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Table of Contents
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Overview
Definitions
Qualification and Requirements (
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Requirements
Qualification Process
Notice of Intent
Medicaid Provider
Memorandum of Understanding
Training
Conflict of Interest
Steps to Complete PE Determinations
Due Dates
Eligibility Policy (
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Groups Eligible for PE
Citizenship and Immigration Status
Residence
Household Composition
Income
Periods of PE
Current Medicaid Recipients
Verification
Eligibility Dates
Systems Support
Case Example
Forms
Presumptive Eligibility Policies and Procedures Handbook
Eligibility Dates
Short-term Medicaid coverage begins the date the presumptive eligibility determination is made. The length of coverage depends on several factors:
If the individual submits an application for regular Medicaid, the short-term Medicaid coverage ends the date the state makes a determination for regular Medicaid.
If the individual does not submit an application for regular Medicaid, the short-term coverage ends the last day of the month following the presumptive eligibility determination.
Short-term Medicaid services are provided as fee-for-service coverage.
For applications for regular Medicaid that HHSC receives outside of business hours or when HHSC is closed, including weekends and holidays, the file date is the next business day.
The file date for the regular Medicaid application is the day HHSC receives the application. The Medicaid coverage is effective the first day of the month of the application month if all eligibility requirements are met.