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Accessibility Date The date that benefits are deposited into an Electronic Benefit Transfer (EBT) account. Trade Adjustment Assistance Act Program (TAAP) A program for workers displaced by foreign workers. Seecase modeandinterview mode. Prepaid Burial Insurance Insurance that pays for a specific funeral arrangement. Electronic Benefit Transfer (EBT) Account A benefit account established by the EBT system where HHSC deposits the household's benefits. Waiver of Continued Benefits An individual option to allow eligibility staff to process an adverse action during the individual's appeal process. The Veterans Crisis Line has a new number: Dial 988 then Press 1. Interview Mode A designation in TIERS Data Collection that queues the driver flow through appropriate pages according to the type of action. 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. Temporary Assistance for Needy Families Non-Cash (TANF-NC) Consists of services for: Temporary Assistance for Needy Families (TANF) Redirect A Texas Works message to TANF applicants delivered up front by Texas Health and Human Services Commission (HHSC) staff before the application process begins, explaining that: Temporary Assistance for Needy Families State Program (TANF-SP) Cash assistance for families with a dependent child and at least two adults. If you are deaf or hard of hearing, you can call us at TTY 1-800-325-0778. A special review is conducted in Special Review mode. Cafeteria Plan Flexible fringe benefit plans offered to employees by their employers. 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. 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. 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. Good Cause A term used to indicate that a person has an acceptable reason for not complying with a program requirement. Recoupment Withholding part of a person's current benefit because of a previous overpayment. 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. IDAs are generally matched dollar-for-dollar with funds from private citizens, corporations, banks, communities, or charitable organizations. Based on the criteria, TIERS generates a sample list. For more information, including who is eligible, click HERE. Business Day Monday through Friday from 8 a.m. to 5 p.m. local time. For the eligibility groups reflected in the table, an individual's income, computed using the Modified Adjusted Gross Income (MAGI)-based income rules described in 42 CFR 435.603, is compared to the income . A request for an administrative review must be submitted in writing within 30 calendar days from the date of the hearing officer's decision. 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. Overrides always require Second Level Review before they can be disposed. Eligibility The functional area that supports Eligibility Determination Benefit Calculation (EDBC). Call us at 1-800-772-1213 to make an appointment to file your application. Availability Date The date that benefits are deposited into the recipients Electronic Benefit Transfer (EBT) account. the requirement of more information from the applicant to manually process the redetermination. Protection at 1-800-252-3439 or www.tdi.texas.gov. Inmates of facilities that meet the definition of public institution are not eligible for Temporary Assistance for Needy Families (TANF) or Medicaid. SeeEDBC. Also formally known as (adult) probation. Data Broker An online portal used to obtain financial and other background information about applicants and recipients. Domicile A home maintained or being established, as shown by continuation of responsibility for day-to-day care of the child, by the relative who the child lives. Reapplication Date Date the Texas Health and Human Services Commission (HHSC) receives a new application for redetermination or complete review of eligibility. Secure Facility Secure boot camp settings. Temporary Assistance for Needy Families (TANF) An adult whose needs are included in a TANF grant because the adult is within the required degree of relationship and is financially eligible according to TANF policy. Birth Verification System (BVS) The inquiry system includes birth records of people born in Texas. minimum service has little or no presence of Choices staff. General Equivalency Diploma (GED) A high school equivalency certificate issued after a person completes a State Board of Education-approved high school equivalency program. 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. Application Visibility Type of YourTexasBenefits.com account given to an applicant who has selected not to go through Advanced Authentication. Communal Dining A public or non-profit establishment approved by Food and Nutrition Services (FNS) that prepares and serves meals to elderly people or those who receive Supplemental Security Income (SSI) and their spouses. . 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. All system-generated correspondence is scheduled for batch printing although it can be retrieved from Pending Correspondence and printed locally. Unemployment Benefits Services allows individuals to submit new applications for unemployment benefits, submit payment requests, get claim and payment status information, change their benefit payment option, update their address or phone number, view IRS 1099-G information, and respond to work search log requests. is not needed to process a redetermination. Standby List Applicants who are awaiting an interview without a specific appointment. Get help over the phone,from an HHSC benefit officeor community partner. After 90 days in the same person's residence, the household is no longer considered homeless. produces reports that meet Texas Health and Human Services Commission (HHSC), state and federal reporting requirements. The Marketplace is also known as the Exchange, Health Insurance Marketplace, and Federally Facilitated Marketplace (FFM). Immigrant An alien who abandons residence in a foreign country to live in the U.S. as a permanent resident, for example a lawful permanent resident (LPR). Former Medicaid recipients may request a certificate within 24 months after their Medicaid is denied by calling 800-723-4789. Self-Service Portal (SSP) A web-based application, atYourTexasBenefits.com. Your case visibility account has been disabled because of inactivity. With this type of access, a person can view and change an application created under their username. HHSC IEVS Staff HHSC eligibility field staff who process Automated System for Office of Inspector General (ASOIG) Match Texas Works Messages and MEPD Long Term Care (LTC) IEVS Matches. Three Months Prior The three-month period before the Medicaid application month. 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. 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. all eligible members receive Temporary Assistance for Needy Families (TANF) or Refugee Cash Assistance (RCA); or. Examples include certified nurse-midwives, clinical nurse specialists, and pediatric nurse practitioners. EDGs denied because of new or increased spousal support income will receive a maximum of four months of coverage. Qualified entities that are also Breast and Cervical Cancer Services (BCCS) contractors with the DSHS may make presumptive eligibility determinations for Medicaid for Breast and Cervical Cancer (MBCC) applicants. 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. You'll get the Lone Star Card once you're approved for benefits. Case Mode Status of a case that identifies that: Case Number A unique 10-digit number that identifies a group of Eligibility Determination Groups (EDGs). Some people qualify for both Medicare and Medicaid. Minor Parent A person under 18 who has a dependent. Each functional area contains pages that allow authorized staff to perform activities related to the business process. The EDG includes members who are eligible and may include members who are not certified for benefits. Medicaid A state and federal cooperative program authorized under Title XIX of the Social Security Act (United States Code [U.S.C. The Eligibility Determination Group (EDG) name must be within the required degree of relationship to the dependent child. It is used to apply cascade logic by reforming EDGs until establishing eligibility. Continued Benefits Continuing or restoring benefits to the level authorized immediately before the notice of adverse action. Answer some basic questions in our prescreening tool to find which benefits and support services you might be able to get. Also benefits issued for the first month of eligibility after a break in eligibility of at least one month. To be eligible for Texas Medicaid, you must be a resident of the state of Texas, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income. The program reimburses the policy holder for private health insurance payroll deductions for Medicaid-eligible persons when HHSC determines that it is cost-effective. 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. For your convenience, the Help Center will open in a new window. cash contributions of the sponsor or others; and. Helps families with children age 18 and younger pay for basic needs. The last number in your TANF Eligibility Determination Group number tells what day you get your benefits. Unauthorized access to this site and its information assets is prohibited. Individual Retirement Account (IRA) Deduction A federal income tax deduction for people who contributed to a traditional IRA. It provides monthly income to aged people and persons who are blind or have a disability. 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. Supplemental Nutrition Assistance Program (SNAP) applicants and individuals in these counties are not subject to SNAP federal time limits because of the job market. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely. 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. Reinstatement Process of providing Transitional Medical Assistance (TMA) to a household denied because of failure to return a complete Medicaid Report. First Cousin Once Removed A person who is either one's first cousin's child or the parent's first cousin. See functional area. The discovery date is compared with the report date to determine whether a change is reported timely. After certification, the Office of Attorney General (OAG) sends the person the first $75 received on monthly child support collections. Four Months Post-Medical Medicaid coverage extended for a maximum of four months after denial of a case because of spousal support income. Welcome to UnitedHealthcare Individual Exchange plans, also referred to as Individual and Family plans. Underpayment Issuance of fewer benefits than an individual is entitled to receive. Managed Care A health care delivery system with the aim of controlling costs. Management The way in which a household pays its expenses with available income. Personal Representative A person who can represent another person's rights with respect to individually identifiable health information. Expedited Service Special, faster processing of SNAP applicants who qualify for an emergency food allotment, for active duty military members and their dependents applying for medical coverage and for pregnant women applicants who qualify for current or ongoing medical coverage. 24/7, confidential support is always available. Restored Benefits Full or partial months of benefits for a past month that are owed to a household due to an agency error. See, is a member of a Supplemental Nutrition Assistance Program [SNAP] Eligibility Determination Group [EDG] where a household member is under 18; or. Asylee A person granted asylum under Section 208 of the Immigration and Nationality Act (INA). 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. Health Insurance Premium Payment (HIPP) A reimbursement program administered by the Texas Health and Human Services Commissions (HHSCs) Third-Party Resource Unit, which pays for the cost of premiums, coinsurance, and deductibles. Benefits. This includes profits from the sale of stocks, bonds, or real estate. 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. The money contributed to these accounts is not subject to federal income tax at the time of deposit. Citizenship and Immigration Services (USCIS) and who has received a final order of deportation. They are also subject to disciplinary action from the Texas Health and Human Services Commission (HHSC). Second Parent This is the parent who is not the caretaker. To start a new session, you must close the browser window. ), dentist (D.D.S. TWC has designated all counties in Texas as Choices counties, and the Local Workforce Development Boards (LWDBs), after coordination with the Texas Health and Human Services Commission (HHSC) state office, assign a service level designation for each county depending upon services available in that county. Participation Status The designation of an Eligibility Determination Group (EDG) member as an eligible or ineligible member of the certified group. Batch Scheduling Including an appointment date and time with eligibility staff within application packets mailed from the central mail facility. Data Collection The functional area where individual household, non-financial, resource, income, and deduction information is recorded for use in building Eligibility Determination Groups (EDGs) and determining eligibility for types of assistance. 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. 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. 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. Or send an e-mail to: mail@dhs.state.tx.us. The driver flow is determined by the programs, types of assistance, and answers to questions as the case is worked. Initial Benefits Benefits issued for the first month of eligibility. are received for a minimum of three months. an applicant or a certified Temporary Assistance for Needy Families (TANF); Supplemental Nutrition Assistance Program (SNAP)or Medical Program household member or a member who would be certified but is disqualified; or. Children's Health Insurance Program (CHIP) Medical coverage for children under 19 whose family income exceeds the limits for Children's Medicaid. Historical Correspondence Records of forms and notices that have been printed. Not all Texas Health and Human Services Commission (HHSC) programs and types of assistance have certification periods. Need help buying food because of recent disasters in your area? Purchasing a product with SNAP benefits with the intent of obtaining cash or something other than eligible food. The person must be a legal parent(s) or other caretaker relative within the required degree of relationship who meets the income limits for that program. A user can click the plus sign next to a functional area or sub-functional areas to display the pages available within that area. Non-Employment and Training (E&T) Counties Those Texas counties where the Texas Workforce Commission (TWC) determines it does not have enough offices to assist people who are mandatory work registrants. Automated Renewal Process The first step in an administrative renewal. Vested Interest A situation or circumstance to which a person has a strong personal commitment. 401(k) A retirement plan allowing an employee to postpone receiving a portion of current income until retirement. It compares an applicants statement of income against income provided by electronic data sources. Noncompliance with the PRA results in a sanction. Refugee A person admitted to the U.S. under Section 207 of the INA. Judicial Review A review of the fair hearing decision by a district court in Travis County to determine whether the agency decision is correct. People can apply using a simplified application, and they do not typically have to complete an interview at redetermination. My career spans a number of years, industries, and roles in education, computer operations, process improvement, organization development, coaching, marketing, customer service, and corporate . are intended for expenses other than room and board. Streamlined Reporting (SR) Households where all adults are exempt from the 18-50 work requirements due to: Note: These households receive a six-month certification period. Negative Management A household has negative management when its reported basic expenses exceed reported net income and resources plus support the HHSC excludes, such as vendor payments. If the total collection is less than $75, then the amount of the collection is sent to the person . the adult provides more than half of the minor's total support (housing is not considered as support); the adult states that the adult has parental control of the minor; or. Historical Data Records of case, Eligibility Determination Groups (EDGs) and individual information. Intentional Program Violation (IPV) The act of intentionally making a false or misleading statement, or misrepresenting, concealing or withholding facts for the purpose of receiving assistance under the Supplemental Nutrition Assistance Program (SNAP), Temporary Assistance for Needy Families (TANF) or Medicaid program. Here, you can access a variety of resources to help you work with us as you care for . Standard Utility Allowance (SUA) A standard deduction for the cost of utilities. The LUW is represented by a set of tabs at the top of a TIERS page. Reimbursement Repayment for a specific item or service. Tuition or GI Bill Deduction A federal income tax deduction for people who paid qualified tuition fees to eligible post-secondary educational institutions for themselves, their spouse or their dependents. Monthly Obligation The amount of child support which the absent parent has been ordered to pay each month. Escrow An escrow account is an account a mortgage company sets up for the homeowner as part of their monthly mortgage payment. The number is used to record covered wages, track Social Security benefits and for other identification purposes. 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. The PIN must be entered on a keypad before any electronic transaction can be processed. 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. Report Date The date information is reported to the Texas Health and Human Services Commission (HHSC). Balance Receipt A paper receipt that shows the available balance in an person's cash or food account. 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. Combat Pay Supplemental incentive payments for hazardous duty and special pay for duty subject to hostile fire or imminent danger. Examples of public institutions include county and city jails and Texas Department of Corrections prisons. A household member is a TANF or SSI recipient if the person is approved for TANF or SSI but the benefit: A SNAP household that includes members authorized to receive TANF non-cash services and whose household gross income is less than 165 percent of the Federal Poverty Income Limit (FPIL) for its size and meets the resource criteria. TANF provides families with financial assistance and support services. Equity The fair market value of an item minus all money owed on it and the cost associated with its sale or transfer. Medicaid Members: Continuous Medicaid coverage will end on March 31, 2023. Range of Payment The highest to the lowest representative pay amounts used to determine the current ongoing budget. Emancipated Minor A person 17 and under who has been married. Special Immigrant Iraqi and Afghan (SIV) A special immigrant status under 101(a)(27) of the INA may be granted to Iraqi and Afghan people who have worked on behalf of the U.S. government in Iraq or Afghanistan. This figure represents food, clothing, housing, utilities and incidentals. Emergency Medicaid All types of emergency Medicaid coverage programs for people who are nonimmigrants, undocumented aliens or certain legal permanent resident aliens who have emergency medical conditions and who, except for alien status, would be Medicaid-eligible. Royalty A payment to a person for permitting another to use or market property. Supplemental Security Income (SSI) A needs-tested program administered by the Social Security Administration. Blue Shield of Texas at 1-800-521-2227 or www.bcbstx.com or contact the Texas Department of Insurance, Consumer Protection at 1-800-252-3439 or www.tdi.texas.gov. All system-generated correspondence is sent to pending correspondence, but it can be retrieved and printed locally. Card Sleeve A durable paper envelope folded to the dimensions of the plastic EBT card. Home School A type of education in which children are taught by their parents, or someone acting in parental authority, at home, using a set curriculum. 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. This process occurs without staff or specialist action. CEAP replaced the Home Energy Assistance Program (HEAP). This coverage is providedtemporarily while the Texas Health and Human Services Commission (HHSC) determines eligibility for regular Medicaid. Questionable Management A household has questionable management when reported basic expenses exceed reported net income and resources. Incidentals include such things as normal day-to-day transportation, phone, laundry, medical supplies not paid by Medicaid, home remedies, recreation, and household equipment. Radiation Exposure Payments A program to compensate a person for injury or death from exposure to radiation from nuclear testing and uranium mining. createcorrespondence and reports based on system-requested and user-requested criteria. Wrap Up The Texas Integrated Eligibility Redesign System (TIERS) program page in Data Collection where Eligibility Determination Groups (EDGs) are built and the Eligibility Determination Benefit Calculation (EDBC) is run to determine the highest level of eligibility or ineligibility. Your case number is a 10-digit number that HHSC uses to bundle and process benefits you receive through their agency. Conception occurs, but no fetus ever develops. The newborn Medicaid coverage can continue through the month of the child's first birthday if the child continues to live in Texas. Copayment Payment made directly to a provider according to a fee schedule. For Type Program (TP) 08, Parents and Caretaker Relatives Medicaid A relative within the required degree of relationship, other than a legal parent, caring for a dependent child who meets the income limits for that program. 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. Effective Month The first month benefits can be affected based on the monthly cutoff date or applicable policy for advance and adequate notice of adverse action. 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. Standard of Need Basic needs of Temporary Assistance for Needy Families (TANF) families represented by a figure predetermined by the state of Texas per the number of certified people in the group. State Data Exchange (SDX) Computer tape from the Social Security Administration (SSA). Untimely SNAP application filed after the 15th of the last certification month. Periodic Income Check (PIC) The process to determine whether electronic data indicates that there has been a change in the Modified Adjusted Gross Income (MAGI) household income that could make the recipient ineligible for certain Medical Programs.

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