Medicaid Application Process
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State Medicaid Programs List
Published:Thu, 23 Feb 2012 17:45:37 -0800
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Published:Wed, 22 Feb 2012 10:31:01 -0800
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The Texas Medicaid Program
If you are a resident of Texas and need help getting medical care for you or your family because your income is limited, the Texas Medicaid program may be able to help you.
The Medicaid program in Texas helps provide medical coverage for about 3.2 million low income residents of Texas. The Medicaid program in Texas seeks to improve the health of Texans that may not be able to afford necessary medical care for themselves or their families.
Medicaid pays for health care which includes inpatient, outpatient, physician, lab, pharmacy, and x-ray services. Medicaid also helps pay for long-term care, communit-based care, and nursing facility services for people that are 65 years of age and older or have disabilities.
In Texas, the Medicaid program is administered by the Texas Health and Human Services Commission (HHSC). If you are interested in the Texas Medicaid program, you will need to know if you are eligible for Medicaid and how to apply for Medicaid.
Texas Medicaid Application - Applying for Medicaid in Texas is easy. To make your Texas Medicaid application go smoothly, make sure that you have the following documents and information:
Identity - A valid driver's license or Department of Public Safety ID card. If you are having someone representing you, they will need proof of their identity and proof of your identity.
Social Security - A Social Security card or statement from the Social Security Administration for each person that is applying for Medicaid.
Citizenship - U.S. passport, Certificate of Naturalization, U.S. birth certificate, hospital record of birth or a Medicare card.
Qualified Alien/Eligible Non-Citizenship Status - Alien registration card, documents from the Bureau for Citizenship and Immigration Services.
Legal Representative - Power of attorney guardianship order, court order or similar court documents.
Earnings - Your pay stubs, copy of checks, statment from employer or self-employment records.
Social Security, Pension, Veterans Administration, Supplemental Security Income, Worker's Compensation or Unemployment Benefits - Pay stubs or award letter.
Child Support Obligations - Divorce decree, court order or copy of district clerk record.
Child Support Payment - Copy of district clerk record or letter from parent who pays showning any child support amounts and dates paid, including parents name, address, telephone number, signature, and date.
Loans, Gifts, Contributions - Promissory note, loan agreement, statement from person providing the money including the person's name, address, phone number, signature, and date.
Bank Accounts - Current statements for all accounts.
Stocks, Bonds, Annuities, Trusts - Trust agreement, annuity contract, bonds, stock certificates or current statements.
Real Estate, Oil, Gas, Mineral Rights - Current tax statements, deeds, division orders or royalty statements.
Medical Expenses - Medical bills, receipts or statements from your provider.
Insurance Policies - Copies of you life, health insurance, and burial policies. Statements from the insurance provider showing the current value policy.
Rent/Mortgage - Copies of checks, statements from landlord or mortgage company. If you rent your home, provide the name, address, and phone number of your landlord.
Utilities - Your most recent utility bills that show your name and current address.
How to apply for Texas Medicaid - There are 3 different ways that you can apply for Texas Medicaid.
1. You can call 2-1-1 to apply over the phone or to get help in applying for Medicaid.
2. You can apply online at www.YourTexasBenefits.com
3. You can download the Texas Application for Assistance form (PDF file) and FAX or mail it to the Texas Health and Human Services Commission.
Texas Medicaid Eligibility
There are three main groups of Texans that are eligible for Full Medicaid coverage:
1. Families and children which is based on income, age, or pregnancy.
2. Aged and disabled based on age, income level, and mental or phyiscal disability.
3. Recipients of either Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI).
Texas residents that may be eligible for LIMITED Medicaid benefits include:
1. People that receive Medicare benefits may receive some Medicaid coverage based on age and level of income.
2. People that are not eligible for Medicaid based on eligibility standards or are not U.S. citizens but need emergency medical assistance.
3. Women that do not qualify for full Medicaid coverage may receive women's health care services through Medicaid.
Texas Children’s Medicaid provides free health care services to children under the age of 19 whose families have limited incomes and financial resources.
The Texas Children’s Medicaid program provides six months of health care coverage. (Newborns receive 12 months of coverage if the mother was receiving Medicaid when the child was born). Medicaid coverage begins as soon as the Medicaid application is approved. Before the end of each six-month period of coverage, a Medicaid renewal application is sent to your family.
If the child that is receiving Medicaid has a disability, chronic condition or mental retardation, then the Texas HHSC will look at your child’s case to decide if your child can receive special services such as:
Long-term care services at home or in the community.
Treatment in a long-term care facility.
Assistance with high medical expenses.
Home and vehicle modifications.
Mental health services.
Texas Medicaid Coverage For Women
Medicaid for Low-income Pregnant Women
A pregnant woman in Texas may receive Medicaid benefits during pregnancy and up to two months after the birth of the baby if she meets certain income requirements.
Women’s Health Program - this program provides some Medicaid services to women with low incomes between the ages of 18 to 44. This Medicaid program provides one year of coverage and can be renewed every year the woman qualifies.
The Medicaid benefits include:
Complete health history.
Gynecological exam and Pap smear.
Birth control, except emergency contraception.
Screening for diabetes, sexually transmitted diseases, high blood pressure, and breast and cervical cancers.
Assessment of health risk factors, such as smoking, obesity and exercise.
Counseling and education on birth control methods, including the health benefits of abstinence.
Women that have been diagnosed with cervical or breast cancer - you might be able to get health care coverage for your cancer treatment through full Medicaid benefits.
If you are a woman that has cervical or breast cancer, a cancer services clinic will review your diagnosis to help determine if you can receive Medicaid. The clinic will help you fill out and submit and application to the Health and Human Services Commission. You cannot apply at the HHSC benefits office.
To get Medicaid for Cervical and Breast Cancer, you must:
Need treatment for a qualifying cervical or breast cancer diagnosis, including a precancerous condition, metastasis or recurrence of cervical or breast cancer.
Meet income requirements.
Not have insurance coverage for treatment of the cancer.
Be under the age of 65.
If you are eligible for Medicaid for Cervical and Breast Cancer you will receive your full Medicaid benefits beginning the day after you received a qualifying diagnosis. You can continue to receive Medicaid benefits as long as you meet the eligibility criteria and provides proof from your doctor that you are receiving treatment for your cancer.
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The official U.S. Government Medicare Web site is cms.gov.