Revision 15-4; Effective October 1, 2015

 

 

F—2010 Notice to Applicants

Revision 15-4; Effective October 1, 2015

 

When processing an application, redetermination or change, advisors are required to inform the individual if their request is pended, certified, sustained, or denied. Eligibility Determination Group (EDG) disposition is the end result of processing the request for assistance and will generate Form TF0001, Notice of Case Action. However, if the EDG cannot be disposed because it is pending for additional information/verification, the advisor must provide the individual with Form H1020, Request for Information or Action.

Form H1020, Request for Information or Action

Form H1020 informs the individual of the:

  • reason the case is pending;
  • action the individual or advisor must take;
  • date by which the individual or advisor must take action; and
  • date the advisor must deny the application or case if the individual does not take action, if applicable.

Note: For Spanish-speaking only individuals, ensure that all comments provided are in Spanish.

Form TF0001F, Notice of Case Action

TF0001F informs the individual:

  • the date benefits begin; or
  • the date of denial; and
  • about his/her right to request a review of the case action.

Note: For Spanish-speaking only individuals, ensure that all comments provided are in Spanish.

 

 

F—2020 Length of Certification

Revision 15-4; Effective October 1, 2015

 

The Texas Integrated Eligibility Redesign System (TIERS) calculates the eligibility end date from the date the advisor disposes the EDG as follows:

  • Applications – initial certification month plus 11 months.
  • Renewals – 12 months from the last certification month.

Individuals are eligible for Former Foster Care in Higher Education (FFCHE) health care benefits for 12 months or through the month of their 23rd birthday, whichever is earlier.

Exception: A individual is not eligible to receive 12 months of coverage if the individual:

  • reaches age 23,
  • dies,
  • voluntarily withdraws,
  • moves out-of-state,
  • reports receipt of adequate health coverage, or
  • is not attending an institution of higher education.

 

F—2030 Setting Special Reviews

Revision 15-4; Effective October 1, 2015

 

Use Medical Programs policy in A-2330, Setting Special Reviews, to set special reviews.

 

 

F—2040 Adverse Action

Revision 15-4; Effective October 1, 2015

 

After certification, give households advance notice of adverse actions to deny benefits except for reasons listed in A-2344.1, Form TF0001 Required (Adequate Notice), and A-2344.2, No Form TF0001 Required.

Former FFCHE recipients receiving a notice of adverse action do not have the right to request a fair hearing. FFCHE recipients can request a review of their case action. See F-2300, Request for Review.