In this system, patients go to their primary care physician to obtain other health services such as specialty medical care, surgery or physical therapy. 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. A household member may be charged with an IPV even if the person has not actually received benefits to which they are not entitled. Individual Retirement Account (IRA) Deduction A federal income tax deduction for people who contributed to a traditional IRA. It is used to apply cascade logic by reforming EDGs until establishing eligibility. 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. 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. Your case number is a 10-digit number that HHSC uses to bundle and process benefits you receive through their agency. Contact the Texas Department of Insurance's Consumer Health 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 . Interactive Voice Response (IVR) A dial-in inquiry system (also known as Automated Voice Response [AVR]) that provides 24-hour access to automated account information via a digital phone. You do not need to be enrolled in VA benefits or health care to connect. This is also called a timely recertification or redetermination. Life Estate Income a person receives from ownership of property that they only possess for the duration of their life, such as rental income. 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. Examples include loan foreclosures and canceled credit card debt. ], Title 42, 1396 et seq.) Users cannot delete system-generated correspondence. SeeDetail Page. Asylee A person granted asylum under Section 208 of the Immigration and Nationality Act (INA). Dispose To authorize an Eligibility Determination Group (EDG) so eligibility is established or denied. Doctors and pharmacies use this number for billing. This includes, mineral rights, patents or copyrights. Also, the act of trafficking in SNAP benefits. Refugee A person admitted to the U.S. under Section 207 of the INA. The code is used to request permission to use the Lone Star Card in a transaction. cash contributions of the sponsor or others; and. Type Program (TP) 08, Parents and Caretaker Relatives Medicaid A person who supervises and cares for a dependent child. 1-877-541-7905. A request for an administrative review must be submitted in writing within 30 calendar days from the date of the hearing officer's decision. You tried to login 3 times in a row with either the wrong user name or password. This coverage is providedtemporarily while the Texas Health and Human Services Commission (HHSC) determines eligibility for regular Medicaid. Benefits. Supplemental Security Income (SSI) | SSA This includes profits from the sale of stocks, bonds, or real estate. Time Limit The functional area where Temporary Assistance for Needy Families (TANF) state and federal time-limited months can be viewed. Call us at 1-800-777-7328 if you can't locate it. Annuity A series of payments paid under a contract and made at regular intervals over more than one full year. 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. SeeCase Mode. Temporary Assistance for Needy Families (TANF) Certified Child A child who is included in a TANF grant. Administrative Renewal The method used to redetermine eligibility for most Medical Programs, including Medicaid for the Elderly and People with Disabilities (MEPD) and the Childrens Health Insurance Program (CHIP). Answer some basic questions in our prescreening tool to find which benefits and support services you might be able to get. Personal Representative A person who can represent another person's rights with respect to individually identifiable health information. 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. 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. Lump-Sum Payment A financial settlement that often involves funds accumulated over an extended period and that is paid in a single payment. Blocked Time periods that are designated for specific purposes. CHIP Perinatal Medical services to unborn children of pregnant women ineligible for Medicaid due to income or alien status. 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. 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. The EDG is built and eligibility is established at the highest level. Application Registration The functional area where a person's application for assistance is recorded. HHSC expunges these benefits at the end of each state fiscal year (Aug. 31). Clicking the Add, Update or Submit button saves information on specific pages. Note: Not all aliens must obtain a sponsor before being admitted into the U.S. Alimony Payments received from a spouse or former spouse under a divorce or separation decree. Authorization Code A code that identifies a retailer as a Food and Nutrition Service (FNS)-participating store. able to apply for Medicaid on the child's own behalf; or. See User-Generated. A same-sex marriage that occurred on or after June 26, 2015, is considered valid on the date it occurred. 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. Moving Expenses Federal income tax deductible expenses an active duty member of the military may claim for relocating to a new duty station. Payee A person that the Temporary Assistance for Needy Families (TANF) benefits are issued to if no one in the household qualifies or wants to be a caretaker. Falsified Interview An interview with agency personnel at which time the individual does not report all current income or accurate circumstances. Hearing The functional area where individual appeals are recorded and tracked. 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. This category also includes Amerasians admitted under Section 584 of the Foreign Operations, Export Financing and Related Programs Appropriation Act of 1988. Override A Texas Integrated Eligibility Redesign System (TIERS) procedure that allows the user to make a change to the system-determined Eligibility Determination Group (EDG) results. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). EBT involves computers, a variety of cards or types of cards, electronic funds transfer techniques, automated teller machines (ATMs), point-of-sale terminals or other types of terminals, and software to complete the EBT process without the loss of program integrity or individual confidentiality. Seedefinitions of Eligibility Determination Benefit Calculation(EDBC), rebuild EDG,run EDBCandWrap Up. Interview staff Eligibility staff responsible for interviewing applicants and recipients to establish program eligibility. Representative Payee In Temporary Assistance for Needy Families (TANF), a person designated to receive and manage the household's benefits for someone who is incapacitated or incompetent. 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. File Clearance compares the individual's demographic information against databases for potential matches. Participation Status The designation of an Eligibility Determination Group (EDG) member as an eligible or ineligible member of the certified group. 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. Managed care includes the health maintenance organization (HMO) model. Social Security information is also available for people who receive SSI or Medicaid. You can find your EDG number on the TF0001 form we sent you saying that you can get SNAP benefits. produces reports that meet Texas Health and Human Services Commission (HHSC), state and federal reporting requirements. We recommend creating an account so you can: Get alerts about updates to your application. Functional Area Functions and processes that appear in the Texas Integrated Eligibility Redesign System (TIERS) Left Navigation area and represent a particular business process. Molar Pregnancy Also known as hydatidiform mole, a molar pregnancy is considered a degenerating pregnancy. The benefit is funded by taxes collected from businesses. Tax Dependent A person who expects to be claimed by someone else as a dependent on a federal income tax return for the taxable year that Medicaid or Children's Health Insurance Program (CHIP) eligibility is requested. Questions About Your Benefits | Texas Health and Human Services Range of Payment The highest to the lowest representative pay amounts used to determine the current ongoing budget. Also benefits issued for the first month of eligibility after a break in eligibility of at least one month. in canning, packing, ginning, seed conditioning or related research or processing operations. 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. 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. The user reaches the end of the driver flow at the Case Assignment page and must use the Left Navigation to return to specific pages in Data Collection. Good Cause A term used to indicate that a person has an acceptable reason for not complying with a program requirement. a correctional or holding facility for people who: have been arrested or detained pending disposition of charges; or. 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. Alternative Benefit Plan Eligibility; . Seebatch processing,pending correspondence,print mode,print type,system-generatedanduser-generated. Mastectomy surgery is a significant life event for many people. Alternate Payee A person who receives the benefits for the EDG when people on the EDG are unable or ineligible to receive them. Your application visibility account has been disabled because of inactivity. 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. An example of a publicly operated community residence that is not a public institution is a county homeless shelter with a capacity of up to 16 people. For your convenience, the Help Center will open in a new window. Monthly Obligation The amount of child support which the absent parent has been ordered to pay each month. Initial Benefits Benefits issued for the first month of eligibility. createcorrespondence and reports based on system-requested and user-requested criteria. 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. Persons with illnesses that require expensive treatment are not subject to lock-in status. determining if a medical bill can be counted for spend down; corresponding with the applicant about eligible and ineligible medical bills; determining if and when the applicant meets spend down; and. Administrative Terminal Application (ATA) A software program accessible on one or more Texas Health and Human Services Commission (HHSC) desktop computers in each office. Lawful Permanent Resident (LPR) A person lawfully admitted for legal permanent residence in the U.S. Qualified Health Professional A person who provides care under the supervision of a licensed practitioner or a medical or dental practice that is state regulated. causing serious dysfunction of any bodily organ or part. They will become lawful permanent residents (LPRs) upon the removal of their conditions by the Department of Homeland Security (DHS). Conception occurs, but no fetus ever develops. 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. Absent Parent A child's parent who is not living in the home. Availability Date The date that benefits are deposited into the recipients Electronic Benefit Transfer (EBT) account. These occupations include beauticians, waiters, valets and food delivery staff. System-Generated Created by a computer system programmed with given parameters. TWC is part of a local and state network dedicated to developing the workforce of Texas. Availability Period For TANF, the availability period is two fiscal years after the benefit was issued. See Alternate Payee. Alerts A functional area on a navigation bar that allows eligibility staff to request alerts and view outstanding and processed alerts. 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 Correspondence The functional area in which system and user-generated notices and forms are processed and stored. Overpayment The amount of benefits issued in excess of what should have been issued. Child A child is an adoptive, step, or natural child who is under 19. Medicaid Members: Continuous Medicaid coverage will end on March 31, 2023. The exchange of firearms, ammunition, explosives, or controlled substances, defined in Section 802 of Title 21, United States Code, for SNAP benefits. These benefits are accessed by: card and personal identification numbers (PINs); or, Attempting to buy, sell, steal, or otherwise effect an exchange of SNAP benefits and using them for cash or something other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone. Inaccessible Resources Resources not legally available to the person. A molar pregnancy is considered a normal pregnancy that terminates early because of miscarriage or abortion. Trafficking Supplemental Nutrition Assistance Program (SNAP) . People can apply using a simplified application, and they do not typically have to complete an interview at redetermination. Examples of batch processing include schedule system-generated correspondence to be printed at and mailed from a central site, mail out review packets at scheduled intervals from the central mail facility, and gathering information and share it through interfaces with other agencies. See, is a member of a Supplemental Nutrition Assistance Program [SNAP] Eligibility Determination Group [EDG] where a household member is under 18; or. 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. Independent living services may include, but is not limited to: Second Level Review Review of a case by a second party before the Eligibility Determination Group (EDG) is disposed. The Veterans Crisis Line has a new number: Dial 988 then Press 1. 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. Coordination of benefits (COB) allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities (i.e., determine which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more The PIN must be entered on a keypad before any electronic transaction can be processed. *Important: Don't write your PIN on your Lone Star Card. Three Months Prior The three-month period before the Medicaid application month. Each functional area contains pages that allow authorized staff to perform activities related to the business process. The sleeve also has important information printed on it for easy reference, such as the Lone Star Help Desk number. Also known as a pre-need plan or prepaid funeral agreement. 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. During this step, information from electronic data sources is automatically requested, reasonable compatibility is run when income verification is required and correspondence is sent to the recipient. or registered nurse (R.N.). 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. Activity Fee An additional cost incurred by the household associated with a structured dependent care program. Batch and Online are the types of print modes. Medical Support Health insurance that absent parents will be ordered to obtain for their children who receive Medicaid when it is available at reasonable cost. Public Assistance (PA) Household A Supplemental Nutrition Assistance Program (SNAP) Eligibility Determination Group (EDG) in which: Public Institution A facility that is either an organizational part of a governmental entity or over which a governmental unit exercises final administrative control. 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. Parents and Caretaker Relatives Emergency (TA 31), Medically Needy with Spend Down Emergency (TP 32). A calendar tax year is 12 consecutive months beginning Jan. 1 and ending Dec. 31. SeeCorrespondence,Print ModeandPrint Type. Appeal A request for a fair hearing concerning an HHSC action. These people must have parental consent or court permission. receive copies of the applicants or recipient's notices in the preferred language selected on the application and other communications from the agency; act on behalf of the applicant or recipient in all other matters with the agency, such as reporting changes. Print Mode Indicates where historical correspondence was printed. Continuing Scheme A situation in which a recipient commits two or more acts. In-Kind Contribution Any gain or benefit to a person that is not in the form of money paid directly to the person such as clothing, public housing or food. To find out if you might be eligible for Medicaid in Texas, visit yourtexasbenefits.com The User Guide includes information about numerous TIERS topics. Your case visibility account has been disabled because of inactivity. Payments may be either fixed (under which one receives a definite amount) or variable (not fixed). Passive Renewal A process by which the Texas Integrated Eligibility Redesign System (TIERS) automatically recertifies a Former Foster Care in Higher Education (FFCHE) active Eligibility Determination Group (EDG) for another certification period. Incidentals include such things as normal day-to-day transportation, phone, laundry, medical supplies not paid by Medicaid, home remedies, recreation, and household equipment. The canceled amount is included as countable income on federal income tax returns. 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. the requirement of more information from the applicant to manually process the redetermination. Untimely SNAP application filed after the 15th of the last certification month. are intended for expenses other than room and board. ), osteopathic medical physician (D.O. Medicaid Card An identification card issued to people determined eligible for Medicaid that verifies Medicaid coverage. State and federal government websites often end in .gov. Carryover Standby List Applicants from a previous day's standby list who have not been interviewed. Publicly Operated Community Residence A facility designed to serve up to 16 residents and to provide some services beyond food and shelter, such as social services, training in socialization, and life skills. Pick or change your PIN. an account that contains the household's Supplemental Nutrition Assistance Program (SNAP) food benefits; an account that contains the household's Temporary Assistance for Needy Families (TANF) cash grant amount; or, Type Assistance (TA) 31, Parents and Caretaker Relatives Emergency, Type Program (TP) 32, Medically Needy with Spend Down Emergency. Intentionally purchasing products originally purchased with SNAP benefits in exchange for cash or consideration other than eligible food. Opportunity to Participate Providing a certified applicant with benefits, a Lone Star Card, personal identification number (PIN), and Electronic Benefit Transfer (EBT) training material. That means bringing some manufacturing back home, or "reshoring" and moving some of it . Feb 17, 2022 Knowledge Article The Food and Nutrition Service (FNS) number is the 7-digit number printed on the Supplemental Nutrition Assistance Program (SNAP) permit sent to you when you became authorized to participate in SNAP. A same-sex marriage that occurred before June 26, 2015, is considered valid effective June 26, 2015. Licensed Practitioner A person who has met certain educational requirements and passed an examination to be licensed in the state of Texas and regulated by a state board. The Food and Nutrition Act of 2008 limits eligibility for SNAP benefits to U.S. citizens and certain lawfully present non-citizens.