Appendix XIV, TIERS Type Program and Type Assistance Chart
Revision 22-4 Effective Dec. 1, 2022
The following chart may be used for the determination of financial eligibility based on automated records. The chart indicates the type program (TP) or type assistance (TA) a person may be receiving in Texas Integrated Eligibility Redesign System (TIERS), and how existing coverage affects eligibility for Community Care Services Eligibility (CCSE) services.
SNAP
| TIERS Type Program or Type Assistance | Description | Long Description | Eligibility for Community Care Services Eligibility |
|---|---|---|---|
|
TA 51 |
SNAP-CAP/FS-CAP |
Supplemental Nutrition Assistance Program Combined Application Project |
Title XX categorically eligibility. |
|
TA 53 |
TSAP/FS-TSAP |
Texas Simplified Application Project for SNAP Food Benefits |
Title XX categorically eligibility. |
|
TP 06 |
SNAP (PA)/FS-PA |
Supplemental Nutrition Assistance Program Public Assistance |
Title XX categorically eligibility. |
|
TP 09 |
SNAP/FS-NPA |
Supplemental Nutrition Assistance Program |
Title XX categorically eligibility. |
TANF
| TIERS Type Program or Type Assistance | Description | Long Description | Eligibility for Community Care Services Eligibility |
|---|---|---|---|
|
TP 01 |
TANF Basic |
Cash assistance for caretakers and deprived children with income below TANF recognizable needs |
Title XX categorically eligible. |
|
TP 60 |
One-Time TANF for Relatives |
Once in a lifetime TANF payment for certain relatives who are the caretaker or payee of a related dependent child certified for TANF |
Not categorically eligible. |
|
TP 61 |
TANF State Program |
Cash assistance for two-parent household with income below TANF recognizable needs |
Title XX categorically eligibility. |
|
TP 71 |
OTTANF – 1 Adult |
One-Time TANF (OTTANF) payment for households with one parent |
Not categorically eligible. |
| TP 72 | OTTANF – 2 Parents | OTTANF payment for households with two parents | Not categorically eligible. |
Medical Assistance or Programs — Texas Works (TW)
| TIERS Type Program or Type Assistance | Description | Long Description | Eligibility for Community Care Services Eligibility |
|---|---|---|---|
|
TA 31 |
MA – Parents and Caretaker Relatives – Emergency |
Medicaid for an emergency condition for parents and caretaker relatives who do not meet alien status requirements and are caring for a dependent child who receives Medicaid |
Title XIX and Title XX categorical eligibility during eligible months. Note: Title XIX applicants must meet citizenship criteria. |
|
TA 41 |
Health Care – Healthy Texas Women |
Healthy Texas Women (HTW) for women 15–44 with income at or below the applicable income limit |
Title XX categorical eligibility. Can apply for Title XIX CAS, not eligible for Title XIX DAHS or PHC as not full Medicaid. |
|
TA 66 |
MA – MBCC – Presumptive |
Medicaid for Breast and Cervical Cancer – Presumptive |
Title XX categorically eligible. Mandatory to STAR+PLUS. |
|
TA 67 |
MA – MBCC |
Medicaid for Breast and Cervical Cancer – Presumptive |
Title XX categorically eligible. Mandatory to STAR+PLUS. |
| TA 74 | MA – Children Under 1 Presumptive | Short-term Medicaid for children under 1 with income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only. |
| TA 75 | MA – Children 1–5 Presumptive | Short-term Medicaid for children 1–5 with income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only. |
| TA 76 | MA – Children 6–18 Presumptive | Short-term Medicaid for children 6–18 with income at or below the applicable income limit | Title XX categorically eligible at 18. Title XIX categorically eligible for CAS only. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 77 | Health Care – FFCHE | Health Care for Former Foster Care in Higher Education with income at or below the applicable income limit | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 82 | MA – Former Foster Care Children | Medicaid for former foster care children 18–25 | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 83 | MA – FFCC Presumptive | Short-term Medicaid for former foster care children 18–25 | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 84 | CI – CHIP | The Children’s Health Insurance Program (CHIP) is health care coverage for children under 19 who are ineligible for Medicaid due to income and who have income at or below the applicable income limit | Title XX categorically eligible at 18. |
| TA 85 | CI – CHIP perinatal | CHIP perinatal is health care coverage for unborn children whose mother is ineligible for Medicaid or CHIP due to income or immigration status and whose income is at or below the applicable income limit | Not categorically eligible. |
| TA 86 | MA – Parents and Caretaker Relatives Presumptive | Short-term Medicaid for parents and caretaker relatives caring for a dependent child | Title XIX and Title XX categorical eligibility during eligible months. |
| TP 07 | MA – Earnings Transitional | Twelve months of transitional Medicaid resulting from an increase in earnings | Title XIX and Title XX categorical eligibility. |
| TP 08 | MA – Parents and Caretaker Relatives | Medicaid for parents and caretaker relatives caring for a dependent child with income at or below the applicable income limit | Title XIX and Title XX categorical eligibility. |
| TP 20 | MA Alimony/Spousal Support Transitional | Up to four months of post Medicaid resulting from an increase in alimony or spousal support | Title XIX and Title XX categorical eligibility during eligible months. |
| TP 32 | MA – MN w/Spend Down – Emergency | Medicaid for an emergency condition for children or pregnant women who do not meet alien status requirements and who are ineligible for any other type of Medicaid, but who have medical expenses that spend down their income to below the Medically Needy Income Limit (MNIL) | Title XIX and Title XX categorical eligibility during eligible months. Note: Title XIX applicants must meet citizenship criteria. |
| TP 33 | MA – Children 1–5 – Emergency | Medicaid for an emergency condition for children 1–5 who do not meet alien status requirements and who have income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorical eligibility CAS during eligible months. Note: CAS applicants must meet citizenship criteria. |
| TP 34 | MA – Children 6–18 – Emergency | Medicaid for an emergency condition for children 6–18 who do not meet alien status requirements and who have income at or below the applicable income limit | Title XX categorically eligible at 18. Title XIX categorically eligible for CAS only during eligible months. Note: CAS applicants must meet citizenship criteria. |
| TP 35 | MA – Children Under 1 – Emergency | Medicaid for an emergency condition for children under 1 who do not meet alien status requirements and who have income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only during eligible months. Note: CAS applicants must meet citizenship criteria. |
| TP 36 | MA – Pregnant Women – Emergency | Medicaid for an emergency condition for pregnant women who do not meet alien status requirements and who have income at or below the applicable income limit | Title XX categorical eligibility during eligible months. Title XIX categorically eligible for CAS only during eligible months. Note: CAS applicants must meet citizenship criteria. |
| TP 40 | MA – Pregnant Women | Medicaid for pregnant woman with income at or below the applicable income limit | Title XIX and XX categorical eligibility during eligible months. |
| TP 42 | MA – Pregnant Women Presumptive | Short-term Medicaid for pregnant women with income at or below the applicable income limit | Title XIX and XX categorical eligibility during eligible months. |
| TP 43 | MA – Children Under 1 | Medicaid for children under 1 with income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only. |
| TP 44 | MA – Children 6–18 | Medicaid for children 6 –18 with income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only. |
| TP 45 | MA – Newborn Children | Medicaid for children through 1 who are born to a Medicaid-eligible mother | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only. |
| TP 48 | MA – Children 1–5 | Medicaid for children 1–5 with income at or below the applicable income limit | Not eligible for Title XX programs. Title XIX categorically eligible for CAS only. |
| TP 56 | MA – MN w/Spend Down | Medicaid for children or pregnant women who are ineligible for any other type of Medicaid, but who have medical expenses that spend down their income to below the MNIL | Title XIX and Title XX categorically eligibility during the coverage period. Note: For Title XX must be 18. |
| TP 70 | Medicaid for the Transitioning Foster Care Youth | Medicaid for Transitioning Foster Care Youth people with income at or below the applicable income limit | Title XIX and Title XX categorical eligibility. Note: For Title XX must be 18. |
| TPAL | MA – Historical FMA – Emergency | N/A | Title XIX and XX categorical eligibility during eligible months. |
| TPDE | MA – Deceased Prior Medical | Medicaid for a deceased person | Not categorically eligible. |
| TPPM | MA/ME – Historical Prior Medical | Three months of prior Medicaid – not currently eligible | Title XIX and XX categorical eligibility during eligible months. |
Medical Assistance or Programs — Texas Department of Family and Protective Services (DFPS)
| TIERS Type Program or Type Assistance | Description | Long Description | Eligibility for Community Care Services Eligibility |
|---|---|---|---|
|
TP 52 |
MA – State Foster Care – A |
Medicaid |
Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
|
TP 53 |
MA – State Foster Care – B |
Medicaid |
Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
|
TP 54 |
MA – State Foster Care – 32 |
Medicaid |
Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
|
TP 57 |
MA – State Foster Care – D |
Medicaid |
Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 58 | MA – State Foster Care – JPC | Medicaid | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 78 | PCA Medicaid – Federal Match – No Cash | Permanency Care Assistance (PCA) Medicaid – Federal Match – No Cash | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 79 | PCA Medicaid – No Federal Match – No Cash | PCA Medicaid – No Federal Match – No Cash | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 80 | PCA Medicaid – Federal Match – With Cash | PCA Medicaid – Federal Match – With Cash | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TA 81 | PCA Medicaid – No Federal Match – With Cash | PCA Medicaid – No Federal Match – With Cash | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 88 | MA – Non-AFDC Foster Care – JPC | Medicaid | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 90 | MA – State Foster Care | Medicaid | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 91 | Adoption Assistance – Federal Match – No Cash | Adoption Assistance – Federal Match – No Cash | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 92 | Adoption Assistance – Federal Match – With Cash | Adoption Assistance – Federal Match – With Cash | Title XIX and Title XX categorical eligibility. May be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 93 | Foster Care – Federal Match – No Cash | Foster Care – Federal Match – No Cash | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 94 | Foster Care – Federal Match – With Cash | Foster Care – Federal Match – With Cash | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 95 | Adoption Assistance – No Federal Match – No Cash | Adoption Assistance – No Federal Match – No Cash | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 96 | Adoption Assistance – No Federal Match – With Cash | Adoption Assistance – No Federal Match – With Cash | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 97 | Foster Care – No Federal Match – No Cash | Foster Care – No Federal Match – No Cash | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 98 | Foster Care – No Federal Match – With Cash | Foster Care – No Federal Match – With Cash | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TP 99 | MA – Non-AFDC Foster Care | Medicaid | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
| TPAS | MA – Historical Adoption Subsidy | Medicaid | Title XIX and Title XX categorical eligibility may be on CFC or PCS verify no duplicate services are provided using Appendix XX, Mutually Exclusive Services. |
Medical Assistance or Programs — Social Security Administration (SSA)
| TIERS Type Assistance or Type Program | Description | Long Description | Eligibility for Community Care Services Eligibility |
|---|---|---|---|
|
TA 02 |
ME – SSI Waivers |
SSI Recipient Waivers |
Title XIX DAHS categorical eligibility CLASS, DBMD, HCS, MDCP, and TxHmL. Title XX HDM categorical eligibility for TxHmL only. See Appendix XX, Mutually Exclusive Services. |
|
TA 03 |
ME – Manual SSI Waivers |
Manual SSI Waivers |
Title XIX DAHS categorical eligibility CLASS, DBMD, HCS, MDCP, and TxHmL. Title XX HDM categorical eligibility for TxHmL only. See Appendix XX, Mutually Exclusive Services. |
|
TA 04 |
ME – Manual SSI State Group Home |
Manual SSI Recipient State Community-based Group Homes |
Not eligible for CCSE.** |
|
TA 05 |
ME – Manual SSI Non-State Group Home |
Manual SSI Recipient Non-State Community-based Group Homes |
Not eligible for CCSE.** |
| TA 06 | ME – Manual SSI Nursing Facility | Medicaid for Nursing Facility Resident | Not eligible for CCSE.** |
| TA 07 | ME – Manual SSI State Hospital | Medicaid for State Hospital Resident | Not eligible for CCSE.** |
| TA 08 | ME – SSI State Group Home | SSI Recipient State Community Based Group Home | Not eligible for CCSE.** |
| TA 09 | ME – Manual SSI State Supported Living Center | Medicaid for State Supported Living Center Resident | Not eligible for CCSE.** |
| TA 22 | ME – Manual SSI | Manually certified SSI — processed by SSA | Title XIX categorically eligible. |
| TA 26 | ME – SSI Non-State Group Home | SSI Non-State Community-based Group Homes | Not eligible for CCSE.** |
| TP 13 | ME – SSI | SSI (processed by SSA) | Title XIX categorical eligibility. See Appendix XX, Mutually Exclusive Services. |
| TP 38 | ME – SSI Nursing Facility | Medicaid for Nursing Facility Resident | Not eligible for CCSE.** |
| TP 39 | ME – SSI State Hospital | Medicaid for State Hospital Resident | Not eligible for CCSE.** |
| TP 46 | ME – SSI State Supported Living Center | Medicaid for State Supported Living Center Residents | Not eligible for CCSE.** |
Medical Assistance or Programs — Medicaid for the Elderly and People with Disabilities (MEPD)
| TIERS Type Assistance or Type Program | Description | Long Description | Eligibility for Community Care Services Eligibility |
|---|---|---|---|
|
TA 10 |
ME – Waivers |
Home and Community-Based (HCBS) Medicaid |
Title XIX DAHS categorical eligibility CLASS, DBMD, HCS, MDCP, and TxHmL. Title XX HDM categorical eligibility for TxHmL only. See Appendix XX, Mutually Exclusive Services. |
|
TA 12 |
ME – State Group Home |
Medicaid for ICF/IID Resident |
Not eligible for CCSE.* |
|
TA 27 |
ME – Prior Medicaid Institutional/Waiver |
Prior Medicaid for person applying for Institutional or Waiver Medicaid |
Categorically eligible for Title XX during eligible months. |
|
TA 88 |
ME – Medicaid Buy-In for Children (ME-MBIC) |
Medicaid for eligible children with disabilities up 19 years old who pay a share of the Medicaid premium to be eligible for Medicaid |
Title XX and Title XIX categorical eligibility for DAHS, PHC and TxHmL waiver. See Appendix XX, Mutually Exclusive Services. |
| TP 03 | ME – Pickle | RSDI COLA Disregard Programs — considered eligible based on the 1977 Pickle Amendment | Title XIX categorical eligibility. |
| TP 10 | ME – State Supported Living Center | Medicaid for State Support Living Center Resident | Not eligible for CCSE.* |
| TP 11 | ME – SSI Prior | SSI, two or three months prior, as appropriate | Categorically eligible for Title XIX during eligible months. See Appendix XX, Mutually Exclusive Services. |
| TP 14 | ME – Community Attendant | Community Attendant Services | Title XIX CAS program provides PHC, funded through §1929(b)(2)(B) of the Social Security Act. |
| TP 15 | ME – Non-State Group Home | Medicaid for ICF/IID Resident | Not eligible for CCSE.* |
| TP 16 | ME – State Hospital | Medicaid for State Hospital Resident | Not eligible for CCSE.* |
| TP 17 | ME – Nursing Facility | Medicaid for Nursing Facility Resident | Not eligible for CCSE.* |
| TP 18 | ME – Disabled Adult Child | Adult children at least 18 who have a disability and who were denied SSI due to an entitlement to or an increase in their RSDI Disabled Adult Child (DAC) benefits and who are eligible for Medicaid to ensure continued coverage | Title XIX categorical eligibility. |
| TP 21 | ME – Disabled Widow(er) | Widows, widowers or surviving divorced spouses who are at least 50 and less than 60 with a disability and who are ineligible for Medicare and were denied SSI due to an increase in their RSDI widow or widower benefits. They are eligible for Medicaid under TP 21 until they reach 60 or become eligible for Medicare, whichever occurs first | Title XIX categorical eligibility. |
| TP 22 | ME – Early Aged Widow(er) | Early age widows, widowers or surviving divorced spouses who are 50–65 and ineligible for Medicare and who were denied SSI due to an increase in their RSDI widow or widower benefits. They are eligible for Medicaid under TP 22 until they reach 65 or become eligible for Medicare, whichever occurs first | Title XIX categorical eligibility. |
| TP 23 | MC – SLMB | Medicare Savings Program — Specified Low-Income Medicare Benefits | Title XX categorical eligibility. |
| TP 24 | MC – QMB | Medicare Savings Program — Qualified Medicare Beneficiary | Title XX categorical eligibility. |
| TP 25 | MC – QDWI | Qualified Disabled and Working Individuals — A special Medicare savings program that pays Part A Medicare premiums for certain working people under 65 who have a disability and are no longer eligible for free Medicare Part A because of earnings | Title XX categorical eligibility. |
| TP 26 | MC – QI 1 | Medicare savings program — Qualified people | Title XX categorical eligibility. |
| TP 30 | ME – A and D Emergency | Emergency Medicaid for a nonqualified alien | Title XIX and Title XX categorical eligibility during eligible months. Note: Title XIX applicants must meet citizenship criteria. |
| TP 87 | ME – Medicaid Buy In (ME-MBI) | Working people with disabilities who pay a share of the Medicaid premium to be eligible for Medicaid. | Title XIX DAHS categorical eligibility CLASS, DBMD, HCS, MDCP, and TxHmL. Title XX HDM categorical eligibility for TxHmL only. See Appendix XX, Mutually Exclusive Services. |
STAR+PLUS members are entitled to Title XX services if all eligibility criteria are met. However, CCSE staff must first ensure that approval of the request would not result in a duplication of services.
STAR members are entitled to Title XIX and Title XX services if all eligibility criteria are met. However, CCSE staff must first ensure that approval of the request would not result in a duplication of services.
CCSE staff must not authorize any Title XX services for people enrolled in the STAR+PLUS HCBS program.
Note: When Medicaid type indicates facility or institutional living arrangement the person is not eligible for CCSE services. See asterisks below for specific instructions for reporting changes.
* Not eligible for CCSE programs under this type assistance (TA) or type program (TP). Confirm living arrangement with the person or authorized representative (AR), send H1746-A to MEPD staff to process the change in living arrangement and referral. MEPD staff will test for community programs.
** Not eligible for CCSE under this TA or TP. Confirm living arrangement with the person or AR, then have them contact SSA (at the local office or at 800-772-1213) to correct the living arrangement.
Note: HHSC is not responsible for making SSA changes, all changes need to be reported to SSA.