Presumptive Eligibility Policies and Procedures Handbook


Presumptive eligibility is a process that allows qualified hospitals and qualified entities to determine if an individual can get Short-term Medicaid. It provides individuals with Medicaid coverage while HHSC processes their application for regular Medicaid.

You can find information here on the:
  • Qualification requirements and process for hospitals and entities
  • Steps for completing presumptive eligibility determinations
  • Eligibility policies and forms
Presumptive eligibility for Medicaid for Breast and Cervical Cancer (MBCC) is a separate process with additional requirements and is not included.