Disqualified Person Someone who is normally considered a participating member of a household but whose needs are not considered because they failed to meet or comply with a program requirement. This coverage is providedtemporarily while the Texas Health and Human Services Commission (HHSC) determines eligibility for regular Medicaid. Child A child is an adoptive, step, or natural child who is under 19. Recognizable Needs The maximum needs amount allowed by the Texas Health and Human Services Commission (HHSC) when determining eligibility. Manage your case usingthe Your Texas Benefitsapp on your phone. The house parent assumes responsibility and acts in lieu of the parent in meeting the childrens ongoing needs. allthe EDGs in a case are denied (Ongoing). the adult provides more than half of the minor's total support (housing is not considered as support); the adult states that the adult has parental control of the minor; or. Your total base period wages are at least 37 times your weekly benefit amount. Second Chance Home An adult-supervised living arrangement that provides independent living services to teen mothers and their children. These occupations include beauticians, waiters, valets and food delivery staff. Combat Pay Supplemental incentive payments for hazardous duty and special pay for duty subject to hostile fire or imminent danger. Your case number is a 10-digit number that HHSC uses to bundle and process benefits you receive through their agency. Common Law Marriage Relationship in which the two parties both 18 years or older: A minor child in Texas cannot legally enter a common law marriage unless the claim of common law marriage began before Sept. 1, 1997. Newborn Child A child receiving Type Program (TP) 45, Medical Assistance for Newborn Children, because the child's mother was eligible for and received Medicaid coverage at time of the child's birth or whose mother was eligible for and received Medicaid coverage retroactively for the time of the child's birth. provides health coverage to eligible low-income adults, children, pregnant women, and people who are older or who have disabilities. Deferred Adjudication A type of probation where the decision for a conviction is postponed until the end of the probationary period. Medicaid & CHIP in . Payments: Indian Tribal Household A household in which at least one household member is recognized as a tribal member by any Indian tribe. Crime Victim's Compensation Payments from the funds authorized by state legislation to assist a person who: The payments are distributed by the Office of the Attorney General (OAG) in monthly payments or in a lump-sum payment. Your Medicaid number also known as a recipient number or individual number is a 9-digit number than can be found on the 'Your Texas Benefits' card. The Medicaid phone number is 800-252-8263, 2-1-1, or 1-877-541-2190; you can speak with a representative who will assist you in obtaining the answers and services you require. Modified Adjusted Gross Income (MAGI) Individual Income The sum of certain income received by aperson in a MAGI household composition, from which certain expenses are subtracted. Trade Adjustment Assistance Act Program (TAAP) A program for workers displaced by foreign workers. Educator Expenses Expenses for which educators, kindergarten through grade 12 teachers, counselors, principals or aides can receive a federal income tax deduction. 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. Customs and Border Protection is responsible for border security functions. ITINs let people without SSNs pay taxes. 1-877-541-7905. Adverse Action Any HHSC action resulting in denial, suspension, reduction or termination of assistance. All system-generated correspondence is scheduled for batch printing although it can be retrieved from Pending Correspondence and printed locally. Unemployment benefits range from $69 per week to $521 per week. Independent Child A child who does not live with a parent and who is: Independent Living Payments Payments from Title IV-E funds that are distributed by Child Protective Services to certain people when they leave foster care. Health Insurance Premium Payment (HIPP) A reimbursement program administered by the Texas Health and Human Services Commissions (HHSCs) Third-Party Resource Unit, which pays for the cost of premiums, coinsurance, and deductibles. to file a federal income tax return for the taxable year in which Medical Program eligibility is requested; if married, to file a joint federal income tax return for the taxable year in which Medical Program eligibility is requested; that no other taxpayer will be able to claim the person or the couple as a tax dependent on a federal income tax return for the taxable year in which Medical Program eligibility is requested; or. 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. Nonliquid Resources Resources such as vehicles, buildings, land, or certain other property that are considered countable, except as explained in the vehicles portion of resource policy or unless the resource is specifically exempted. Advanced Nurse Practitioner A registered nurse with additional training and certification in a specific area of medicine. A boarder can receive Supplemental Nutrition Assistance Program (SNAP) benefits only with the household where they board. To learn more about Texas Works, please visit Texas Workforce Commission website. Non-Secure Facility A publicly operated community residence that serves no more than 16 residents, such as a county emergency shelter or non-public group or foster home. Electronic Benefit Transfer (EBT) Representative A primary cardholder other than the case name. Manual Voucher Transaction A paper-based debit transaction completed by the food retailer when the automated Electronic Benefit Transfer (EBT) system is down or unavailable. Qualified Hospital (QH) A Medicaid provider that notifies HHSC of its intent to make presumptive eligibility determinations and agrees to make PE determinations per HHSC policies and procedures. in canning, packing, ginning, seed conditioning or related research or processing operations. Combat Zone The geographic area or country to which a military member is deployed for combat. Royalty A payment to a person for permitting another to use or market property. Secondary Cardholder A person designated by the primary cardholder as eligible to access the person's Electronic Benefit Transfer (EBT) account with a second EBT card and personal identification number (PIN). *Important: Don't write your PIN on your Lone Star Card. Qualified entities that are also Breast and Cervical Cancer Services (BCCS) contractors with the DSHS may make presumptive eligibility determinations for Medicaid for Breast and Cervical Cancer (MBCC) applicants. Cardholders Persons authorized to use the Lone Star Card to access benefits in the household's Electronic Benefit Transfer (EBT) account(s). 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. This is a toll-free number (2-1-1 or 877-541-7905) that allows people to inquire on the status of their case, their next appointment time, or to determine if Texas Health and Human Services Commission (HHSC) received information. The canceled amount is included as countable income on federal income tax returns. Fluctuating Income Income in which the amount varies because of an increase or decrease in hours worked, rate of pay, or inclusion of a bonus. Individual Number A unique nine-digit number that identifies any person known to the Texas Integrated Eligibility Redesign System (TIERS). This may be a TANF representative payee or protective payee or a SNAP authorized representative for a resident of a Drug and Alcohol Treatment Center or Group Living Arrangement. 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. There are two types of cardholders: primary cardholders and secondary cardholders. 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. Before sharing sensitive information, make sure youre on an official government site. Intentional Program Violation (IPV) The act of intentionally making a false or misleading statement, or misrepresenting, concealing or withholding facts for the purpose of receiving assistance under the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) or Medicaid program. Application Visibility Type of YourTexasBenefits.com account given to an applicant who has selected not to go through Advanced Authentication. Unearned Income Payments received without performing work-related activities, including benefits from other programs. For example, if you are receiving disability benefits through the Social Security Administration, then your Social Security number is the individual number used by the state of Texas. Business day excludes Saturday, Sunday, and holidays designated by a federal or state agency. The certificate is a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), and is sent to denied recipients by the Texas Department of State Health Services (DSHS). Even if designed to serve up to 16 residents, the following facilities are not considered publicly operated community residences: Qualified Entity (QE) A Medicaid provider (in most instances but can also be an organization such as a school or clinic) that notifies HHSC of its election to make presumptive eligibility determinations and agrees to make presumptive eligibility determinations for pregnant women only, per HHSC policies and procedures. Good Cause A term used to indicate that a person has an acceptable reason for not complying with a program requirement. SeeInterview ModeandCase Mode. 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. 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. Also known as a pre-need plan or prepaid funeral agreement. a correctional or holding facility for people who: have been arrested or detained pending disposition of charges; or. This process occurs through a mass update and does not require action. Residents of a publicly operated community residence are potentially eligible for Temporary Assistance for Needy Families (TANF) and Medicaid. 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. Apply for TANF. It compares an applicants statement of income against income provided by electronic data sources. some eligible members receive TANF or RCA, and all other eligible members receive Supplemental Security Income (SSI), including SSI essential persons. Absent Parent A child's parent who is not living in the home. Welfare-to-Work A federal program designed to support state and local efforts to move hard-to-employ Temporary Assistance for Needy Families (TANF) recipients into unsubsidized jobs and promote their self-sufficiency. The code is used to request permission to use the Lone Star Card in a transaction. Helps people with daily living needs, caregivers, and people with mental health, drug or alcohol issues. Advanced Authentication Personal security questions generated by third-party software to perform authentication of an applicant's identity before granting the person an account through YourTexasBenefits.com (link is external) with Case Visibility. Self-Employed Health Insurance A federal income tax deduction for self-employed people paying for health insurance for themselves, their spouse, their tax dependents, or their child(ren) under 27. Untimely SNAP application filed after the 15th of the last certification month. A household member is a TANF or SSI recipient if the person is approved for TANF or SSI but the benefit: A SNAP household that includes members authorized to receive TANF non-cash services and whose household gross income is less than 165 percent of the Federal Poverty Income Limit (FPIL) for its size and meets the resource criteria. Convertible bonds are countable resources. You can check the status of your application or you can start a new one. Copayment Payment made directly to a provider according to a fee schedule. Expunged Benefits Benefits that are removed from an EBT account by the issuer of the benefits. The LUW is represented by a set of tabs at the top of a TIERS page. When the OAG receives a child support collection on the current monthly obligation and that payment exceeds the TANF grant plus any unreimbursed assistance, the excess is sent to the person. A mastectomy bra can provide comfort, support, and security to an individual as they become accustomed to their new normal. Eligibility Determination Benefit Calculation (EDBC) The process of applying program policy to household, non-financial, resource, income and deduction information entered in the Data Collection functional area. Automated Renewal Process The first step in an administrative renewal. Sufficient Employment Job earnings, other than seasonal work such as migrant or seasonal farm work, that would result in Temporary Assistance for Needy Families (TANF) ineligibility without including the 90 percent earned income disregard . 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. 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. Ongoing Benefits Benefits issued for months after the initial benefit month. Annulment A court order declaring a marriage invalid. Data Collection The functional area where individual household, non-financial, resource, income, and deduction information is recorded for use in building Eligibility Determination Groups (EDGs) and determining eligibility for types of assistance. A stripe of magnetic material, which is machine-readable and allows for the activation of point-of-sale equipment, is affixed to the back of the card at the time of manufacture. Step Grandparent The spouse of a blood-related grandparent. Prospective Budgeting Determination of eligibility for and the amount and type of benefits using the best estimate of the household's current and future circumstances and income. If you can't find it, call us at 800-777-7328. OPTION 2: Start an Application Online You can start the application process online. Intentionally purchasing products originally purchased with SNAP benefits in exchange for cash or consideration other than eligible food. Vested Interest A situation or circumstance to which a person has a strong personal commitment. Left Navigation The list of functional areas that appears on the left side of the Texas Integrated Eligibility Redesign System (TIERS) page. voluntary not court-ordered and given voluntarily when the childs caretaker or the person making the payment states the purpose of the payment is to support the child. Modified Adjusted Gross Income (MAGI) Household Size The number of people in an applicants or recipients MAGI household composition, including the number of unborn children, if applicable. For example, those with incomes over $200,000 had an average refund of $3,239 while those with incomes under $50,000 had an . Sentences are served in the community rather than in jail or prison. For the eligibility groups reflected in the table, an individual's income, computed using the Modified Adjusted Gross Income (MAGI)-based income rules described in 42 CFR 435.603, is compared to the income . Authorization Code A code that identifies a retailer as a Food and Nutrition Service (FNS)-participating store. Overpayment The amount of benefits issued in excess of what should have been issued. Periodic Income Check (PIC) The process to determine whether electronic data indicates that there has been a change in the Modified Adjusted Gross Income (MAGI) household income that could make the recipient ineligible for certain Medical Programs. The person must be a legal parent(s) or other caretaker relative within the required degree of relationship who meets the income limits for that program. The Workforce Information System of Texas (TWIST) The computer system used by the Texas Workforce Commission (TWC) for intake, eligibility determination, assessment, service tracking, and reporting of TWC-administered programs, such as child care, Supplemental Nutrition Assistance Program (SNAP), Employment and Training, Choices, and the Workforce Innovation and Opportunity Act. Trafficking Supplemental Nutrition Assistance Program (SNAP) . Legally Obligated Child Support Court order or a legally recorded document requiring the payments of child support to be made in the form of cash, medical support, or to a third party. are intended for expenses other than room and board. Continuous Eligibility A period where a person remains eligible during a continuous eligibility period regardless of any change in circumstances, except for: Convertible Bond A bond that can be converted to cash according to program policy. The account transfer from the Marketplace to HHSC, and from HHSC to the Marketplace, includes the information the applicant submitted through the original application in addition to information from verifications performed by either the Marketplace or HHSC. Medicaid Supplemental Payment & Directed Payment Programs, Part D, Children's Health Insurance Program, Part F, Former Foster Care in Higher Education, Part M, Medicaid for Transitioning Foster Care Youth, Part X, Medicaid for Breast and Cervical Cancer. Eligibility staff access BVS as a source to verify age, relationship and citizenship. A household member may be charged with an IPV even if the person has not actually received benefits to which they are not entitled. Reception Log The functional area in the Texas Integrated Eligibility Redesign System (TIERS) where office contacts by phone, mail, fax and in-person can be recorded. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). minimum service has little or no presence of Choices staff. receives Supplemental Nutrition Assistance Program (SNAP) benefits; is physically and mentally able to work at least an average of 20 hours per week; is not a member of a SNAP Eligibility Determination Group (EDG) where a household member on the SNAP EDG is under 18; an automated eligibility determination; or. Nonconvertible bonds are exempt resources. Medicaid is also known as the medical assistance program. Eligibility Determination Benefit Calculation (EDBC) uses the discovery and report dates to determine if a required report of change is reported timely. Veterans can still call 800-273-8255 and Press 1 to reach the Crisis Line as well. Normal Living Expense Items necessary for a Supplemental Nutrition Assistance Program (SNAP) household to carry on its normal daily activities. Your unique Medicaid numberwill be displayed on the Texas Health and Human Services Commission's 'Your Texas Benefits' card. Pick or change your PIN. Trust Property held by one person for the benefit of another. SeeEDBCand Run EDBC. Communal Dining A public or non-profit establishment approved by Food and Nutrition Services (FNS) that prepares and serves meals to elderly people or those who receive Supplemental Security Income (SSI) and their spouses. Ten-Ten-Thirteen Concept Time periods used to determine the first month of an over-issuance claim. Monthly Obligation The amount of child support which the absent parent has been ordered to pay each month. Standard Utility Allowance (SUA) A standard deduction for the cost of utilities. A special review is conducted in Special Review mode. The user name or password is incorrect. Processing Time Frames Number of days eligibility staff must complete a particular action. Prepaid Burial Insurance Insurance that pays for a specific funeral arrangement. on a farm or ranch performing field work about planting, cultivating or harvesting operations; or. Change Action A data collection interview mode that allows eligibility staff to navigate to pages on which they want to update or record information. Expenses of Fee-Basis Government Officials Federal income tax deductible employment-related expenses paid for or accrued by employees of a state or political subdivision who are compensated on a fee basis. eligible for Medicaid because a responsible person who is not within the degree of relationship required for Temporary Assistance for Needy Families (TANF) applies on the child's behalf. In some interview modes, staff cannot advance to pages that have not yet been accessed as part of the driver flow. Colonias Unincorporated and unregulated settlements (neighborhoods) along the U.S. and Mexico border. Electronic Benefit Transfer (EBT) Regional Coordinator An HHSC employee designated to oversee, monitor, lead regional planning and act as a point of contact for EBT security procedures. Summary Page A page that lists a summary of all records available for that Texas Integrated Eligibility Redesign System (TIERS) page. Review Temporary Assistance for Needy Families (TANF) evaluative interview. Lump-Sum Payment A financial settlement that often involves funds accumulated over an extended period and that is paid in a single payment. Doctors and pharmacies use this number for billing. Noncompliance with the PRA results in a sanction. the minor lives with an adult other than the minor's parent or legal guardian and the minor's parent or legal guardian states that the adult has parental control of the child. The employer does not match the money contributed by the employee until the defined period of time ends. Disaster SNAP (D-SNAP) gives short-term food benefits to people recovering from a disaster. Nonconvertible Bond A bond that cannot be converted to cash per program policy. You are exiting this workflow before finishing. Administrative Terminal Application (ATA) A software program accessible on one or more Texas Health and Human Services Commission (HHSC) desktop computers in each office. Applied Income The countable amount of income for TANF after allowing deductions for tax dependents, child support, alimony and persons a legal parent is legally obligated to support. Its given to an elderly household member, a household member with a disability, or both, who incur medical expenses of more than $35 but less than or equal to $137. To ensure the information is saved in an LUW in Data Collection, the user can click on the Next button to advance to the next LUW or on the Previous button to return to the previous LUW. When the term is used in the handbook, it means all the following programs combined: Emergency Medical Condition An eligibility requirement for Emergency Medicaid for nonimmigrants, undocumented aliens and certain legal permanent resident aliens. The: User-Generated Action generated directly by an individual's computer input. Domestic Production Activities Deduction A federal income tax deduction that a person may receive for certain qualified production activities. temporary quarters in another person's residence for 90 days or less. Types of alternate payees include a court appointed guardian, EBT representative, Financial Management Information System (FMIS) payee, long-term care (LTC) payee, protective payee and representative payee. Treat an untimely reapplication the same as an initial application. Subsistence Life supporting or survival. Workforce Innovation and Opportunity Act A federal program to streamline state workforce development systems combining job training, adult education and literacy, and vocational rehabilitation. See Alternate Payee. The primary cardholder is usually the Eligibility Determination Group (EDG) name, but the EDG may have an alternate payee who is the primary cardholder. . Proration Portion of total monthly benefits a household is entitled to receive. Personal Identification Number (PIN) Security Actions cardholders should take to prevent others from gaining access to their PIN and Electronic Benefit Transfer (EBT) account. Alert A system or user-generated reminder that action needs to be taken on a case or a notification that an action has already taken place. These items include housing, utilities, deposits for housing or utilities, food, clothing, and incidentals. The last number in your TANF Eligibility Determination Group number tells what day you get your benefits. These include a county holding facility for juveniles or a facility that a government unit exercises final administrative authority. 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. Underpayment Issuance of fewer benefits than an individual is entitled to receive. Range of Payment The highest to the lowest representative pay amounts used to determine the current ongoing budget. Incidentals include such things as normal day-to-day transportation, phone, laundry, medical supplies not paid by Medicaid, home remedies, recreation, and household equipment. SeeBatch Processing. Reinstatement Process of providing Transitional Medical Assistance (TMA) to a household denied because of failure to return a complete Medicaid Report. Personal Possessions Possessions that include furniture, appliances, jewelry, clothing, livestock, farm equipment, and other items that an applicant uses to meet personal needs essential for daily living. The system generates an alert when the SSA Benefit amount on file does not match the information on the BENDEX file.