Processing Time Frames Number of days eligibility staff must complete a particular action. General Equivalency Diploma (GED) A high school equivalency certificate issued after a person completes a State Board of Education-approved high school equivalency program. This process occurs without staff action. is not needed to process a redetermination. To be eligible for Texas Medicaid, you must be a resident of the state of Texas, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. The system generates an alert when the SSA Benefit amount on file does not match the information on the BENDEX file. Judicial Review A review of the fair hearing decision by a district court in Travis County to determine whether the agency decision is correct. Advanced Premium Tax Credit (APTC) The payment of a tax credit by the federal government, provided on an advanced basis or at tax filing time, to an eligible person enrolled in a qualified health plan (QHP) through the Marketplace. SeeCorrespondence,Print ModeandPrint Type. Second Chance Home An adult-supervised living arrangement that provides independent living services to teen mothers and their children. Case Visibility Type of YourTexasBenefits.com account given to an applicant who has been through Advanced Authentication so is granted a Case Visibility level account. Temporary Assistance for Needy Families (TANF) proration is based on the number of days between the begin date of eligibility and the end of the first month of eligibility. See Alternate Payee. CEAP replaced the Home Energy Assistance Program (HEAP). Essential Person The need for a particular member of a household to be in the home on a continuous basis because another member has a (certified) mental or physical impairment. Meal delivery services A non-profit establishment approved by Food and Nutrition Services (FNS) that prepares and delivers meals to elderly people or people who are housebound, have a physical handicap, or otherwise have a disability that prevents the person from adequately preparing all their meals. Medicaid Report (Form H1146) A form completed by a transitional Medicaid household in the fourth, seventh and tenth months of medical coverage to report earnings and household composition changes. Protective Payee Person selected to receive and manage the Temporary Assistance for Needy Families (TANF) benefit when the caretaker is not using the TANF payments for the children's benefit. intended to inflict emotional harm, including an act of emotional abuse. temporary quarters in another person's residence for 90 days or less. During this step, information from electronic data sources is automatically requested and a reasonable compatibility test is run. Texas Health & Human Services Commission. HHSC The Texas Health and Human Services Commission. Veterans can still call 800-273-8255 and Press 1 to reach the Crisis Line as well. The current Land Loans interest rate for Texas veterans is 6.95%. Unemployment Benefits Services allows individuals to submit new applications for unemployment benefits, submit payment requests, get claim and payment status information, change their benefit payment option, update their address or phone number, view IRS 1099-G information, and respond to work search log requests. Quality Control The functional area that supports the state's approach to quality control and allows authorized staff to enter sample selection criteria. Temporary Assistance for Needy Families (TANF) Certified Child A child who is included in a TANF grant. In most instances, Children's Medicaid relates to comprehensive policy for Type Programs (TPs) 43, 44, 45 and 48, unless specifically stated otherwise in a handbook section. is the guardian of a victim of a violent crime. Medicaid Members: Continuous Medicaid coverage will end on March 31, 2023. If you are just looking for support services and want to be contacted by programs, you need to create an account. Capital Goods The accumulated possessions (property, goods and products) used to produce income or other goods. You have unsaved changes that will be lost if you exit. These include construction of real property or lease, rental, license, sale, exchange, or other disposition of personal property, computer software, sound recordings, produced films, produced electricity, natural gas, or potable water. Expedited Service Special, faster processing of SNAP applicants who qualify for an emergency food allotment, for active duty military members and their dependents applying for medical coverage and for pregnant women applicants who qualify for current or ongoing medical coverage. A person may buy the contract alone or with the help of an employer. Unreimbursed Assistance Money paid in prior months in the form of public assistance under the Title IV-A program (that is, under the current Temporary Assistance for Needy Families [TANF] program or the former Aid to Families with Dependent Children [AFDC] program) that has not yet been recovered from collections that are applied to assigned arrears. Apply for TANF. Equity The fair market value of an item minus all money owed on it and the cost associated with its sale or transfer. For example, those with incomes over $200,000 had an average refund of $3,239 while those with incomes under $50,000 had an . State Online Query SOLQ allows states real-time online access to SSA's SSN verification service. Lock-in A status created by the Texas Health and Human Services Commission (HHSC) for certain people to help contain Medicaid costs, which allows additional review of high Medicaid users. Modified Adjusted Gross Income (MAGI) Household Composition The people whose income and needs are considered when determining eligibility for an applicant or recipient for certain Medical Programs based on tax status, tax relationships, living arrangement, and family relationships. Electronic Benefit Transfer (EBT) System A system HHSC staff with security access use to issue and replace Lone Star Cards. Changes in income identified through this process may impact eligibility for other programs. Third-Party Resource A source of payment of medical expenses other than the recipient or the Texas Health and Human Services Commission (HHSC). BENDEX (Beneficiary and Earnings Data Exchange) A computer tape match from the Social Security Administration that provides Social Security and Medicare information about Texas Health and Human Services Commission (HHSC) recipients. Trust Property held by one person for the benefit of another. The intention is to get cash by purposely discarding the product and returning the container for the deposit amount. Recognizable Needs The maximum needs amount allowed by the Texas Health and Human Services Commission (HHSC) when determining eligibility. Eligibility Determination Benefit Calculation (EDBC) uses the discovery and report dates to determine if a required report of change is reported timely. The program reimburses the policy holder for private health insurance payroll deductions for Medicaid-eligible persons when HHSC determines that it is cost-effective. Choices County Service Levels Counties designated by the Texas Workforce Commission (TWC) as Choices counties. Questionable Management A household has questionable management when reported basic expenses exceed reported net income and resources. In some interview modes, staff cannot advance to pages that have not yet been accessed as part of the driver flow. This includes legal parents and stepparents who are disqualified for one of the reasons listed inA-222, Who Is Not Included, No. Convertible bonds are countable resources. Once correspondence is printed, whether in batch or locally, the record of the printing is stored in History Correspondence functional area. Temporary Assistance for Needy Families (TANF) A child who meets the definition of deprivation and who lives with a relative who meets the relationship requirement. TWC has designated all counties in Texas as Choices counties, and the Local Workforce Development Boards (LWDBs), after coordination with the Texas Health and Human Services Commission (HHSC) state office, assign a service level designation for each county depending upon services available in that county. It is also referred to as spousal support. Legal Parents Mother, by having given birth to the child, by proof of adoption, legal document or court adjudication or father, by proof of adoption, legal document, court adjudication or his acknowledgement of paternity. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans. to claim a personal exemption deduction on the taxpayers federal income tax return for one or more applicants. Standard of Need Basic needs of Temporary Assistance for Needy Families (TANF) families represented by a figure predetermined by the state of Texas per the number of certified people in the group. SeeCascade Logic,Rebuild EDG, andRun EDBC. The persons may or may not be included in EDGs as certified members. When you're done, you can create an account to apply for benefits and send your info to support services to be contacted by programs. Legal Requirements The non- financial eligibility requirements for a Temporary Assistance for Needy Families(TANF) or Medicaid child, such as age, relationship, domicile, citizenship, Social Security number (SSN), and deprivation. Hearing The functional area where individual appeals are recorded and tracked. Individual Retirement Account (IRA) An account in which a person contributes an amount of money to supplement retirement income, regardless of their participation in a group retirement plan. Automated Renewal Process The first step in an administrative renewal. Cascade Logic A hierarchy of logic used to build Eligibility Determination Groups (EDGs) and evaluate eligibility for Texas Health and Human Services Commission (HHSC) programs and types of assistance. This process occurs without staff or specialist action. OPTION 2: Start an Application Online You can start the application process online. They are still required to be registered for work with the Texas Workforce Commission (TWC) and are mandatory participants if they do not meet work registration exemption requirements. The Workforce Innovation and Opportunity Act replaced the Workforce Investment Act of 1998. Treat an untimely reapplication the same as an initial application. Enter this for various situations including: Real Property Land and any improvements on it. See functional area. Advance Notice A notice of adverse action that expires 13 days after it is sent. (FPL). For example, a user can: User Guide A Texas Integrated Eligibility Redesign System (TIERS) help tool accessed by clicking on the Help icon in the upper right corner of TIERS pages. Home School A type of education in which children are taught by their parents, or someone acting in parental authority, at home, using a set curriculum. People with Application Visibility accounts may only apply for benefits and view and modify applications created under their username. SeePrint Mode. an applicant or a certified Temporary Assistance for Needy Families (TANF); Supplemental Nutrition Assistance Program (SNAP)or Medical Program household member or a member who would be certified but is disqualified; or. Review Temporary Assistance for Needy Families (TANF) evaluative interview. There are three types of benefit accounts: The person or their representative uses the Lone Star Card and a personal identification number (PIN) to access benefits in the account. Texas Health Steps A health care program of prevention, diagnosis, and treatment for Medicaid people. You must also be one of the following: Pregnant, or Additionally, a consumer assistance program can help you file your appeal. It compares an applicants statement of income against income provided by electronic data sources. Excess Payment A payment sent to a TANF recipient by the Office of the Attorney General (OAG). Contact the Texas Department of Insurance's Consumer Health Restored Benefits Full or partial months of benefits for a past month that are owed to a household due to an agency error. Transitional Medical Assistance (TMA) Medicaid coverage provided after denial of certain Eligibility Determination Groups (EDGs) because of new or increased earnings or new or increased spousal support income. Those who see several doctors each month and make questionable visits to hospital emergency rooms are limited to seeing one doctor or using one pharmacy for a minimum of six months. Seedefinitions of Eligibility Determination Benefit Calculation(EDBC), rebuild EDG,run EDBCandWrap Up. With this type of access, a person can view and change an application created under their username. These items include housing, utilities, deposits for housing or utilities, food, clothing, and incidentals. My career spans a number of years, industries, and roles in education, computer operations, process improvement, organization development, coaching, marketing, customer service, and corporate . Nonconvertible Bond A bond that cannot be converted to cash per program policy. Alternate Payee A person who receives the benefits for the EDG when people on the EDG are unable or ineligible to receive them. A molar pregnancy is considered a normal pregnancy that terminates early because of miscarriage or abortion. Illegally Present Alien A non-citizen living in the U.S. without proper approval from the U.S. Supplemental Nutrition Assistance Program (SNAP) and Temporary Assistance for Needy Families (TANF) Multiple people may be certified on a single EDG. Complete Action A data collection interview mode that sets up the driver flow for a complete review of all eligibility requirements in an ongoing case. Instructions include not writing their PIN on the card sleeve or anything they carry in their purse or wallet, not revealing their PIN to anyone, or letting anyone use their card. Left Navigation The list of functional areas that appears on the left side of the Texas Integrated Eligibility Redesign System (TIERS) page. Blocked Time periods that are designated for specific purposes. Low Income Home Energy Assistance Program (LIHEAP) The federal program that funds assistance for energy costs for low-income households. This results in: Administrative Review A desk review of the fair hearing record by a Texas Health and Human Services (HHS) attorney to determine if the hearing officer's decision is correct. Advanced Nurse Practitioner A registered nurse with additional training and certification in a specific area of medicine. Individually Identifiable Health Information Information that either identifies or could be used to identify a person that relates to the: Ineligible Alien A non-citizen whose alien status makes them ineligible for program benefits. Carryover Standby List Applicants from a previous day's standby list who have not been interviewed. Escrow An escrow account is an account a mortgage company sets up for the homeowner as part of their monthly mortgage payment. Permissible Purpose A federal requirement that allows staff to legally request a credit report from the Data Broker system for the sole purpose of determining eligibility. Practitioner A person who holds a license to practice medicine, including a physician (M.D. EDGs denied because of new or increased earnings will receive a maximum of 12 months of coverage. The: User-Generated Action generated directly by an individual's computer input. Annualize Averaging income over a 12-month period. All rights reserved. Citizenship and Immigration Services (USCIS). Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP) A demonstration project that outreaches elderly Supplemental Security Income (SSI) recipients who are not currently certified for SNAP. State and federal government websites often end in .gov. These facilities have limited power of attorney to obtain health care and educational services for the children under their care. Be receiving disability-related assistance or benefits. Data Broker An online portal used to obtain financial and other background information about applicants and recipients. perform initial self-screening to check for potential eligibility; view general benefit program information. Asylee A person granted asylum under Section 208 of the Immigration and Nationality Act (INA). Assignable Time periods that are available to be used to schedule appointments using the Scheduling functional area. The mortgage company uses money in the account to pay annual property taxes, home insurance premiums and sometimes homeowner association fees on behalf of the homeowner. This is also called a timely recertification or redetermination. This coverage is providedtemporarily while the Texas Health and Human Services Commission (HHSC) determines eligibility for regular Medicaid. Standard MAGI Income Disregard An income disregard equal to five percentage points of the Federal Poverty Income Limit (FPIL) for the applicable Modified Adjusted Gross Income (MAGI) household size. Helps people with daily living needs, caregivers, and people with mental health, drug or alcohol issues. If the total collection is less than $75, then the amount of the collection is sent to the person . Also covers medicines ordered by doctors and dentists. This gives a source of citizenship or alien status verification for certain Medical Programs. processeligibility determinations for multiple programs based on data provided through direct input and interfaces with other systems; assistusers in monitoring and managing workload; and. Apply online and make a Your Texas Benefitsaccount so you can start, save and go backto your online application at any time. See Permissible Purpose. According to the IRS, in 2015, "4.4 million ITIN filers paid over $5.5 billion in payroll and Medicare taxes and $23.6 billion in total taxes.". Electronic Data Sources (ELDS) Verification sources that are available electronically and presented to advisors in the Texas Integrated Eligibility Redesign System (TIERS) during Data Collection. TSAP provides a 36-month certification period. ), advanced nurse practitioner (A.N.P.) Functions of the clearinghouse include: Collateral Contact A person the advisor can contact to verify a person's information. Tuition or GI Bill Deduction A federal income tax deduction for people who paid qualified tuition fees to eligible post-secondary educational institutions for themselves, their spouse or their dependents. Pick or change your PIN. The following factors are considered in determining the alien's total income: Individual Development Accounts (IDAs) An account similar to a savings account that enables a person to save earned income for a qualifying purpose. Expunged Benefits Benefits that are removed from an EBT account by the issuer of the benefits. Or send an e-mail to: mail@dhs.state.tx.us. are received for a minimum of three months. Children's Medicaid Medical coverage for children whose family income is under the applicable income limit. They are not considered inmates of a public institution. Falsified Interview An interview with agency personnel at which time the individual does not report all current income or accurate circumstances. Certification Date The date that eligibility staff dispose the Eligibility Determination Group (EDG) to certify an applicant. Jury Duty Pay Taxable income received as compensation for jury duty. Temporary Assistance for Needy Families (TANF) a disqualified legal parent, second parent, or a non-parent relative certified as caretaker. Alien Sponsor A person who signed an affidavit of support (U.S. Effective Month The first month benefits can be affected based on the monthly cutoff date or applicable policy for advance and adequate notice of adverse action. Capital Gains A profit from the sale of property or an investment when the sale price is higher than the initial purchase price. past, present or future payment for the provision of health care to the person. Permissible purpose means the person whose credit report is requested must be: Staff who request credit information without permissible purpose are subject to fines, imprisonment, or both. Your unique Medicaid numberwill be displayed on the Texas Health and Human Services Commission's 'Your Texas Benefits' card. Seecase modeandinterview mode. A child who will not graduate until after the month of their 19th birthday is not considered a dependent child after the month of their 18th birthday. Birth Verification System (BVS) The inquiry system includes birth records of people born in Texas. Citizenship and Immigration Services (USCIS) The government agency that oversees lawful immigration to the U.S. Earned Income Tax Credits (EITC) Payments from the Internal Revenue Service (IRS) to people with gross monthly earnings at or below levels established by the IRS. First Cousin Once Removed A person who is either one's first cousin's child or the parent's first cousin. The code is used to request permission to use the Lone Star Card in a transaction. Tip Income Income earned along with wages paid by patrons to people employed in service-related occupations. Each reprint of an original has the same Correspondence ID as the original. Adults on the Eligibility Determination Group (EDG) must be legal parents (including a certified stepparent) to the dependent child. ITINs let people without SSNs pay taxes. Medicaid & CHIP in . You can still manage your benefits online.Once we review your application you will be able to see your information on Your Texas Benefits. The 5% down payment is subject to credit approval. A petition for judicial review must be filed by the appellant in a district court in Travis County within 30 calendar days after the date the administrative decision is issued. Electronic Benefit Transfer (EBT) Site Coordinator An HHSC employee designated to ensure local offices comply with guidelines on security and accountability operations. Underpayment Issuance of fewer benefits than an individual is entitled to receive. Explore health plans for you and your family, including short-term gap coverage and more. Third Party Person or organization outside the certified household. Reactivation Date The effective date to reinstate benefits for an Eligibility Determination Group (EDG). High School Diploma Certification issued by a state-accredited school to a student who successfully completes the curriculum requirements for secondary school as approved by the State Board of Education. Preschool Children Children who are under six. Self-Employment Income Earned or unearned income available from one's business, trade or profession rather than from an employer. See Taxpayer. The ATA allows access to the EBT system and may also be used for inquiry on EBT-related information, expedited Supplemental Nutrition Assistance Program (SNAP) benefit authorization, and account transaction updates to the EBT database. You can buy individual coverage through: An insurance company or health maintenance organization (HMO) A licensed health insurance agent who has a relationship with one or more insurance companies ; Healthcare.gov, the online federal health insurance Marketplace ; The Plan Finder on Healthcare.gov for individuals and small businesses It is used to apply cascade logic by reforming EDGs until establishing eligibility. Adjusting to the physical changes post-surgery can be difficult, and finding the right mastectomy bra is one of the most important steps in the process. Supplemental Nutrition Assistance Program (SNAP) applicants and people in these counties are still subject to E&T work registration requirements with TWC, but are exempt from E&T participation and are not subject to SNAP federal time limits. Blue Shield of Texas at 1-800-521-2227 or www.bcbstx.com or contact the Texas Department of Insurance, Consumer Protection at 1-800-252-3439 or www.tdi.texas.gov. Combat Pay Supplemental incentive payments for hazardous duty and special pay for duty subject to hostile fire or imminent danger. Reinstatement Process of providing Transitional Medical Assistance (TMA) to a household denied because of failure to return a complete Medicaid Report. You can find your EDG number on the TF0001 form we sent you saying that you can get SNAP benefits. Parent A person with either a natural, biological, adopted or stepchild. Annulment A court order declaring a marriage invalid. The person's must have no vested interest in the household's situation. Timely Supplemental Nutrition Assistance Program (SNAP) application filed by the 15th of the last month of certification. In many instances, batch processing occurs overnight, when Texas Health and Human Services Commission (HHSC) offices are closed and the system is not being heavily used throughout the state. Modified Adjusted Gross Income (MAGI) The rules used to determine financial eligibility for certain Medical Programs that are based on Internal Revenue Service (IRS) tax rules. To continue working, click on Stay on page. See, is a member of a Supplemental Nutrition Assistance Program [SNAP] Eligibility Determination Group [EDG] where a household member is under 18; or. Child Support A payment made from a biological or adoptive parent to a biological or adoptive child. This number may be found on the paperwork we gave you informing you that you are eligible for SNAP assistance. Other-Related Temporary Assistance for Needy Families/Medical Program (TANF/MP) Child An eligible child living with a relative other than the child's legal parent. Reasonable Compatibility The method of verification used for Medical Programs. reinstating Transitional Medicaid Assistance (TMA); and. Manage your case usingthe Your Texas Benefitsapp on your phone. Fixed Income Unearned income that does not vary. Helps pregnant, breastfeeding women and families with children younger than 5 buy healthy foods. These households may bypass the income and resources tests and are deemed financially eligible. The PAN is not related to the persons Texas Health and Human Services Commission (HHSC) case number. Electronic Benefit Transfer (EBT) Vendor A company that performs EBT-related services for the state of Texas. Recoupment Withholding part of a person's current benefit because of a previous overpayment. If File Clearance is not processed in Application Registration, the system will perform it in Data Collection. Electronic Benefit Transfer (EBT) Card A plastic card called the Lone Star Card issued to primary and secondary cardholders that allows the cardholders access to the benefits in the EBT system. These are benefits issued and accessed by EBT cards, card numbers and PINs, or by manual voucher and signature. Medicaid In Texas, there are 5 different types of Medicaid: STAR STAR+PLUS STAR Kids STAR Health Traditional Medicaid The type of Medicaid coverage you get depends on where you live and what kind of health issues you have.
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