Presumptive Eligibility Policies and Procedures Handbook – Groups Eligible for Presumptive Eligibility Determined by Hospitals.

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Presumptive Eligibility Policies and Procedures Handbook

Groups Eligible for Presumptive Eligibility Determined by Hospitals

The eligibility requirements for Short-term Medicaid are consistent with the eligibility requirements for regular Medicaid coverage for the same group.

Children

To qualify for children’s Medicaid, an applicant must:

Be age 18 or under
Meet citizenship or immigration status requirements
Meet income standards
Be a resident of Texas and intend to remain in Texas

Former Foster Care Children (FFCC)

To qualify for FFCC, an applicant must:

Be age 18 up to 26
Meet citizenship or immigration status (CHIPRA Qualified Aliens eligible to age 21) requirements
Have aged out of foster care or voluntary agency (VolAg) conservatorship at the age of 18 or older in Texas
Have received Medicaid at the time of aging out of foster care
Be a resident of Texas and intend to remain in Texas

Pregnant Women

To qualify for Medicaid as a pregnant woman, an applicant must:

Be pregnant
Meet citizenship or immigration status requirements
Meet income standards
Be a resident of Texas and intend to remain in Texas

Parents and Caretaker Relatives

To qualify for Medicaid as a parent and caretaker relative, an applicant must:

Meet citizenship or immigration status requirements
Meet income standards
Be a resident of Texas and intend to remain in Texas
Be a parent or caretaker relative caring for a dependent child who receives Medicaid

Note: Qualified Entities may only make presumptive eligibility determinations for pregnant women.