Dual Eligible Members

Clients who are enrolled in both Medicaid and Medicare are "dual eligible" Members. Dual eligible clients must choose a STAR+PLUS health plan, but do not choose a PCP because they receive acute care services from their Medicare providers. The STAR+PLUS health plan only provides Medicaid long term support services for dual eligible Members. Prescription drugs are covered under Medicare Part D for dual eligible members.

To find out who is responsible for paying claims for dual eligible Members, select a service below.

Claims Responsibility for Acute Care Services
Select the Member's coverage, then identify the appropriate payer for acute care services in the "Acute Care Payer" column.

Member's CoverageAcute Care Payer
Cigna-HealthSpring STAR+PLUS Only Cigna-HealthSpring STAR+PLUS
Cigna-HealthSpring STAR+PLUS with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Other STAR+PLUS Health Plan with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Cigna-HealthSpring STAR+PLUS with Medicare or other Medicare Health Plan Medicare or Member's Medicare Health Plan

Claims Responsibility for Long Term Support Services
Select the Member's coverage, then identify the appropriate payer for long term support services in the "Long Term Support Services Payer" column.

Member's CoverageLong Term Support Services Payer
Cigna-HealthSpring STAR+PLUS Only Cigna-HealthSpring STAR+PLUS
Cigna-HealthSpring STAR+PLUS with HealthSpring Medicare Cigna-HealthSpring STAR+PLUS
Other STAR+PLUS Health Plan with HealthSpring Medicare Member's STAR+PLUS Health Plan
Cigna-HealthSpring STAR+PLUS with Medicare or other Medicare Health Plan Cigna-HealthSpring STAR+PLUS

Claims Responsibility for Pharmacy Services
Select the Member's coverage, then identify the appropriate payer for pharmacy services in the "Pharmacy Payer" column.

Member's CoveragePharmacy Payer
Cigna-HealthSpring STAR+PLUS Only Vendor Drug Program
Cigna-HealthSpring STAR+PLUS with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Other STAR+PLUS Health Plan with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Cigna-HealthSpring STAR+PLUS with Medicare or other Medicare Health Plan Medicare or Member's Medicare Health Plan

Claims Responsibility for Vision Services
Select the Member's coverage, then identify the appropriate payer for routine vision services in the "Vision Care Payer" column.

Member's CoverageVision Care Payer
Cigna-HealthSpring STAR+PLUS Only Cigna-HealthSpring STAR+PLUS
(Value Added Services are paid through Superior Vision Managed Vision)
Cigna-HealthSpring STAR+PLUS with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Other STAR+PLUS Health Plan with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Cigna-HealthSpring STAR+PLUS with Medicare or other Medicare Health Plan Medicare or Member's Medicare Health Plan

Claims Responsibility for Dental Services
Select the Member's coverage, then identify the appropriate payer for dental care services in the "Dental Care Payer" column.

Member's CoverageDental Care Payer
Cigna-HealthSpring STAR+PLUS Only Cigna-HealthSpring STAR+PLUS
(Value Added Services are paid through DentaQuest, subject to benefit limits.)
Cigna-HealthSpring STAR+PLUS with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Other STAR+PLUS Health Plan with Cigna-HealthSpring Medicare Cigna-HealthSpring Medicare
Cigna-HealthSpring STAR+PLUS with Medicare or other Medicare Health Plan Medicare or Member's Medicare Health Plan