
(ii) Community Living Assistance and Support Services
(CLASS);
(iii) Texas Home Living (TxHmL); or
(iv) Deaf Blind with Multiple Disabilities (DBMD);
(C) not eligible for full Medicaid benefits; or
(D) in the conservatorship of the Texas Department
of Family and Protective Services.
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