Interactive Voice Response (IVR) A dial-in inquiry system (also known as Automated Voice Response [AVR]) that provides 24-hour access to automated account information via a digital phone. the requirement of more information from the applicant to manually process the redetermination. There are two types of categorically eligible households: Certificate of Coverage A certificate that serves as proof of a Medicaid recipient's most recent period of Medicaid coverage. 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). System-Generated Created by a computer system programmed with given parameters. Moving Expenses Federal income tax deductible expenses an active duty member of the military may claim for relocating to a new duty station. Processing Time Frames Number of days eligibility staff must complete a particular action. Summary Page A page that lists a summary of all records available for that Texas Integrated Eligibility Redesign System (TIERS) page. Sanction Either a disqualification or a penalty applied to a case or program because a person failed to follow a program requirement. This gives a source of citizenship or alien status verification for certain Medical Programs. placing the patient's health in serious jeopardy; seriously impairing the patient's bodily functions; or. The newborn Medicaid coverage can continue through the month of the child's first birthday if the child continues to live in Texas. Veterans can still call 800-273-8255 and Press 1 to reach the Crisis Line as well. Case All the persons living together, and alien sponsors, who are related by Eligibility Determination Group (EDG) affiliation. Power of Attorney (POA) Written legal authorization to represent or act on another's behalf in private affairs, business, or some other legal matters. Note:This does not include anyone who otherwise qualifies as a resident of a drug and alcohol treatment center, federally subsidized housing for the elderly, a qualifying group living arrangement, a shelter for battered persons, or a shelter for the homeless. Absent Parent A child's parent who is not living in the home. Coordination of benefits (COB) allows plans that provide health and/or prescription coverage for a person with Medicare to determine their respective payment responsibilities (i.e., determine which insurance plan has the primary payment responsibility and the extent to which the other plans will contribute when an individual is covered by more They have already gone through the eligibility determination for those programs. Unemployment benefits range from $69 per week to $521 per week. Expenses of Performing Artists Federal income tax deductible expenses for qualified performing artists paid or accrued through performances while serving as an employee in the performing arts. Contact the Texas Department of Insurance's Consumer Health Personal Identification Number (PIN) A four-digit numeric code assigned to each cardholder and used to control access to the person's account. Electronic Benefit Transfer (EBT) System A system HHSC staff with security access use to issue and replace Lone Star Cards. The notice contains programmed information based on the program, type of assistance, and eligibility result. reactivating an EDG without requiring a new application form. Hearing The functional area where individual appeals are recorded and tracked. . An example of a publicly operated community residence that is not a public institution is a county homeless shelter with a capacity of up to 16 people. People can apply using a simplified application, and they do not typically have to complete an interview at redetermination. If you already have a Lone Star Card PIN, you can keep it or change it. Overpayment The amount of benefits issued in excess of what should have been issued. Protective Payee Person selected to receive and manage the Temporary Assistance for Needy Families (TANF) benefit when the caretaker is not using the TANF payments for the children's benefit. Conception occurs, but no fetus ever develops. request an alert and send it to another user; generate manual correspondence on a case; and. Scheduling The functional area that manages eligibility appointments. Meal delivery services A non-profit establishment approved by Food and Nutrition Services (FNS) that prepares and delivers meals to elderly people or people who are housebound, have a physical handicap, or otherwise have a disability that prevents the person from adequately preparing all their meals. Aperson under18 may not be a party to an informal (common law) marriage. Ongoing Benefits Benefits issued for months after the initial benefit month. Reasonable Opportunity The 95-day period following the date a notice is sent to a person. Managing Conservator A person designated by a court to have daily legal responsibility for a child. Batch Processing Actions postponed until a later time when they can be processed by the system more efficiently. Adjusting to the physical changes post-surgery can be difficult, and finding the right mastectomy bra is one of the most important steps in the process. receives Supplemental Nutrition Assistance Program (SNAP) benefits; is physically and mentally able to work at least an average of 20 hours per week; is not a member of a SNAP Eligibility Determination Group (EDG) where a household member on the SNAP EDG is under 18; an automated eligibility determination; or. Timely Supplemental Nutrition Assistance Program (SNAP) application filed by the 15th of the last month of certification. 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. Birth Verification System (BVS) The inquiry system includes birth records of people born in Texas. reaching the maximum age for that specific program; state error in the eligibility determination; or, fraud, abuse, or perjury attributed to the people or persons representative, was the spouse, parent, sibling or adult child of a victim who died as a result of a violent crime; or. The .gov means its official. Type of Assistance (TOA) The specific aid for one or more people in an Eligibility Determination Group (EDG). some eligible members receive TANF or RCA, and all other eligible members receive Supplemental Security Income (SSI), including SSI essential persons. Modified Adjusted Gross Income (MAGI) Financial Eligibility The result of a comparison between an applicants or recipients MAGI household income to the applicable Medicaid or Children's Health Insurance Program (CHIP) income limit based on the Federal Poverty Income Limit (FPIL) and the MAGI household size. Standard Utility Allowance (SUA) A standard deduction for the cost of utilities. Pick numbers that are easy for you to remember, but hard for others to guess. A same-sex marriage that occurred before June 26, 2015, is considered valid effective June 26, 2015. Functional Area Functions and processes that appear in the Texas Integrated Eligibility Redesign System (TIERS) Left Navigation area and represent a particular business process. If you are deaf or hard of hearing, you can call us at TTY 1-800-325-0778. Or you can call the Texas Department of Human Service (DHS) toll-free at: 1-877-541-7905. Normal Living Expense Items necessary for a Supplemental Nutrition Assistance Program (SNAP) household to carry on its normal daily activities. ), dentist (D.D.S. Three Months Prior The three-month period before the Medicaid application month. past, present or future physical, mental health condition of the person; provision of health care to the person; or. voluntary not court-ordered and given voluntarily when the childs caretaker or the person making the payment states the purpose of the payment is to support the child. Citizenship and Immigration Services (USCIS) and who has received a final order of deportation. Trust Property held by one person for the benefit of another. Feb 17, 2022 Knowledge Article The Food and Nutrition Service (FNS) number is the 7-digit number printed on the Supplemental Nutrition Assistance Program (SNAP) permit sent to you when you became authorized to participate in SNAP. For example, a notice is system-generated when an Eligibility Determination Group (EDG) is disposed. Priority Supplemental Nutrition Assistance Program (SNAP) Issuances Expedited SNAP benefits, benefits issued on or after the 25th day from the date of application, and issuances ordered by a hearing officer decision that must be made available in order to meet fair hearing timeliness requirements. Child Support A payment made from a biological or adoptive parent to a biological or adoptive child. Administrative Terminal Application (ATA) A software program accessible on one or more Texas Health and Human Services Commission (HHSC) desktop computers in each office. Lawful Permanent Resident (LPR) A person lawfully admitted for legal permanent residence in the U.S. Payments: Indian Tribal Household A household in which at least one household member is recognized as a tribal member by any Indian tribe. Primary Cardholder (PCH) The person designated to receive and be responsible for the household's Lone Star Card. Appeals are logged and updated in the Hearing functional area on the navigation bar. Temporary Assistance for Needy Families (TANF) A child who lives with either one or both parents, or a parent and step-parent, and one or both parents or step-parent do not receive TANF benefits. Your Medicaid number also known as a recipient number or individual number is a 9-digit number than can be found on the 'Your Texas Benefits' card. Legally Obligated Child Support Court order or a legally recorded document requiring the payments of child support to be made in the form of cash, medical support, or to a third party. Medicaid is also known as the medical assistance program. Former Medicaid recipients may request a certificate within 24 months after their Medicaid is denied by calling 800-723-4789. Available at reasonable cost is usually defined as being available through the employer. Untimely SNAP application filed after the 15th of the last certification month. a correctional or holding facility for people who: have been arrested or detained pending disposition of charges; or. See User-Generated. Presumptive Eligibility (PE) Short-term Medicaid coverage provided to people determined potentially eligible for regular Medicaid by a qualified hospital or a qualified entity. Also, the act of trafficking in SNAP benefits. intended to inflict emotional harm, including an act of emotional abuse. For your convenience, the Help Center will open in a new window. The User Guide includes information about numerous TIERS topics. Discovery Date The date a person learns of a change. HHSC The Texas Health and Human Services Commission. causing serious dysfunction of any bodily organ or part. Indigent Alien A sponsored alien whose total income in the month of application does not exceed 130 percent of the federal poverty level for the alien's household size. 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. Annualize Averaging income over a 12-month period. Managed care includes the health maintenance organization (HMO) model. Rebuild EDG (Eligibility Determination Group)A button in the Wrap Up management group. Your total base period wages are at least 37 times your weekly benefit amount. Newborn Child A child receiving Type Program (TP) 45, Medical Assistance for Newborn Children, because the child's mother was eligible for and received Medicaid coverage at time of the child's birth or whose mother was eligible for and received Medicaid coverage retroactively for the time of the child's birth. SOLQ enables state social services to rapidly get information they need to qualify people for programs. Certification Date The date that eligibility staff dispose the Eligibility Determination Group (EDG) to certify an applicant. The Workforce Innovation and Opportunity Act replaced the Workforce Investment Act of 1998. Case Visibility Type of YourTexasBenefits.com account given to an applicant who has been through Advanced Authentication so is granted a Case Visibility level account. Continuing Scheme A situation in which a recipient commits two or more acts. The notices and forms processed in this functional area are also called correspondence and linked to a specific case. 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. A petition for judicial review must be filed by the appellant in a district court in Travis County within 30 calendar days after the date the administrative decision is issued. Find Texas health insurance options at many price points. Taxpayer A person or a married couple who expects: Temporary Assistance for Needy Families (TANF) Basic Cash assistance for families that include a dependent child and no more than one eligible adult. EDGs denied because of new or increased earnings will receive a maximum of 12 months of coverage. Individual Retirement Account (IRA) Deduction A federal income tax deduction for people who contributed to a traditional IRA. Generally, to qualify for SNAP, non-citizens must meet one of the following criteria: Have lived in the United States for at least 5 years. Copayment Payment made directly to a provider according to a fee schedule. Texas's EBT customer service number is 1-800-777-7328. Spend Down The amount of excess income that the applicant must deplete with incurred medical bills before being certified as medically needy. (FPL). Electronic Benefit Transfer (EBT) Vendor A company that performs EBT-related services for the state of Texas. Nonliquid Resources Resources such as vehicles, buildings, land, or certain other property that are considered countable, except as explained in the vehicles portion of resource policy or unless the resource is specifically exempted. ), osteopathic medical physician (D.O. Other-Related Temporary Assistance for Needy Families/Medical Program (TANF/MP) Child An eligible child living with a relative other than the child's legal parent. These occupations include beauticians, waiters, valets and food delivery staff. This process occurs without staff or specialist action. Initial Benefits Benefits issued for the first month of eligibility. Benefits. This procedure can be used when policy has changed and TIERS has not yet been updated to process the policy change correctly. Clearinghouse A centrally located site that processes medical bills submitted by applicants for Medically Needy with Spend Down. Commingled Resources Resources of a Temporary Assistance for Needy Families (TANF) or Supplemental Security Income (SSI) recipient combined with those of a non-TANF or SSI household member. Migrant Farmworker in the Workstream Farmworkers who travel to work in agriculture or a related industry and who are presently employed away from their permanent residence or home base. Carryover Standby List Applicants from a previous day's standby list who have not been interviewed. Electronic Benefit Transfer (EBT) Account A benefit account established by the EBT system where HHSC deposits the household's benefits. createcorrespondence and reports based on system-requested and user-requested criteria. See Taxpayer. Explore health plans for you and your family, including short-term gap coverage and more. Supplemental Security Income (SSI) A needs-tested program administered by the Social Security Administration. Users cannot delete system-generated correspondence. This results in: Administrative Review A desk review of the fair hearing record by a Texas Health and Human Services (HHS) attorney to determine if the hearing officer's decision is correct. The Food and Nutrition Act of 2008 limits eligibility for SNAP benefits to U.S. citizens and certain lawfully present non-citizens. 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. Deductible Part of Self-Employment Tax A federal income tax deduction for self-employed people paying self-employment taxes. Each reprint of an original has the same Correspondence ID as the original. Some people qualify for both Medicare and Medicaid. These databases contain information for individuals who are currently on assistance and for individuals who have applied for or received assistance in the past. formal court-ordered or legally mandated; or. This category also includes Amerasians admitted under Section 584 of the Foreign Operations, Export Financing and Related Programs Appropriation Act of 1988. TWC is part of a local and state network dedicated to developing the workforce of Texas. SeeEDBC. These people must have parental consent or court permission. Non-Secure Facility A publicly operated community residence that serves no more than 16 residents, such as a county emergency shelter or non-public group or foster home. Trade Adjustment Assistance Act Program (TAAP) A program for workers displaced by foreign workers. Expunged Benefits Benefits that are removed from an EBT account by the issuer of the benefits. Nonconvertible Bond A bond that cannot be converted to cash per program policy. Authorization Code A code that identifies a retailer as a Food and Nutrition Service (FNS)-participating store. According to the most recent IRS statistics for the 2017 tax year, the average married couple filing jointly received a tax refund of $2,781. The official document indicates to and for whom the support is paid, the frequency and the amount of payment. Medicaid Card An identification card issued to people determined eligible for Medicaid that verifies Medicaid coverage. is not needed to process a redetermination. Your case number is a 10-digit number that HHSC uses to bundle and process benefits you receive through their agency. Those who see several doctors each month and make questionable visits to hospital emergency rooms are limited to seeing one doctor or using one pharmacy for a minimum of six months. The persons may or may not be included in EDGs as certified members. The buying, selling, stealing, or otherwise effecting an exchange of SNAP benefits for cash or consideration other than eligible food, either directly, indirectly, in complicity or collusion with others, or acting alone. You have unsaved changes that will be lost if you exit. See Permissible Purpose. It must take place before the person receives a seventh warrant. Molar Pregnancy Also known as hydatidiform mole, a molar pregnancy is considered a degenerating pregnancy. CHIP perinatal The mother and child will be certified on a single EDG during the month the child is born. Jury Duty Pay Taxable income received as compensation for jury duty. Asylee A person granted asylum under Section 208 of the Immigration and Nationality Act (INA). Eligibility The functional area that supports Eligibility Determination Benefit Calculation (EDBC). Prospective Budgeting Determination of eligibility for and the amount and type of benefits using the best estimate of the household's current and future circumstances and income. Historical Correspondence Records of forms and notices that have been printed. Electronic Benefit Transfer (EBT) Card A plastic card called the Lone Star Card issued to primary and secondary cardholders that allows the cardholders access to the benefits in the EBT system. The Department of Defense Appropriations Act of 2010, PL 111-118, enacted on Dec. 19, 2009, says SIV are eligible for all benefits to the same extent and the same period as refugees. 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. With this type of access, a person can view and change an application created under their username. Emancipated Minor A person 17 and under who has been married. SDX information can be used as a source of verification and is available in the Texas Integrated Eligibility Redesign System (TIERS). The same benefit is now called One-Time TANF for Relatives, with payment records stored in TIERS. See Cascade Logic. Also benefits issued for the first month of eligibility after a break in eligibility of at least one month. BENDEX (Beneficiary and Earnings Data Exchange) A computer tape match from the Social Security Administration that provides Social Security and Medicare information about Texas Health and Human Services Commission (HHSC) recipients. This process occurs through a mass update and does not require action. With an account, you will also be able to save your support service screening forms and check the status of any you have already filled out.
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