Revision 22-3; Effective July 1, 2022

HTW provides for a continuous 12-month certification period with the following limited health care benefits:

• Annual family planning exams
• Family planning counseling and education
• Treatment of certain sexually transmitted infections
• Birth control (except emergency birth control), including methods to permanently prevent pregnancy (tubal ligations or Essure)
• Follow-up family planning visits related to the method of birth control

Note: For people 15-17, a parent or legal guardian's signature is required.

HTW Plus (HTW+)

Enhanced and limited postpartum care services are available to HTW members whose pregnancies ended within the 12 months preceding their enrollment into HTW.

Enhanced postpartum benefits include services that address:

• postpartum depression and other mental health conditions;
• cardiovascular and coronary conditions; and 
• substance use disorders, including drug, alcohol and tobacco use.

There is no separate eligibility determination for HTW+. If a woman is determined eligible for HTW and her pregnancy ended within the 12 months before her HTW eligibility date, she is eligible for HTW+ benefits during her 12-month HTW certification period. TIERS automatically adds an HTW+ indicator flag to the woman’s HTW EDG.

W—111 Type of Assistance (TA) 41 – MA – Healthy Texas Women

Revision 21-3; Effective July 1, 2021

To be eligible for HTW, applicants must:

• be female, 15 through 44;
  • a parent or legal guardian must apply on behalf of applicants 15-17;
• have countable income of less than or equal to 204.2% of the federal poverty level;
• be a U.S. citizen or a legally admitted alien who meets all eligibility requirements for Medicaid;
• be a Texas resident;
• not be pregnant;
• not have creditable health insurance that covers family planning services; and
• not currently receive Medicaid, Medicare Part A or B, or Children's Health Insurance Program benefits.

Notes:

• A legal guardian is a person appointed by a judge to care for a child younger than 18.
• Deny applications received for minors, 15-17, without a parent or legal guardian signature if they are not eligible for full coverage Medicaid or CHIP. Use the denial reason, “Denied 15-17 without parent or legal guardian’s signature."
• Married minors, 15-17, are not eligible for HTW. Deny applications for married minors if they are not eligible for full coverage Medicaid or CHIP. Use the denial reason, “Denied 15-17 married minors.”

Related Policy

Income Limits, C-131
General Policy, W-510

W—112 Application Procedures

Revision 21-3; Effective July 1, 2021

Applicants can use any Texas Works medical benefits application form to apply for HTW.

Related Policy

Application Requests and Submissions, A-113

W—113 Requesting an Application

Revision 21-3; Effective July 1, 2021

Applicants can request and submit an application using any of the medical program application channels.

If an applicant applies in-person at a local office or through participating family planning providers or other community-based organizations and requests help completing an application, a volunteer or staff member must give help and initial the parts completed or sign the application to show the applicant received help.

Related Policy

Application Requests and Submissions, A-113

W—121 Reserved for Future Use

Revision 21-3; Effective July 1, 2021

W—122 Telephonic Signatures

Revision 21-3; Effective July 1, 2021

An applicant or designated Authorized Representative (AR) can complete and sign an application using a telephonic signature. Follow the telephonic signature policy for medical programs.

Related Policy

Receipt of Application, A-121
Application Signature, A-122.1

W—123 File Date

Revision 21-3; Effective July 1, 2021

Follow policy for medical programs to determine if the application is valid and the application’s file date.

Document why a certain file date was used to determine eligibility when:

• a file date differs from the received date on the application; or
• the application has two received dates (stamp dates).

Related Policy

Receipt of Application, A-121
Filing the Application, A-122
General Policy, W-910

W—124 Faxed Applications

Revision 21-3; Effective July 1, 2021

The file date for faxed applications is the day the application is received by the HHSC fax line.

Verbally inform the applicant or provider to fax the confirmation page and original application to determine the correct file date when: an applicant or provider states that an application was faxed to the HHSC fax line; but the fax was not received.

If HHSC receives the fax confirmation page and the original application:

• Within 30 days of the submission of the original application, the file date is the submission date as shown on the fax confirmation page. Use the date printed by the fax machine to verify the original submission date.
• More than 30 days after the original submission date, the file date is the date the application is resubmitted.

W—131 General Policy

Revision 17-2; Effective April 1, 2017

An interview is not required when applying for or renewing an application for HTW. Schedule a telephone interview only if the individual requests an interview. Process an application or renewal by mail or telephone.

Note: Do not deny the application if the applicant misses the interview; continue determining eligibility.