Value-added Services

Coverage that covers more. It’s all part of my plan.

Superior delivers the quality health-care coverage that you deserve. Our commitment to your well-being extends far beyond the doctor’s office and into your everyday life. We are proud to offer extra services to keep our members healthy. As a member, you are able to get extra benefits and services in addition to your regular benefits. These are called Value-added Services (VAS)*. For questions or to learn how to get these benefits for you/your child, contact Member Services.

Value-added Services by Product

At Superior HealthPlan, members can get many great services in addition to their regular benefits. These are called Value-added Services*. From extra vision care to online resources and help getting a ride, Superior is proud to offer many extra services to help keep our members healthy. For questions, contact Member Services.

Value-added Services
Benefit	Description
24-Hour Nurse Advice Line	Access to Superior’s 24-hour nurse advice line. Call 1-800-783-5386 to contact a registered nurse for health questions 24 hours a day, 7 days a week.
Extra Help Getting a Ride	Rides for members to a Social Security Administration-approved physician for appointments requested by disability determination services. Rides must be pre-authorized and scheduled at least two (2) business days before the appointment. Travel reimbursement, ambulance and emergency transport are excluded. Members must be accompanied by a responsible adult. Excludes CHIP Perinate members. Rides for members to participate in Superior's Member Advisory Group (MAG) meetings. If the Superior member is a child, LAR and siblings may accompany member. The number of riders is limited to the space available in the transportation vehicle provided. The most cost-effective method of transportation will be offered. Travel reimbursement, ambulance, and emergency transport are excluded. CHIP Perinate members are excluded.
Extra Vision Benefits	Extra vision benefits, including a $150 retail allowance towards select prescription eyeglass frames, lenses or contact lenses not covered by CHIP, once per year. Coverage is for frames and lenses and does not cover additional features such as tints and coating. This allowance may not be used toward replacement eyewear or sunglasses. The member will be responsible for any charges exceeding $150. Excludes CHIP Perinate members.
Flu Shot	$25 rewards card for getting a flu shot on or before member’s second birthday. Members can earn this Value-added Service twice before child’s second birthday. Flu shot must be administered according to the CDC recommended child immunization schedule. CHIP Perinate pregnant members are excluded.
Healthy Play and Exercise Programs (Boys & Girls Clubs)	Up to a $60 allowance for CHIP members to use towards a one-time club membership for members 6-18 years old or a one-time sports registration fee for members 6-12 years old through Superior’s partnerships with select Boys & Girls Clubs (BGC). Activities may vary by location. Members are subject to the rules and regulations of the participating BGC they choose to join. There must be a contracted BGC within the area of the member’s residence in order to be eligible. Limit one per member, per year, not to exceed $60. Excludes BGC locations in Bexar, El Paso and Nueces service delivery areas and CHIP Perinate members.
Healthy Play and Exercise Programs (YMCA)	CHIP members ages birth to 17 years old and one adult family member may receive a six-month YMCA membership at locations included in the Texas State Alliance of YMCAs. Activities may vary by location. Members are subject to the rules and regulations of the participating YMCA they choose to join. 6-month membership must be consecutive and is available once per year. The family member must be an adult over 18 years of age. There must be a Texas State Alliance of YMCAs within the vicinity of the member’s residence to be eligible. CHIP Perinate members are not eligible. A family-based weight-management program, Healthy Weight and Your Child, for children ages 5-17 and with a BMI at or greater than the 85^th percentile. Program focuses on healthy eating, regular physical activity and behavior change to encourage a positive life-long lifestyle transformation. Families must commit to the 25-session, 4-month program prior to signing up. Excludes Lubbock, Nueces, RSA service delivery areas and CHIP Perinate members.
Help for Members with Asthma	Members enrolled in Asthma Care Management program are offered enhanced asthma care. This enhanced care provides support to help reduce asthma attacks. Participating members get an allergy-free mattress cover and pillowcase once every 2 years. Excludes CHIP Perinate members.
Home Visits for Members who are Pregnant	Members who are enrolled in Service Management for high-risk pregnancy may receive a home visit to help address their special symptoms. Excludes CHIP Perinate members.
Joy for All™	Eligible CHIP members in Bexar and El Paso service delivery areas who are enrolled in Case Management for at least 60 days can receive a Joy for All™ battery-operated plush companion pet. Value-added Service must be authorized by Superior’s Case Management upon member’s request. Limited to one per member lifetime. Excludes CHIP Perinate members.
My Health Pays^® Rewards Program	Superior’s rewards program offers financial, non-cash incentives that reward pregnant members for completing healthy activities related to their pregnancy and delivery. Rewards are loaded onto a prepaid card. Pregnant members can receive awards for completing these activities following confirmation of the visit: $100 for prenatal visit within the first trimester or 42 days of enrollment with Superior. $50 for postpartum visit within 7-84 days of delivery.
Nicotine Recovery Program	Online nicotine recovery program through a web and mobile app that offers a wide variety of resources to help members meet their nicotine recovery goals. This online resource provides ideas, information and education such as expert videos, interactive activities and stories of hope.
Online Mental Health Resources	Online mental health resources through a website and mobile app that offers a range of resources to support mental health and overall well-being. Members can also engage in personalized e-Learning programs to help address depression, anxiety, stress, chronic pain, substance use and sleep issues.
Online Social Services Resource Directory	Online social services resource directory for members through Superior to help locate community supports such as food and nutrition, housing, education and employment services.
Over-the-Counter (OTC) Items	Up to $25 every quarter, per member for commonly-used OTC items. This benefit covers items that do not need a prescription and are not otherwise covered by CHIP. Members will select from a catalog of items supplied by Superior. Members can place orders by using the vendor’s app, via the Superior member portal or by calling the vendor’s toll-free number. Unused balances are not carried over from quarter to quarter and members are allowed only one order per quarter. The total cost of items must be less than or equal to the program allowance in order for the items to be shipped to the member’s home. Products may not be returned. OTC items may be ordered for the member only. Excludes CHIP Perinate members.
Smoking Cessation	Telephonic outreach, education and support services offered to reduce the health risks associated with smoking during pregnancy through Superior’s Puff-Free Pregnancy program. Members receive an individualized cessation plan, health kit to support smoking abstinence and materials that enhance understanding and compliance. Pregnant members receive a smoking cessation support kit upon enrolling in the program and completing initial assessment. Excludes CHIP Perinate members.
Sports/School Physicals	Annual sports/school physicals for CHIP members. This Value-added Service is restricted to one physical per year with a maximum reimbursement of $35. The sports physical must be provided by a contracted Superior provider. Excludes CHIP Perinate members.
Start Smart^®For Your Baby Program	Superior’s award-winning program for pregnant CHIP members offers educational materials and supplies. Pregnant members can earn Value-added Services one time per pregnancy. Pregnant members can receive a diaper bag, starter supply of diapers and educational materials by: Completing a Notification of Pregnancy (NOP) form and; Attending a baby shower hosted by Superior. Pregnant CHIP members have access to a mobile app which offers pregnancy-related support and information according to their pregnancy stage.

At Superior HealthPlan, members can get many great services in addition to their regular benefits. These are called Value-added Services. For questions or to learn how to get these benefits, contact Member Services.

Value-added Services
Benefit	Description
24-Hour Nurse Advice Line	Access to Superior’s 24-hour nurse advice line. Call 1-800-783-5386 to contact a registered nurse for health questions 24 hours a day, 7 days a week.
My Health Pays^® Rewards Program	Superior’s rewards program offers financial, non-cash incentives that reward pregnant members for completing healthy activities related to their pregnancy and delivery. Rewards are loaded onto a prepaid card. Pregnant members can receive awards for completing these activities following confirmation of the visit: $100 for prenatal visit within the first trimester or 42 days of enrollment with Superior. $50 for postpartum visit within 7-84 days of delivery.
Nicotine Recovery Program	Online nicotine recovery program through a web and mobile app that offers a wide variety of resources to help members meet their nicotine recovery goals. This online resource provides ideas, information and education such as expert videos, interactive activities and stories of hope.
Online Mental Health Resources	Online mental health resources through a website and mobile app that offers a range of resources to support mental health and overall well-being. Members can also engage in personalized e-Learning programs to help address depression, anxiety, stress, chronic pain, substance use and sleep issues.
Online Social Services Resource Directory	Online social services resource directory for members through Superior to help locate community supports such as food and nutrition, housing, education and employment services.
Start Smart^® For Your Baby Program	Superior’s award-winning program for pregnant CHIP members offers educational materials and supplies. Pregnant members can earn Value-added Services one time per pregnancy. Pregnant members can receive a diaper bag, starter supply of diapers and educational materials by: Completing a Notification of Pregnancy (NOP) form and; Attending a baby shower hosted by Superior. Pregnant CHIP members have access to a mobile app which offers pregnancy-related support and information according to their pregnancy stage.

Value-added Services

Benefit	Description
24-Hour Nurse Advice Line	Access to Superior’s 24-hour nurse advice line. Call 1-800-783-5386 to contact a registered nurse for health questions 24 hours a day, 7 days a week.
Extra Help Getting a Ride	Rides for members to a Social Security Administration-approved physician for appointments requested by disability determination services. Rides are provided through Superior’s Medical Ride Program vendor, SafeRide. Rides must be pre-authorized and scheduled at least two (2) business days before the appointment. Travel reimbursement, ambulance and emergency transport are excluded. Members under the age of 18 must be accompanied by a responsible adult. Rides for members to participate in Superior's Member Advisory Group (MAG) meetings. If the Superior member is a child, LAR and siblings may accompany member. The number of riders is limited to the space available in the transportation vehicle provided. The most cost-effective method of transportation will be offered. Rides are provided through Superior’s Medical Ride Program vendor, SafeRide. Travel reimbursement, ambulance, and emergency transport are excluded.
Extra Vision Benefits	Extra vision benefits, including a $150 retail allowance towards select prescription eyeglass frames, lenses or contact lenses not covered by Medicaid, once every 2 years. Coverage is for frames and lenses and does not cover additional features such as tints and coating. This allowance may not be used toward replacement eyewear or sunglasses. The member will be responsible for any charges exceeding $150.
Healthy Play and Exercise Programs (Boys & Girls Clubs)	Up to a $60 allowance for STAR members to use towards a one-time club membership for members 6-18 years old or a one-time sports registration fee for members 6-12 years old through Superior’s partnerships with select Boys and Girls Clubs (BGC). Activities may vary by location. Members are subject to the rules and regulations of the participating BGC they choose to join. There must be a contracted BGC within the area of the member’s residence in order to be eligible. Limit one per member, per year, not to exceed $60. Excludes members in Bexar, El Paso and Nueces service delivery areas.
Healthy Play and Exercise Programs (YMCA)	STAR members, ages birth to 17 years old, and one adult family member for a six-month YMCA membership at locations included in the Texas State Alliance of YMCAs. Activities may vary by location. Members are subject to the rules and regulations of the participating YMCA they choose to join. 6-month membership must be consecutive and is available once per year. The family member must be an adult over 18 years of age. There must be a Texas State Alliance of YMCAs within the vicinity of the member’s residence to be eligible. Excludes members in the Hidalgo and MRSA Northeast service delivery areas. A family-based weight-management program, Healthy Weight and Your Child, is for children ages 5-17 and with a BMI at or greater than the 85^th percentile. Program focuses on healthy eating, regular physical activity and behavior change to encourage a positive life-long lifestyle transformation. Families must commit to the 25-session, 4-month program prior to signing up. Excludes Lubbock, Nueces, Hidalgo, Central, Northeast and West service delivery areas.
Help for Members with Asthma	Members enrolled in Asthma Care Management program are offered enhanced asthma care. This enhanced care provides support to help reduce asthma attacks. Participating members get an allergy-free mattress cover and pillowcase once every 2 years.
Joy for All™	Eligible STAR members in Bexar, El Paso and Central service delivery areas who are enrolled in Case Management for at least 60 days can receive a Joy for All™ battery-operated plush companion pet. Value-added Service must be authorized by Superior’s Case Management upon member’s request. Limited to one per member lifetime.
Nicotine Recovery Program	Online nicotine recovery program through a web and mobile app that offers a wide variety of resources to help members meet their nicotine recovery goals. This online resource provides ideas, information and education such as expert videos, interactive activities and stories of hope.
Online Mental Health Resources	Online mental health resources through a website and mobile app that offers a range of resources to support mental health and overall well-being. Members can also engage in personalized e-Learning programs to help address depression, anxiety, stress, chronic pain, substance use and sleep issues.
Online Social Services Resource Directory	Online social services resource directory for members through Superior to help locate community supports such as food and nutrition, housing, education and employment services.
Over-the-Counter (OTC) Items	Up to $25 every quarter, per member for commonly-used OTC items. This benefit covers items that do not need a prescription and are not otherwise covered by Medicaid. Members will select from a catalog of items supplied by Superior Members can place orders by using the vendor’s app, via the Superior member portal or by calling the vendor’s toll-free number. Unused balances are not carried over from quarter to quarter and members are allowed only one order per quarter. The total cost of items must be less than or equal to the program allowance in order for the items to be shipped to the member’s home. Products may not be returned. OTC items may be ordered for the member only.
Sports/School Physicals	Annual sports/school physicals for STAR members. This Value-added Service is restricted to one physical per year with a maximum reimbursement of $35. The sports physical must be provided by a contracted Superior provider.
Weight Watchers® Program	To promote weight management and improve health, nutrition and wellness, Superior will offer STAR members a 3-month limited subscription for Weight Watchers^® online program per year. Weight-loss support is also available with unlimited workshops both in-person and online. Members must be 18 and have a BMI value of 30 or higher. Members who are pregnant or have a diagnosis of bulimia nervosa are not eligible. Member must have online access.

More services for pregnant members:

Benefit	Description
Extra Dental Benefits	Extra dental benefits for pregnant members who are 21 and over. These members may receive up to $250 annually for dental services, including a routine exam and cleanings, x-rays and fluoride application.
Extra Help Getting a Ride	Transportation to a prenatal or postpartum visit when member has additional riders (limited to child/children) and no other options are available. Rides are provided through Superior’s Medical Ride Program vendor, SafeRide. Rides need to be pre-authorized and scheduled at least two (2) business days before the appointment. Member must bring car seat(s) for children who need one. Travel reimbursement, ambulance, and emergency transport are excluded.
Home Visits for Members who are Pregnant	Members who are pregnant, have elevated risk levels and who are enrolled in Service Management programs may receive a home visit to help address their special symptoms and have a healthy pregnancy.
In-Home OB Support	Superior connects pregnant STAR members in Obstetrician (OB) Care Management with in-home support and assistance from non-clinical community caregivers. These individuals can help identify resources, address unmet needs, schedule reminders about prenatal/postpartum visits and provide companionship and care for members. Limited to 48 hours of services before delivery and an additional 48 hours following delivery. Excludes members in Central, Northeast and West service delivery areas.
My Health Pays^®Rewards Program	Superior’s rewards program offers financial, non-cash incentives that reward pregnant members for completing healthy activities related to their pregnancy and delivery. Rewards are loaded onto a prepaid card. Pregnant members can receive awards for completing these activities following confirmation of the visit: $100 for prenatal visit within the first trimester or 42 days of enrollment with Superior. $50 for postpartum visit within 7-84 days of delivery.
Smoking Cessation	Telephonic outreach, education and support services offered to reduce the health risks associated with smoking during pregnancy through Superior’s Puff-Free Pregnancy program. Members receive an individualized cessation plan, health kit to support smoking abstinence and materials that enhance understanding and compliance. Pregnant members receive a smoking cessation support kit upon enrolling in the program and completing the initial assessment.
Start Smart^®For Your Baby Program	Superior’s award-winning program for pregnant women offers educational materials and supplies to STAR members. Pregnant women can earn Value-added Services one time per pregnancy. Pregnant members can receive a diaper bag, starter supply of diapers and educational materials by: Completing a Notification of Pregnancy (NOP) form, and; Attending a baby shower hosted by Superior. Pregnant STAR members have access to a mobile app which offers pregnancy-related support and information according to their pregnancy stage.

Value-added Services
Benefit	Description
a2A My Health Pays^® Rewards Program	The program offers financial, non-cash incentives that reward members for completing wellness visits, dental checkups and more for members ages 18 through 20 years old (see complete details below). Members can receive rewards for completing these activities following confirmation of the visit/vaccine/exam: $25 for completing a Texas Health Steps visit within 30 days of 18th birthday $30 for completing an initial dental checkup $30 for a sixth month dental checkup $20 for receiving a flu shot during flu season $20 for completing an annual well woman exam (for female members)
Care Grants	Small grants in the form of gift cards are available for members to be used for non-Medicaid covered benefits and other items up to $50 per member, per year.
Extra Vision Services	Eligible members are entitled to receive a $150 retail allowance for choice of upgraded eyeglass frames and lenses or contact lenses, not covered by Medicaid, once per year. The allowance does not cover additional features such as tints and coating. The member will be responsible for any charges exceeding $150.
Inpatient Follow-up Incentive Program	Members, ages 6 to 20, who have been hospitalized for a mental health or substance abuse episode are eligible to receive a $20 gift card and journal upon attending a follow-up appointment within 7 days of hospital discharge. Members are eligible to receive the gift 1 time per year.
Over-the-Counter (OTC) Items	Up to $30 every quarter for commonly-used over-the-counter (OTC) items. This benefit covers items that do not need a prescription and are not otherwise covered by Medicaid or available through DME. Members will select from a catalog of items supplied by Superior, up to the program specific dollar limit per quarter, per member. Items on the list include, but are not limited to household items, mobility supports, first aid supplies, personal care items, oral care, baby/children’s items and other miscellaneous OTC products. Members can place orders by using the vendor’s app, via the Superior member portal or by calling the vendor’s toll-free number. Unused balances are not carried over from quarter to quarter and members are allowed only 1 order per quarter. The total cost of items must be less than or equal to the program allowance in order for the items to be shipped to the member’s home. Products may not be returned. OTC items may be ordered for the member only.
Sports/School Physicals	Sports or school physicals for members ages 4 to 18 years old. Members may receive 1 sports/school physical per year with a maximum fee of $35. Any in-network provider can provide this service. Superior encourages members to use their PCP, but it is not required.

At Superior HealthPlan, members can get many great services in addition to their regular benefits. These are called Value-added Services*. For questions or to learn how to get these benefits for you/your child, call Member Services at 1-844-590-4883.

Value-added Services
Benefit	Description
Camp	Up to $150 each year for members to enroll in an approved camp. This Value-added Service is subject to need and must be authorized by Superior’s Service Coordination Department. Eligible members must identify the camp they would like to attend from an approved list and submit a request to the Service Coordination Department for approval 90 days prior to the camp start date. Participating members are subject to the rules and regulations set forth by the camp and its sponsor organization, as applicable. This Value-added Service is not to exceed $150 per member, per year. Allowance will be paid directly to the camp provider. Limited to non-MDCP members.
Careopolis™	An online "caring community" enabling members to engage friends and family as it relates to their healing or healthcare journey. Members create and manage private online accounts to enhance connections with friends and loved ones. Create a Careopolis.
Extra Vision Benefit	Extra vision benefits, including a $150 retail allowance towards select prescription eyeglass frames, lenses or contact lenses not covered by Medicaid, once every two years. Coverage is for frames and lenses and does not cover additional features such as tints and coating. This allowance may not be used towards replacement eyewear or sunglasses. The member will be responsible for any charges exceeding $150.
Guardianship Documentation	$15 reward for STAR Kids members ages 18 and older upon successful completion and submission of proper guardianship paperwork. This Value-added Service is a one-time benefit.
Help for Members with Asthma	Members enrolled in Asthma Disease Management are offered enhanced asthma care. This enhanced care provides support to help reduce asthma attacks. Participating members get an allergy-free mattress cover and pillowcase to help control asthma symptoms when enrolled in Asthma Disease Management for 60 continuous days. Members are eligible to receive this Value-added Service one time per year.
Home-delivered Meals	Members have access to 10 home-delivered prepared meals per year following discharge from an acute inpatient hospital stay. Home-delivered meals must be pre-authorized by Superior’s Service Coordination Department.
In-home Respite Services	Up to 8 hours per year of in-home respite services for members not in the Medically Dependent Children Program (MDCP). Members are eligible for respite services upon completion of the annual STAR Kids Screening and Assessment (SAI) and return of the signed Individual Service Plan (ISP). Members must be up to date with their Texas Health Steps checkups. Services must be pre-authorized by Superior’s Service Coordination Department. Excludes members in Nueces and Hidalgo service delivery areas. Up to 32 hours per year of in-home respite services for non-MDCP STAR Kids members in Nueces and Hidalgo service delivery areas. Members are eligible for respite services upon completion of the annual STAR Kids Screening and Assessment (SAI) and return of the signed Individual Service Plan (ISP). Members must be up to date with their Texas Health Steps checkups. Services must be pre-authorized by Superior’s Service Coordination Department.
Inpatient Follow-up Incentive Program	Members ages 6 to 20 who complete a follow-up doctor visit within 7 days of leaving the hospital for an inpatient behavioral health or substance abuse stay will receive a $20 rewards card and journal. Members are eligible to receive this Value-added Service 1 time per year.
Joy for All™	Eligible STAR Kids members enrolled in Behavioral Health Disease Management for at least 30 days can receive a Joy for All™ battery-operated plush companion pet. Value-added Service must be authorized by Superior’s Service Coordination Department. Limited to one per member lifetime.
My Health Pays® Rewards Program	Superior’s My Health Pays^® is a rewards program that offers financial, non-cash incentives for members. Members are limited to 1 reward per health-related activity per year. Rewards include: $20 for members who get their Texas Health Steps checkup within 90 days of joining Superior. Limited to 1 reward per member per year. $120 for members birth to 15 months that get all 6 Texas Health Steps checkups on schedule. $20 per checkup for members ages 3-20 years who get their annual Texas Health Steps checkup each year. $20 for female members 18-20 years who get their annual well woman exam. $10 for members 18-20 years who get their annual flu shot. There are also rewards for pregnant members for completing healthy activities related to their pregnancy and delivery. Pregnant members can receive rewards for completing these activities following confirmation of the visit: $20 for prenatal visit within the first trimester or 42 days of enrollment with Superior. $20 for 3^rd prenatal visit. $20 for 6^th prenatal visit. $20 for 9^th prenatal visit. $20 for postpartum visit within 7-84 days of delivery.
Nicotine Recovery Program	Online nicotine recovery program through a web and mobile app that offers a wide variety of resources to help members meet their nicotine recovery goals. This online resource provides ideas, information and education such as expert videos, interactive activities and stories of hope.
Online Mental Health Resources	Online mental health resources through a website and mobile app that offers a range of resources to support mental health and overall well-being. Members can also engage in personalized e-Learning programs to help address depression, anxiety, stress, chronic pain, substance use and sleep issues.
Online Social Services Resource Directory	Online social services resource directory for members through Superior to help locate community supports such as food and nutrition, housing, education and employment services.
Over-the-Counter (OTC) Items	Up to $30 every quarter per member for commonly-used OTC items. This benefit covers items that do not need a prescription and are not otherwise covered by Medicaid. Members will select from a catalog of items supplied by Superior. Members can place orders by using the vendor’s app, via the Superior member portal or by calling the vendor’s toll-free number. Unused balances are not carried over from quarter to quarter and members are allowed only 1 order per quarter. The total cost of items must be less than or equal to the allowance in order for the items to be shipped to the member’s home. Products may not be returned. OTC items may be ordered for the member only.
Social Determinants of Health Reward	$25 reward to non-MDCP members in MRSA West and Lubbock service delivery areas, after 90-days of continuous enrollment who: Complete their annual STAR Kids Screening and Assessment (SAI) timely, and; Return the signed Individual Service Plan (ISP-Narrative) and; Are up to date with their Texas Health Steps checkups. Members are eligible to receive this Value-added Service one time per year.
Sports/School Physicals	Annual sports/school physicals for children ages 4 through 18. This Value-added Service is restricted to one physical per calendar year with a maximum reimbursement of $35 paid to the provider. The sports/school physical must be provided by a contracted Superior provider.
Start Smart^®For Your Baby Program	Superior’s award-winning Start Smart^® program for pregnant women. This program offers educational materials and supplies for STAR Kids members. Pregnant women can earn Value-added Services one time per pregnancy. Pregnant members can receive a diaper bag, starter supply of diapers, and educational materials by: Completing a Notification of Pregnancy (NOP) form, and; Attending a baby shower hosted by Superior. Pregnant STAR Kids members also have access to a mobile app which offers pregnancy-related support and information according to their pregnancy stage.
Transition Assessment	$25 reward for members ages 18 to 20 who successfully complete their transition assessment on time. A transition assessment helps members as they prepare to age out of STAR Kids. Members are eligible to receive this Value-added Service one time.
Wellness Activity	$25 reward for STAR Kids members 11 to 16 years old who participate in a wellness activity, non-school sports program or successful participation in a community physical activity. Members in Nueces and Hidalgo service delivery areas are eligible to receive this Value-added Service one time per year.

Value-added Services
Benefit	Description
24-hour Emergency Response Services	Superior will provide round-the-clock emergency response services (ERS) for up to 6 months when a member is discharged from a hospital, resulting from an acute inpatient hospital stay, or from a nursing facility back into the community setting. This is a Value-added Service for all Superior STAR+PLUS non-HCBS Waiver and non-CFC members who do not reside in an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID). ERS must be preauthorized by Superior’s Service Coordination Department.
24-hour Nurse Advice Line	Access Superior’s 24-hour nurse advice line. Call 1-877-277-9772 to contact a registered nurse for health questions 24 hours a day, 7 days a week. This service is not available to members who reside in an ICF-IID residential home.
Behavioral Health Emergency Room (ER) Follow-up Incentive Program	$20 rewards card for members who go to a follow-up doctor visit within 7 days of a substance use disorder ER visit. Members are eligible to receive this Value-added Service 1 time per year. Excludes STAR+PLUS members who are dual-eligible.
Careopolis™	An online "caring community" enabling members to engage friends and family as it relates to their healing or healthcare journey. Members create and manage private online accounts to enhance connections with friends and loved ones. Create a Careopolis.
Cervical Cancer Screening Incentive Program	$50 reward for current Superior female STAR+PLUS members ages 18 to 64, at average risk for cervical cancer, who complete a recommended cervical cancer screening. Limited to one $50 reward per year. Excludes STAR+PLUS members who are dual-eligible.
Diabetes Testing Incentive Program	$20 reward every 6 months for STAR+PLUS members with diabetes who do not reside in an ICF-IID residential home or nursing facility. Members must complete a blood sugar test (HbA1c) with a result less than 8 to receive rewards. This Value-added Service is limited to two $20 rewards per year. Excludes STAR+PLUS members who are dual-eligible.
Extra Dental Benefits	Non-dual, non-HCBS Waiver STAR+PLUS members in Dallas and Nueces may receive $500 annually towards exams and cleanings, x-rays, fluoride treatments or a simple extraction. Non-dual, non-HCBS Waiver STAR+PLUS members may receive $250 annually in dental services towards exams, x-rays, cleanings and fluoride treatments. Excludes members in Dallas and Nueces.
Extra Foot Doctor (Podiatry) Services	Eligible members can access up to one pair of diabetic shoes and/or one pair of foot insoles per year. Members must have a diagnosis of diabetes and at least one of the following: amputation of all or part of either foot, foot deformity, poor blood circulation, history of ulcers, history of pre-ulcerative calluses and/or, diabetic neuropathy with evidence of callus formation. This Value-added Service must be authorized and medically necessary. Excludes STAR+PLUS members who are dual-eligible.
Extra Help Getting a Ride	Ride assistance for members when Medicaid transportation is not available. Rides must be pre-authorized and scheduled at least two (2) business days before the appointment. Travel must be within the service delivery area and not to exceed 30 miles, one way. Travel reimbursement, ambulance and emergency transport are excluded. This includes: Rides to behavioral health community supports and services. Rides are provided on a case-by-case basis to non-dual STAR+PLUS members who do not reside in an ICF-IID residential home. This Value-added Service must receive prior authorization from Service Coordination/Care Management. Rides for STAR+PLUS members enrolled in health or safety education classes including diabetes self-management education and “A Matter of Balance” fall prevention classes. “A Matter of Balance” transportation limited to 8 roundtrip rides per lifetime. Educational classes limited to 2 roundtrip rides per year. Service Coordination/Care Management must approve utilization. Excludes STAR+PLUS members who are dual-eligible. Rides for STAR+PLUS dual-eligible members enrolled in “A Matter of Balance” fall prevention classes. “A Matter of Balance” transportation limited to 8 roundtrip rides per lifetime. This is for members who do not reside in a nursing facility. Service Coordination/Care Management must approve utilization. Rides for members enrolled in H-E-B nutritional counseling program. Rides are provided to non-dual STAR+PLUS members in Bexar, Hidalgo, Lubbock and Nueces service delivery areas who do not reside in a nursing facility. Nutritional counseling rides limited to 4 roundtrip rides per year. Service Coordination/Care Management must approve utilization. Rides for members accessing their dental or vision Value-added Service benefits. Limited to 2 roundtrip rides per year. Service Coordination/Care Management must approve utilization. Excludes STAR+PLUS members who are dual-eligible. Rides for members to a local benefits office. Benefits office visit rides limited to 1 roundtrip ride per year. Service Coordination/Care Management must approve utilization. Excludes STAR+PLUS members who are dual-eligible.
Extra Vision Services	Members are eligible to receive a $150 allowance per year towards a choice of upgraded eyeglass frames and lenses or contact lenses not covered by Medicaid. This allowance may not be used towards replacement eyewear or sunglasses. Coverage is for new frames and lenses and does not cover additional features such as tints and coating. The member will be responsible for any Medicaid non-covered vision charges over $150. Excludes STAR+PLUS members who are dual-eligible.
Fall Prevention Program Graduation Incentive	STAR+PLUS members not residing in an ICF-IID residential home or nursing facility can earn a $50 rewards card upon attending and graduating from an 8-week fall prevention program called “A Matter of Balance.” Members will learn to control their fear of falling, set goals to increase exercise to promote strength and balance and change their environment to reduce fall risk factors. The program may be offered by Superior or a community support service agency. Participating members are subject to the rules and regulations set forth by the program and its sponsor organization, as applicable. Members must provide verification of graduation to be eligible. Limited to 1 per member lifetime.
GED Support Services	Superior supports members with an IDD diagnosis in achieving goals that improve their quality of life by offering access to resources to help pass the General Educational Development (GED) test. Superior will assist all interested members by providing GED preparatory materials and identifying available testing centers close to the member. Members must be enrolled with Superior for at least 60 days to be eligible. This Value-added Service is limited to 1 per member lifetime.
Home-delivered Meals	Non-HCBS Waiver members who do not reside in an ICF-IID residential home have access to 10 home-delivered prepared meals per year following discharge from an acute inpatient hospital stay or from a nursing facility back into the community setting. Home-delivered meals must be preauthorized by Superior’s Service Coordination Department.
In-home Respite Care	Non-HCBS Waiver members with certain complex and chronic conditions will have access to up to 8 hours of in-home respite services each year. This is available to all STAR+PLUS non-HCBS waiver members who do not reside in an ICF-IID residential home. Services must be preauthorized by Superior’s Service Coordination Department.
Inpatient Follow-up Incentive Program	$20 rewards card for members who have been admitted to an inpatient psychiatric facility for a mental health or substance abuse diagnosis and go to a follow up doctor visit within 7 days of leaving the hospital. Members are eligible to receive this Value-added Service 1 time per year. Excludes STAR+PLUS members who are dual-eligible.
Joy for All™	Eligible STAR+PLUS non-dual members can receive a Joy for All™ battery-operated plush companion pet. Members must: Be enrolled in MIND at Home or Cognitive Adaptation Therapy Case Management for 60 days, and Have a diagnosis of dementia or Alzheimer’s. Value-added Service must be authorized by Superior’s Service Coordination Department. Limited to one per member lifetime.
My Health Pays^® Rewards Program	Superior’s My Health Pays^® is a rewards program that offers financial, non-cash incentives that reward pregnant members for completing healthy activities related to their pregnancy and delivery. Excludes STAR+PLUS members who are dual-eligible. Pregnant members can receive rewards for completing these activities following confirmation of the visit: $100 for prenatal visit within the first trimester or 42 days of enrollment with Superior. $50 for postpartum visit within 7-84 days of delivery.
Nicotine Recovery Program	Online nicotine recovery program through a web and mobile app that offers a wide variety of resources to help members meet their nicotine recovery goals. This online resource provides ideas, information and education such as expert videos, interactive activities and stories of hope.
Nutritional Services	Non-dual STAR+PLUS members who do not reside in an ICF-IID residential home or nursing facility have access to up to 4 nutritional visits per year with a registered dietitian. This is available to members who have a BMI value of 32 or higher, an ER or hospital discharge in the last 6 months and a diagnosis of diabetes, cardiovascular disease or COPD. Participating members are subject to the rules and regulations set forth by the program and its sponsor organization, as applicable.
Online Mental Health Resources	Online mental health resources through a website and mobile app that offers a range of resources to support mental health and overall well-being. Members can also engage in personalized e-Learning programs to help address depression, anxiety, stress, chronic pain, substance use and sleep issues.
Online Social Services Resource Directory	Online social services resource directory for members through Superior to help locate community supports such as food and nutrition, housing, education and employment services.
Over-the-Counter (OTC) Items	STAR+PLUS members who do not reside in an ICF-IID residential home can get up to $30 every quarter, per member for commonly-used OTC items. This benefit covers items that do not need a prescription and are not otherwise covered by Medicaid. Members will select from a catalog of items supplied by Superior. Members can place orders by using the vendor’s app, via the Superior member portal or by calling the vendor’s toll-free number. Unused balances are not carried over from quarter to quarter and members are allowed only 1 order per quarter. The total cost of items must be less than or equal to the program allowance in order for the items to be shipped to the member’s home. Products may not be returned. OTC items may be ordered for the member only. Excludes STAR+PLUS members who are dual-eligible.
Remote Medication Monitoring Services	Non-HCBS Waiver members who do not reside in an ICF-IID residential home and are enrolled in Care Management can receive up to 6 months of remote medication monitoring services. Members must have a recent inpatient discharge and a diagnosis of diabetes, asthma, COPD or heart failure (CHF). This Value-added Service is not offered by a telehealth provider. Care Management must approve utilization. Excludes STAR+PLUS members who are dual-eligible.
Short-Term Phone Assistance	A Connections Plus pre-programmed phone with unlimited talk and text is available for members who do not qualify for a SafeLink phone and are enrolled in Care Management. Superior Service Coordination must approve requests for Connections Plus.
Start Smart^® For Your Baby Program	Superior’s award-winning Start Smart^® program for pregnant women. This program offers educational materials and supplies for STAR+PLUS members. Pregnant members can receive a diaper bag, starter supply of diapers, and educational materials by: Completing a Notification of Pregnancy (NOP) form and; Attending a baby shower hosted by Superior. Pregnant STAR+PLUS members have access to a mobile app which offers pregnancy-related support and information according to their pregnancy stage. Pregnant women can earn Value-added Services one time per pregnancy. Excludes STAR+PLUS members who are dual-eligible.
Trualta	Online resource for eligible members and their caregivers to help with entering or discharging from facilities. Specifically, members that are discharging from or at risk of entering a nursing facility (NF), assisted living facility (ALF), adult foster care (AFC), ICF/IID facilities, Institutions for Mental Disease (IMD, state hospitals), inpatient psychiatric facility (IPF) and are dependent on caregivers for their activities of daily living. Members must be diagnosed with IDD, schizophrenia, schizoaffective, bipolar, major depression, Alzheimer’s, dementia, COPD, diabetes or hypertension. Trualta is a personalized, skills-based training platform for family members caring for aging loved ones living at home. Members must be referred by Service Coordination or Case Management. Excludes STAR+PLUS members who are dual-eligible.
Weight Watchers^® Program	To promote weight management and improve health, nutrition and wellness, Superior will offer STAR+PLUS members a 3-month subscription for Weight Watchers^® online program. Members must have a BMI value of 30 or higher and a primary diagnosis of diabetes, prediabetes, hypertension or heart disease to qualify. BMI and diagnosis must be verified to be eligible. Members who are pregnant or have a diagnosis of bulimia nervosa are not eligible. Member must have online access. Excludes STAR+PLUS members who are dual-eligible.

Value-added Services
Benefit	Description
24-hour Nurse Advice Line	Access Superior’s 24-hour nurse advice line. Call 1-877-277-9772 to contact a registered nurse for health questions 24 hours a day, 7 days a week.
Careopolis™	An online "caring community" enabling members to engage friends and family as it relates to their healing or healthcare journey. Members create and manage private online accounts to enhance connections with friends and loved ones. Create a Careopolis.
GED Support Services	Superior supports members with an IDD diagnosis in achieving goals that improve their quality of life by offering access to resources to help pass the General Educational Development (GED) test. Superior will assist interested members by providing GED preparatory materials and identifying available testing centers close to the member. Members must be enrolled with Superior for at least 60 days to be eligible. This Value-added Service is limited to 1 per member lifetime.
Nicotine Recovery Program	Online nicotine recovery program through a web and mobile app that offers a wide variety of resources to help members meet their nicotine recovery goals. This online resource provides ideas, information and education such as expert videos, interactive activities and stories of hope.
Nursing Facility Welcome Kit	Welcome kit for all dual and non-dual members who are entering a nursing facility for the first time. Welcome kits will include personal items such as a shower cap, blanket, non-slip socks, coffee cup, water bottle, lighted magnifying glass, tote bag, Sudoku game and crossword puzzles. Members will receive the welcome kit within 30 days of entering the facility.
Online Mental Health Resources	Online mental health resources through a website and mobile app that offers a range of resources to support mental health and overall well-being. Members can also engage in personalized e-Learning programs to help address depression, anxiety, stress, chronic pain, substance use and sleep issues.
Online Social Services Resource Directory	Online social services resource directory for members through Superior to help locate community supports such as food and nutrition, housing, education and employment services.

The Value-added Services listed below do not apply to dual-eligible members.

Benefit	Description
Cervical Cancer Screening Incentive Program	$50 reward for female STAR+PLUS members ages 21-64, at average risk for cervical cancer, who complete a recommended cervical cancer screening. Limited to one $50 reward per year. Excludes STAR+PLUS members who are dual-eligible.
Enhanced Dental Benefits	Non-dual, non-HCBS Waiver STAR+PLUS members in Dallas and Nueces may receive $500 annually towards exams and cleanings, x-rays, fluoride treatments or a simple extraction.
Extra Dental Benefits	Non-dual, non-HCBS Waiver STAR+PLUS members may receive $250 annually in dental services towards exams, x-rays, cleanings and fluoride treatments. Excludes members in Dallas and Nueces.
Extra Help Getting a Ride	Rides for members accessing their dental or vision Value-added Service benefits. VAS visits are limited to 2 roundtrip rides per year. Rides must be pre-authorized and scheduled at least two (2) business days before the appointment. Travel must be within the service delivery area and not to exceed 30 miles, one way. Travel reimbursement, ambulance and emergency transport are excluded. Service Coordination/Care Management must approve utilization. Excludes STAR+PLUS members who are dual-eligible.
Extra Vision Services	Members are eligible to receive a $150 allowance once per year towards a choice of upgraded eyeglass frames and lenses or contact lenses not covered by Medicaid. Coverage is for new frames and lenses and does not cover additional features such as tints and coating. This allowance may not be used towards replacement eyewear or sunglasses. The member will be responsible for any Medicaid non-covered vision charges exceeding $150.
Trualta	Online resource for eligible members and their caregivers to help with entering or discharging from facilities. Specifically, members that are discharging from or at risk of entering a nursing facility (NF), assisted living facility (ALF), adult foster care (AFC), Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID), Institutions for Mental Disease (IMD, state hospitals), inpatient psychiatric facility (IPF) and are dependent on caregivers for their activities of daily living. Members must be diagnosed with IDD, schizophrenia, schizoaffective, bipolar, major depression, Alzheimer’s, dementia, COPD, diabetes or hypertension. Trualta is a personalized, skills-based training platform for family members caring for aging loved ones living at home. Members must be referred by Service Coordination or Case Management. Excludes STAR+PLUS members who are dual-eligible.

* Value-added Services may have restrictions and limitations. These services are effective 9/1/22-8/31/23.

Value-added Services