Managed Care A health care delivery system with the aim of controlling costs. Judicial Review A review of the fair hearing decision by a district court in Travis County to determine whether the agency decision is correct. The automated process uses existing applicant information, electronic data source information and reasonable compatibility when income verification is required. Combat Zone The geographic area or country to which a military member is deployed for combat. 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. They have already gone through the eligibility determination for those programs. Initial Benefits Benefits issued for the first month of eligibility. Traditional Medicaid Click here to view alternate account management instructions to re-activate your account. Helps people with daily living needs, caregivers, and people with mental health, drug or alcohol issues. The 5% down payment is subject to credit approval. Make payments to the surviving spouse, children, parents, grandchildren or grandparents when the affected person is deceased. 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. With this type of access, a person can view and change an application created under their username. Expenses of Reservists Federal income tax deductible expenses for National Guard and military reserve members who traveled more than 100 miles from home for service. Print Mode Indicates where historical correspondence was printed. The last number in your TANF Eligibility Determination Group number tells what day you get your benefits. the prevention and treatment of substance abuse; Women, Infants, and Children (WIC) nutrition. 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. The LUW is represented by a set of tabs at the top of a TIERS page. Call us at 1-800-772-1213 to make an appointment to file your application. EBT card = a card that looks and works like a debit or credit card but is loaded with food stamps (also known as SNAP benefits) and/or cash benefits. Self-Service Portal (SSP) A web-based application, atYourTexasBenefits.com. 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. If you are just looking for support services and want to be contacted by programs, you need to create an account. The notice contains programmed information based on the program, type of assistance, and eligibility result. Copayment Payment made directly to a provider according to a fee schedule. The discovery date is compared with the report date to determine whether a change is reported timely. It is a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) that the absence of immediate medical attention could reasonably have been expected to result in: Employable Household Member A person whose earnings are countable and who: Employer-Paid Taxes Taxes that are paid by the employer on behalf of the employee rather than deducting the tax amount from the employee's wages. People with Application Visibility accounts may only apply for benefits and view and modify applications created under their username. You'll get an email or text when there'sa form or notice available online in yourMessage Center. Second Parent This is the parent who is not the caretaker. Community Supervision The placement of a misdemeanor or felony offender under supervision for a specified length of time ordered by the court. Your information has not been sent. The same benefit is now called One-Time TANF for Relatives, with payment records stored in TIERS. For example, a notice is system-generated when an Eligibility Determination Group (EDG) is disposed. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans. Copyright 2016-2023. The PIN must be entered on a keypad before any electronic transaction can be processed. 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. SeeBatch Scheduling. If the total collection is less than $75, then the amount of the collection is sent to the person . Emergency Medicaid All types of emergency Medicaid coverage programs for people who are nonimmigrants, undocumented aliens or certain legal permanent resident aliens who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible. The user name or password is incorrect. Voluntary Quit Leaving a job without good cause. The .gov means its official. Indigent Alien A sponsored alien whose total income in the month of application does not exceed 130 percent of the federal poverty level for the alien's household size. Medicaid & CHIP in . Texas Integrated Eligibility Redesign System (TIERS) A computer system used to: Texas Simplified Application Project (TSAP) TSAP is a simplified application and certification process for SNAP. There are two types of categorically eligible households: Certificate of Coverage A certificate that serves as proof of a Medicaid recipient's most recent period of Medicaid coverage. This information is compared to the application and details from the interview to identify case discrepancies and reduce the possibility of case error and fraud. 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 https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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. Authorized staff can correct months in this functional area. Once correspondence is printed, whether in batch or locally, the record of the printing is stored in History Correspondence functional area. Cafeteria Plan Flexible fringe benefit plans offered to employees by their employers. 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. Customs and Border Protection is responsible for border security functions. Get help over the phone,from an HHSC benefit officeor community partner. Illegally Present Alien A non-citizen living in the U.S. without proper approval from the U.S. It provides monthly income to aged people and persons who are blind or have a disability. That means bringing some manufacturing back home, or "reshoring" and moving some of it . SeeInterview ModeandCase Mode. This includes profits from the sale of stocks, bonds, or real estate. 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. The Eligibility Determination Group (EDG) name must be within the required degree of relationship to the dependent child. CHIP perinatal The mother and child will be certified on a single EDG during the month the child is born. 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. Your unique Medicaid numberwill be displayed on the Texas Health and Human Services Commission's 'Your Texas Benefits' card. Normal Living Expense Items necessary for a Supplemental Nutrition Assistance Program (SNAP) household to carry on its normal daily activities. Available at reasonable cost is usually defined as being available through the employer. The Workforce Innovation and Opportunity Act replaced the Workforce Investment Act of 1998. 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. Manage Office Resources (MOR) The functional area that supports the administrative structure in the Texas Integrated Eligibility Redesign System (TIERS) and relationships between regional offices and their local offices, units, and employees. Migrant Farmworker in the Workstream Farmworkers who travel to work in agriculture or a related industry and who are presently employed away from their permanent residence or home base. 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. This includes management and medical, at a specified time other than at application or complete action. 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. 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. 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. Supplemental Nutrition Assistance Program (SNAP) proration is based on the number of days between the file date and the end of the month. 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. Type Program (TP) 08, Parents and Caretaker Relatives Medicaid A child who is18 or under, and a full-time student meeting the school attendance requirement. You need 4 numbers for your PIN. Batch is correspondence managed by batch processing and printed at a central mail facility. Seecase modeandinterview mode. Conception occurs, but no fetus ever develops. 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. 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. 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. Sanction Either a disqualification or a penalty applied to a case or program because a person failed to follow a program requirement. 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. When an individual is added, File Clearance can be processed in Application Registration. Electronic Benefit Transfer (EBT) Vendor A company that performs EBT-related services for the state of Texas. Electronic Benefit Transfer (EBT) Representative A primary cardholder other than the case name. Medicaid Members: Continuous Medicaid coverage will end on March 31, 2023. You are exiting this workflow before finishing. Tip Income Income earned along with wages paid by patrons to people employed in service-related occupations. This will help you know if you should apply for benefits on this site or for health insurance on HealthCare.gov. Each state has its own rules about who's eligible, and what Medicaid covers. there are other alternatives and options for the applicant instead of TANF benefits; an applicant should consider jobs and other resources (such as child support) before pursuing TANF; if an applicant chooses to apply for assistance, the person is requesting help finding a job; and. The driver flow is determined by the programs, types of assistance, and answers to questions as the case is worked. The final digit of your SNAP EDG (Eligibility Determination Group) number indicates the day on which you will receive benefits. Non-Employment and Training (E&T) Counties Those Texas counties where the Texas Workforce Commission (TWC) determines it does not have enough offices to assist people who are mandatory work registrants. It is also referred to as spousal support paid. Noncompliance with the PRA results in a sanction. 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. A boarder can receive Supplemental Nutrition Assistance Program (SNAP) benefits only with the household where they board. Vested Interest A situation or circumstance to which a person has a strong personal commitment. Electronic Benefit Transfer (EBT) Site Coordinator An HHSC employee designated to ensure local offices comply with guidelines on security and accountability operations. See functional area. Categorically Eligible Household Households where all members are either eligible for or receive benefits from Temporary Assistance for Needy Families (TANF), Supplemental Security Income (SSI), or state-financed general assistance programs. Functions of the clearinghouse include: Collateral Contact A person the advisor can contact to verify a person's information. Primary Cardholder (PCH) The person designated to receive and be responsible for the household's Lone Star Card. Business Day Monday through Friday from 8 a.m. to 5 p.m. local time. Ten-Ten-Thirteen Concept Time periods used to determine the first month of an over-issuance claim. Undocumented Alien An alien living in the U.S. without the knowledge and permission of the U.S. To have a payable claim, you must meet all of the following requirements: You have wages in more than one of the four base period calendar quarters. Alternative Benefit Plan Eligibility; . Fugitive An individual fleeing to avoid prosecution of or confinement for a felony criminal conviction or found by a court to be violating federal or state probation or parole. SeePrint Mode. SDX information can be used as a source of verification and is available in the Texas Integrated Eligibility Redesign System (TIERS). Emancipated Minor A person 17 and under who has been married. Low Income Home Energy Assistance Program (LIHEAP) The federal program that funds assistance for energy costs for low-income households. Summer P-EBT (June-August 2022) is a one-time benefit of $391 for each eligible child. Radiation Exposure Payments A program to compensate a person for injury or death from exposure to radiation from nuclear testing and uranium mining. Changes in income identified through this process may impact eligibility for other programs. The PAN is not related to the persons Texas Health and Human Services Commission (HHSC) case number. RSDI Retirement, Survivors and Disability Insurance benefits (RSDI) paid by the Social Security Administration. The Texas Workforce Commission (TWC) administers unemployment benefits, which provide temporary relief for eligible Texans who find themselves out of work or dealing with severely reduced work hours. Bona Fide Agent A person who is familiar with an applicant and knowledgeable of the person's financial affairs. This category also includes Amerasians admitted under Section 584 of the Foreign Operations, Export Financing and Related Programs Appropriation Act of 1988. 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. 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. It could take several weeks for your P-EBT card to arrive after claiming benefits. These include a county holding facility for juveniles or a facility that a government unit exercises final administrative authority. reaching the maximum age for that specific program; state error in the eligibility determination; or, fraud, abuse, or perjury attributed to the people or persons representative, was the spouse, parent, sibling or adult child of a victim who died as a result of a violent crime; or. Texas State Profile Page. Processing Time Frames Number of days eligibility staff must complete a particular action. Before you set up an account, we need to ask you some questions. You must also be one of the following: Pregnant, or Battered Alien A battered spouse, battered child or parent, or child of a battered person with a pending petition with the U.S. Deductible Part of Self-Employment Tax A federal income tax deduction for self-employed people paying self-employment taxes. All rights reserved. It is also referred to as spousal support. They cannot be used to schedule appointments using the Scheduling functional area. 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. Review Temporary Assistance for Needy Families (TANF) evaluative interview. This includes legal parents and stepparents who are disqualified for one of the reasons listed inA-222, Who Is Not Included, No. 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. . Citizenship and Immigration Services (USCIS) The government agency that oversees lawful immigration to the U.S. 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.