See User-Generated. action has been initiated on an Eligibility Determination Group (EDG) in a case (Intake, Complete Action, Change Action, Special Review, Conversion); allthe EDGs in a case are approved (Ongoing); and. produces reports that meet Texas Health and Human Services Commission (HHSC), state and federal reporting requirements. the minor lives with an adult other than the minor's parent or legal guardian and the minor's parent or legal guardian states that the adult has parental control of the child. lives with another person and they represent themselves to the community as married. Children's Medicaid Medical coverage for children whose family income is under the applicable income limit. Personal Identification Number (PIN) A four-digit numeric code assigned to each cardholder and used to control access to the person's account. Types of alternate payees include a court appointed guardian, EBT representative, Financial Management Information System (FMIS) payee, long-term care (LTC) payee, protective payee and representative payee. Point-of-Sale (POS) Transaction An electronic transaction using an Electronic Benefit Transfer (EBT) card to make a purchase, a cash withdrawal, or inquiry. The driver flow is determined by the programs, types of assistance, and answers to questions as the case is worked. This guide will explain the different types of . People with Application Visibility accounts may only apply for benefits and view and modify applications created under their username. 401(k) A retirement plan allowing an employee to postpone receiving a portion of current income until retirement. Accessibility Date The date that benefits are deposited into an Electronic Benefit Transfer (EBT) account. These plans are offered through the Health Insurance Marketplace, or the Exchange, where individuals can research, compare, and purchase health plans. Public Assistance (PA) Household A Supplemental Nutrition Assistance Program (SNAP) Eligibility Determination Group (EDG) in which: Public Institution A facility that is either an organizational part of a governmental entity or over which a governmental unit exercises final administrative control. Click here to re-activate your account. Texas Workforce Commission's Unemployment Benefit Services - Sign Up Trust Property held by one person for the benefit of another. This is also called a timely recertification or redetermination. Non-Public Assistance (NPA) Household Supplemental Nutrition Assistance Program (SNAP) households where no one receives Temporary Assistance for Needy Families (TANF) or only some of the members receive TANF. HHSC expunges these benefits at the end of each state fiscal year (Aug. 31). Contact the Texas Department of Insurance's Consumer Health See Taxpayer. Participation Status The designation of an Eligibility Determination Group (EDG) member as an eligible or ineligible member of the certified group. Workforce Innovation and Opportunity Act A federal program to streamline state workforce development systems combining job training, adult education and literacy, and vocational rehabilitation. Proration Portion of total monthly benefits a household is entitled to receive. Life Estate Income a person receives from ownership of property that they only possess for the duration of their life, such as rental income. Redetermination A complete action to determine eligibility for a new certification period in a program. Lump-Sum Payment A financial settlement that often involves funds accumulated over an extended period and that is paid in a single payment. When you're done, you can create an account to apply for benefits and send your info to support services to be contacted by programs. Some people qualify for both Medicare and Medicaid. Supplemental Nutrition Assistance Program (SNAP) proration is based on the number of days between the file date and the end of the month. The participation status indicates whether the person is considered an adult or a child according to policy. Managed Care A health care delivery system with the aim of controlling costs. This includes management and medical, at a specified time other than at application or complete action. Reasonable Compatibility The method of verification used for Medical Programs. Grandparent Payment System (GPS) An electronic, web-based data system used to inquire about the issuance of archived TANF one-time Grandparent Payments. Cafeteria Plan Flexible fringe benefit plans offered to employees by their employers. U.S. Be receiving disability-related assistance or benefits. The Veterans Land Board (VLB) Land Loan Program provides financing on tracts for eligible veterans up to $150,000 with a minimum 5% down payment and a fixed-rate 30-year loan term. Available at reasonable cost is usually defined as being available through the employer. Helps people with daily living needs, caregivers, and people with mental health, drug or alcohol issues. You have already answered the required questions.If you want to start the questions over, go back to the home page of Your Texas Benefits. Step Grandparent The spouse of a blood-related grandparent. Tax Dependent A person who expects to be claimed by someone else as a dependent on a federal income tax return for the taxable year that Medicaid or Children's Health Insurance Program (CHIP) eligibility is requested. OPTION 2: Start an Application Online You can start the application process online. The sleeve also has important information printed on it for easy reference, such as the Lone Star Help Desk number. Eligibility staff access BVS as a source to verify age, relationship and citizenship. Qualified Hospital (QH) A Medicaid provider that notifies HHSC of its intent to make presumptive eligibility determinations and agrees to make PE determinations per HHSC policies and procedures. The second party selects the Second Level Review interview mode. These include construction of real property or lease, rental, license, sale, exchange, or other disposition of personal property, computer software, sound recordings, produced films, produced electricity, natural gas, or potable water. You will need to login again. These are given to a SNAP household that either incurs a heating or cooling cost separate from the rent or received a Low-Income Home Energy Assistance Program (LIHEAP) payment. Able Bodied Adult Without Dependents (ABAWD) A person, 18 through 50 who: The ABAWD age criteria begins the month after the person turns 18 and ends the month the person turns 50. You can check the status of your application or you can start a new one. The two levels of service are: Claim An amount owed by a person for an overpayment of benefits. This process occurs without staff action. Alien Sponsor A person who signed an affidavit of support (U.S. Parental Control A minor who lives with an adult is under parental control if one of the following conditions applies: Parole The discretionary and conditional release of an eligible offender sentenced to serve the remainder of the sentence under supervision in the community rather than prison. The house parent assumes responsibility and acts in lieu of the parent in meeting the childrens ongoing needs. SeeCorrespondence,Print ModeandPrint Type. My career spans a number of years, industries, and roles in education, computer operations, process improvement, organization development, coaching, marketing, customer service, and corporate . Alternative Benefit Plan Eligibility; . Budgeting The method used to determine eligibility and benefits for Temporary Assistance for Needy Families (TANF), Medical Programs, and the Supplemental Nutrition Assistance Program (SNAP) by calculating income and deductions. Medical Support Health insurance that absent parents will be ordered to obtain for their children who receive Medicaid when it is available at reasonable cost. Lone Star FAQs | Texas Health and Human Services Personal Representative A person who can represent another person's rights with respect to individually identifiable health information. The Homeland Security Act of 2002 dismantled the former Immigration and Naturalization Service (INS) and separated the former agency into three components within the Department of Homeland Security. They are not considered inmates of a public institution. intended to result in physical harm, bodily injury or assault, or that is a threat that reasonably places the member in fear of imminent physical harm or bodily injury or assault, not including defensive measures to protect oneself; or. Payee A person that the Temporary Assistance for Needy Families (TANF) benefits are issued to if no one in the household qualifies or wants to be a caretaker. Each state has its own rules about who's eligible, and what Medicaid covers. 4, Disqualified Members, unless that disqualification is due to not meeting citizenship requirements. Not all Texas Health and Human Services Commission (HHSC) programs and types of assistance have certification periods. These benefits are accessed by: card and personal identification numbers (PINs); or, Attempting to buy, sell, steal, or otherwise effect an exchange of SNAP benefits and using them for cash or something other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone. Each reprint of an original has the same Correspondence ID as the original. 1-877-541-7905. Payments to Civilians Relocated During Wartime Payments made to Aleuts or people of Japanese ancestry or their heirs who were relocated during World War II. This gives a source of citizenship or alien status verification for certain Medical Programs. Combat Zone The geographic area or country to which a military member is deployed for combat. Dispose To authorize an Eligibility Determination Group (EDG) so eligibility is established or denied. SDX information can be used as a source of verification and is available in the Texas Integrated Eligibility Redesign System (TIERS). Medicaid In Texas, there are 5 different types of Medicaid: STAR STAR+PLUS STAR Kids STAR Health Traditional Medicaid The type of Medicaid coverage you get depends on where you live and what kind of health issues you have. Legal Parents Mother, by having given birth to the child, by proof of adoption, legal document or court adjudication or father, by proof of adoption, legal document, court adjudication or his acknowledgement of paternity. During this step, information from electronic data sources is automatically requested, reasonable compatibility is run when income verification is required and correspondence is sent to the recipient. Common Law Marriage Relationship in which the two parties both 18 years or older: A minor child in Texas cannot legally enter a common law marriage unless the claim of common law marriage began before Sept. 1, 1997. Note:See Publicly Operated Community Residence for additional information about a public facility not considered to be a public institution. These include a county holding facility for juveniles or a facility that a government unit exercises final administrative authority. Electronic Benefit Transfer (EBT) A system that uses electronic technology to complete some of a benefit program's functional requirements. Clicking the Add, Update or Submit button saves information on specific pages. Inmates of facilities that meet the definition of public institution are not eligible for Temporary Assistance for Needy Families (TANF) or Medicaid. What Is The Contact Number For Texas Health Benefits Authorization Code A code that identifies a retailer as a Food and Nutrition Service (FNS)-participating store. Medicaid Card An identification card issued to people determined eligible for Medicaid that verifies Medicaid coverage. What is the difference between a Medicaid number and a case number The EDG includes members who are eligible and may include members who are not certified for benefits. Make payments to the surviving spouse, children, parents, grandchildren or grandparents when the affected person is deceased. Recoupment Withholding part of a person's current benefit because of a previous overpayment. Individual Retirement Account (IRA) An account in which a person contributes an amount of money to supplement retirement income, regardless of their participation in a group retirement plan. . Helps families with children age 18 and younger pay for basic needs. SeeInterview ModeandCase Mode. to file a federal income tax return for the taxable year in which Medical Program eligibility is requested; if married, to file a joint federal income tax return for the taxable year in which Medical Program eligibility is requested; that no other taxpayer will be able to claim the person or the couple as a tax dependent on a federal income tax return for the taxable year in which Medical Program eligibility is requested; or. Benefit Issuance The functional area that supports the issuance and tracking of benefits calculated in the Eligibility Determination Benefit Calculation (EDBC) and authorized in disposition. Its given to an elderly household member, a household member with a disability, or both, who incur medical expenses of more than $35 but less than or equal to $137. Purchasing a product with SNAP benefits with a container requiring a return deposit. The payee must be within the required degree of relationship. Pick numbers that are easy for you to remember, but hard for others to guess. The sleeve stores the card and protects the magnetic strip from being damaged by scratches. Application A form that a person or household uses to apply for assistance. One program is the Choices program for TANF recipients, and the other is the SNAP Employment and Training (E&T) program for SNAP recipients. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). Deferred Adjudication A type of probation where the decision for a conviction is postponed until the end of the probationary period. Prudent Person Principle Reasonable decision made by staff based on the best information available and common sense in a particular situation. Evaluative Conclusion An advisor's decision, subject to supervisory approval, to accept something other than a birth or hospital certificate or baptismal record as proof of age and relationship. are intended for expenses other than room and board. Blocked Time periods that are designated for specific purposes. State Online Query SOLQ allows states real-time online access to SSA's SSN verification service. TWC is part of a local and state network dedicated to developing the workforce of Texas. Reapplication Date Date the Texas Health and Human Services Commission (HHSC) receives a new application for redetermination or complete review of eligibility. reactivating an EDG without requiring a new application form. A calendar tax year is 12 consecutive months beginning Jan. 1 and ending Dec. 31. Self-Service Portal (SSP) A web-based application, atYourTexasBenefits.com. Office of Inspector General (OIG) A division of the Texas Health and Human Services Commission (HHSC) created by the 78th Texas Legislature, Regular Session, 2003, to prevent and reduce waste, abuse, and fraud within the Texas Health and Human Services system. Timely Supplemental Nutrition Assistance Program (SNAP) application filed by the 15th of the last month of certification. Homeless Household Households that have no regular nighttime residence or that live in: Hotline (TANF/SNAP Complaints) Toll-free number (877-787-8999) where staff receive complaints for Temporary Assistance for Needy Families (TANF) and Supplemental Nutrition Assistance Program (SNAP) cases. Scheduling The functional area that manages eligibility appointments. Texas Health Steps A health care program of prevention, diagnosis, and treatment for Medicaid people. EBT involves computers, a variety of cards or types of cards, electronic funds transfer techniques, automated teller machines (ATMs), point-of-sale terminals or other types of terminals, and software to complete the EBT process without the loss of program integrity or individual confidentiality. This will help you know if you should apply for benefits on this site or for health insurance on HealthCare.gov. To learn more about Texas Works, please visit Texas Workforce Commission website. These occupations include beauticians, waiters, valets and food delivery staff. Benefits. Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP) A demonstration project that outreaches elderly Supplemental Security Income (SSI) recipients who are not currently certified for SNAP. These are benefits issued and accessed by EBT cards, card numbers and PINs, or by manual voucher and signature. The code is used to request permission to use the Lone Star Card in a transaction. It is a medical condition (including emergency labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) that the absence of immediate medical attention could reasonably have been expected to result in: Employable Household Member A person whose earnings are countable and who: Employer-Paid Taxes Taxes that are paid by the employer on behalf of the employee rather than deducting the tax amount from the employee's wages. EDGs denied because of new or increased spousal support income will receive a maximum of four months of coverage. Emancipated Minor A person 17 and under who has been married. Institution of Higher Education Any public or private college, community college, junior college, technical institute, or university that usually requires a high school diploma or equivalent certificate such as a general equivalency diploma (GED), to enter. There are three types of benefit accounts: The person or their representative uses the Lone Star Card and a personal identification number (PIN) to access benefits in the account. The network is comprised of the statewide efforts of TWC along with planning and service provision by 28 local workforce boards on a regional level. Correspondence The functional area in which system and user-generated notices and forms are processed and stored. Good Cause A term used to indicate that a person has an acceptable reason for not complying with a program requirement. The last number in your TANF Eligibility Determination Group number tells what day you get your benefits. Electronic Benefit Transfer (EBT) Representative A primary cardholder other than the case name. Print Type Classification of historical correspondence as the original record or a reprint of the original. receive copies of the applicants or recipient's notices in the preferred language selected on the application and other communications from the agency; act on behalf of the applicant or recipient in all other matters with the agency, such as reporting changes. Discovery Date The date a person learns of a change. Annualize Averaging income over a 12-month period. Community Supervision The placement of a misdemeanor or felony offender under supervision for a specified length of time ordered by the court. Catchment Area The area covered by service. ], Title 42, 1396 et seq.) Get help over the phone,from an HHSC benefit officeor community partner. Run EDBC (Eligibility Determination Benefit Calculation) A process in the Wrap Up eligibility management group used to determine eligibility of the Eligibility Determination Group (EDG). Expunged Benefits Benefits that are removed from an EBT account by the issuer of the benefits. This information is compared to the application and details from the interview to identify case discrepancies and reduce the possibility of case error and fraud. is not needed to process a redetermination. They are still required to be registered for work with the Texas Workforce Commission (TWC) and are mandatory participants if they do not meet work registration exemption requirements. Your case number is a 10-digit number that HHSC uses to bundle and process benefits you receive through their agency. Processing Time Frames Number of days eligibility staff must complete a particular action. Welcome to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. Questionable Management A household has questionable management when reported basic expenses exceed reported net income and resources. You do not need to be enrolled in VA benefits or health care to connect. Radiation Exposure Payments A program to compensate a person for injury or death from exposure to radiation from nuclear testing and uranium mining. Permissible purpose means the person whose credit report is requested must be: Staff who request credit information without permissible purpose are subject to fines, imprisonment, or both. Marketplace The governmental entity that makes qualified health plans available to qualified people, qualified employers or both. Timely Disposed An Eligibility Determination Group (EDG) that is completed in accordance with program timeliness standards. Purchasing a product with SNAP benefits with the intent of obtaining cash or something other than eligible food. You'll get an email or text when there'sa form or notice available online in yourMessage Center. Functions of the clearinghouse include: Collateral Contact A person the advisor can contact to verify a person's information. Waiver Counties Texas counties with an unemployment rate over 10 percent. The number is used to record covered wages, track Social Security benefits and for other identification purposes. Lock-in A status created by the Texas Health and Human Services Commission (HHSC) for certain people to help contain Medicaid costs, which allows additional review of high Medicaid users. Trafficking Victims Victims admitted under the Trafficking Victims Protection Act of 2000. State Data Exchange (SDX) Computer tape from the Social Security Administration (SSA). a correctional or holding facility for people who: have been arrested or detained pending disposition of charges; or. The facts about the individual tax identification number Your total base period wages are at least 37 times your weekly benefit amount. able to apply for Medicaid on the child's own behalf; or. For your convenience, the Help Center will open in a new window. Alimony Paid Payments to a spouse or former spouse under a divorce or separation decree. Even if designed to serve up to 16 residents, the following facilities are not considered publicly operated community residences: Qualified Entity (QE) A Medicaid provider (in most instances but can also be an organization such as a school or clinic) that notifies HHSC of its election to make presumptive eligibility determinations and agrees to make presumptive eligibility determinations for pregnant women only, per HHSC policies and procedures. Data Broker An online portal used to obtain financial and other background information about applicants and recipients. Texas Workforce Commission's Unemployment Benefit Services - Help - Logon This process occurs without staff or specialist action. Presumptive Eligibility (PE) Short-term Medicaid coverage provided to people determined potentially eligible for regular Medicaid by a qualified hospital or a qualified entity. The term also applies to decisions for protective and restricted payments. Please look at the permit to find your number. Continuing Scheme A situation in which a recipient commits two or more acts. Immigration and Customs Enforcement handles immigration enforcement; and. Modified Adjusted Gross Income (MAGI) Household Composition The people whose income and needs are considered when determining eligibility for an applicant or recipient for certain Medical Programs based on tax status, tax relationships, living arrangement, and family relationships. The PAN is not related to the persons Texas Health and Human Services Commission (HHSC) case number. Enter this for various situations including: Real Property Land and any improvements on it. Individual Exchange Plan Information for Providers | UHCprovider.com Alternate Payee A person who receives the benefits for the EDG when people on the EDG are unable or ineligible to receive them.
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