Revision 13-2; Effective June 1, 2013

 

All regular, non-financial Medicaid for the Elderly and People with Disabilities (MEPD) policies apply to Medicaid Buy-In for Children (MBIC), except those specifically identified in this chapter.

Non-financial requirements apply only to an MBIC applicant/recipient.

Note: In the eligibility system, list the parent/guardian of the MBIC child as the head of household. The parent/guardian also needs to be listed as the alternate payee as well as the EDG name. This is primarily for any premium reimbursements and managed care purposes.

 

N-3100 Date of Birth

Revision 11-3; Effective September 1, 2011

 

Although MEPD policy does not require a date of birth for an applicant/recipient's family members, the Texas Integrated Eligibility Redesign System (TIERS) requires an entry in the date of birth (DOB) field for all members of the family unit for file clearance purposes. If a non-MBIC family unit member does not provide a DOB, use a default DOB of 02-29-1988. The date will automatically make any siblings' age over 22 so they will not be included in either the family unit or budget group. Do not request the DOB for a non-MBIC family member if it is not provided.

 

N-3200 Age

Revision 11-3; Effective September 1, 2011

 

Eligibility is available through the end of the month of the child's 19th birthday. If an application is received in the month of the 19th birthday, process the MBIC application and determine eligibility for that month and the three months prior to that application.

Example: Application is received on April 5. Applicant turns 19 on April 17. Determine eligibility for the application month of April and three prior months of January, February and March.

 

N-3300 Disability

Revision 11-3; Effective September 1, 2011

 

An applicant/recipient must meet the Supplemental Security Income (SSI) definition of disability. If an applicant/recipient has not had a disability determination made by the Social Security Administration, use HHSC's Disability Determination Unit for disability determinations. Follow regular MEPD policy for disability determinations.

 

N-3400 Marital Status

Revision 11-3; Effective September 1, 2011

 

An applicant/recipient must not be married.

 

N-3500 School or Job Training Attendance

Revision 11-3; Effective September 1, 2011

 

Verification of school or job training attendance for siblings age 18 through age 22 is required.