Medicaid for the Elderly and People with Disabilities Handbook

Chapter D — Non-Financial

Reminder: Federal law requires that anyone who wishes to apply for Medicaid be allowed to file an application, regardless of the person's ultimate eligibility for services.

Table of Contents

D-1000
Aged, Blind or Disabled
D-1100
Related Texas Administrative Code Rules
D-1200
Age
D-1210
Definition of a Child
D-1300
Blindness
D-1400
Disability
D-2000
Determining Blindness or Disability
D-2100
When a Medical Determination Is Not Required
D-2200
When a Medical Determination Is Required
D-2300
Requesting a Decision from the Disability Determination Unit (DDU)
D-2400
Disability Determination Unit (DDU) Request Required
D-2500
Supplemental Security Income (SSI) Applicants and Retroactive Coverage
D-2600
Disability Determination Unit (DDU) Decision
D-2700
Use of Decision on the Disability Determination - DDU Page in TIERS
D-2800
Disability Determination at Time of Review
D-3000
Residence
D-3100
Related Texas Administrative Code Rules
D-3200
Eligibility
D-3300
Maintaining Presence in the U.S.
D-3310
Exceptions to U.S. Presence
D-3400
Change of Address
D-3500
Intent to Remain in Texas
D-3510
Intent to Return
D-3520
No Intent to Return
D-3600
Interstate Issues
D-3610
Interstate Requests for Assistance
D-3620
Out-of-State Medicaid and Texas Medicaid Recipients
D-3630
Texas Applicant Outside the State of Texas
D-3640
Applicant from Another State
D-3650
Out-of-State Recipient Visiting Texas
D-3660
SSI Recipient Visiting in Texas
D-3700
Special Situations
D-3800
Inmates in a Public Institution
D-4000
Fiduciary Agents and Living Arrangement
D-4100
Fiduciary Agents
D-4110
Texas Administrative Code Rules
D-4120
Transactions Involving Agent
D-4121
Examples
D-4200
Living Arrangements
D-4210
Deeming
D-4211
Spouse
D-4212
Child
D-4213
Parent
D-5000
Citizenship and Identity
D-5100
Texas Administrative Code Rules
D-5200
Citizenship
D-5210
Child Citizenship Act of 2000
D-5220
Compact of Free Association States
D-5300
Acceptable Documentation of Citizenship and Identity
D-5310
Exceptions to Documentation of Citizenship and Identity Requirement
D-5320
Using Wire Third-Party Query (WTPY) to Verify Citizenship
D-5400
Notification
D-5500
Reasonable Opportunity to Provide
D-5510
Initial Request at Time of Application
D-5520
Initial Request at Time of Redetermination
D-5600
Providing Assistance
D-6000
Social Security Number (SSN) and Application for Other Benefits
D-6100
Texas Administrative Code Rules
D-6200
SSN Requirement
D-6210
When a Person Does Not Have an SSN
D-6300
Application for Other Benefits Requirement
D-6310
Other Benefits Subject to Application Requirement
D-6320
Other Benefits Exempt from Application Requirement
D-6330
Payments That Are Not Other Benefits
D-6340
Supplemental Security Income (SSI)
D-6341
MEPD Eligibility Pending Adjudication of SSI Claims
D-6350
Veterans Benefits
D-6351
VA Pension or Compensation
D-6352
VA Wartime Periods
D-6353
VA Payments for Dependents
D-6354
Requirement to Apply for Apportionment of Augmented VA Benefit
D-6360
Workers' Compensation Payments
D-6370
Private Sector Pensions
D-6380
Public Sector Pensions
D-6400
Treatment of Other Benefits
D-6410
Deeming Situations
D-6420
Payment Options for Other Benefits
D-6421
Survivor's Benefits for Spouses and Other Dependents
D-6422
Other Benefit Lump Sum or Annuity Exception
D-6430
Electing the Month of Entitlement
D-6440
Establishing Eligibility after Denial
D-6500
Exceptions to the Application for Other Benefits Requirement
D-6600
When Not to Refer for Other Benefits
D-7000
Third-Party Resources
D-7100
Texas Administrative Code Rules
D-7200
Cooperation and Assignment of Rights for Medicaid Eligibility
D-7300
Potential Sources of Third-Party Coverage
D-7310
Examples of Third-Party Resources
D-7400
Use of Third-Party Resources
D-7410
Cost Avoidance
D-7420
Post-Payment Recovery
D-7500
Third-Party Resources for SSI Recipients
D-7510
Social Security Administration (SSA) Role and Supplemental Security Income (SSI) Recipients
D-7600
Long-Term Care Insurance Policies
D-7700
Health Insurance Premium Payment Reimbursement Program
D-7800
Medicaid Estate Recovery Program
D-8000
Alien Status
D-8100
Texas Administrative Code Rules
D-8200
Authorized Alien Status
D-8210
Terms
D-8220
Groups of Aliens
D-8221
Date of Qualifying Classification
D-8222
Classifications for Qualified Aliens
D-8300
Qualified Alien Categories
D-8310
Qualified Aliens Subject to a Seven-Year Limited Period
D-8320
Qualified Aliens Not Subject to a Waiting Period or Limited Period
D-8330
Qualified Aliens with a Five-Year Waiting Period
D-8340
Establishing Qualifying Quarters of Social Security Coverage
D-8341
Combining Qualifying Quarters of Spouse/Parent
D-8342
Qualifying Quarters Earned on or After Jan. 1, 1997
D-8343
Non-Covered Wages
D-8344
Procedures for Verifying 40 Quarters
D-8345
Response from WTPY
D-8400
LAPR Conditions for Medicaid
D-8410
Veterans, Armed Forces Active Duty and Dependents
D-8411
Loss of “Veteran/Active Duty” Status
D-8420
American Indians Born Outside the U.S.
D-8430
LAPR Residing in the U.S. on Aug. 22, 1996
D-8500
Qualified Aliens, Retroactive Coverage and SSI
D-8600
Non-Qualified Aliens
D-8610
Ineligible Aliens
D-8611
Documents of Ineligible Aliens
D-8620
Illegal Aliens
D-8700
Verification of Alien Status
D-8710
Documentary Evidence by Classification
D-8720
Lawfully Admitted for Permanent Residence (LAPR)
D-8721
Description of Common Resident Alien Cards
D-8730
Refugees
D-8740
Parolee
D-8750
Asylee
D-8760
Deportation Withheld
D-8770
Cuban/Haitian Entrants
D-8780
Qualified Alien Based on Battery or Extreme Cruelty
D-8800
Systematic Alien Verification for Entitlements (SAVE)
D-8810
Getting Permission to Access to SAVE
D-8820
Primary Verification of Alien Status
D-8830
Additional Verification — Online Process of Alien Status
D-8840
Secondary Verification of Alien Immigration Status
D-8900
Alien Status Eligibility Charts
D-8910
Entry Before 1996
D-8920
Entry On or After Aug. 22, 1996 — Qualified Alien No Waiting Period
D-8930
LAPR Aliens With or Without Five-Year Waiting Period
D-8940
Summary of Charts
D-9000
Alien Sponsorship
D-9100
Definition of Sponsor and Sponsored Alien
D-9200
Sponsor-to-Alien Deeming Policy
D-9210
Deeming Period
D-9220
Deeming Exceptions
D-9230
Providing Verification of Alien Sponsor's Income and Resources
D-9300
Sponsor-to-Alien Resource Deeming
D-9310
Examples of Sponsor-to-Alien Resource Deeming
D-9400
Sponsor-to-Alien Income Deeming
D-9410
Examples of Sponsor-to-Alien Income Deeming
D-9500
Income Excluded from Sponsor-to-Alien Deeming
D-9510
Food
D-9520
Housing and Utilities
D-9530
Education and Employment
D-9540
Native Americans
D-9550
Other
D-9600
Notification Requirements