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Texas Medicaid: Frequently Asked Questions

This Texas Medicaid FAQ is a listing of the most frequently asked questions about Texas Medicaid. A great place to start getting answers to all your basic Texas Medicaid questions.

Who Qualifies for Texas Medicaid?

To qualify for Medicaid, you or your children must: • Be a Texas resident • Be a U.S. Citizen or a legal resident • Meet certain resource and income limits • Fit into one of these groups: Families and children with low incomes Children Pregnant women Non-U.S. citizens needing emergency medical services, including labor and delivery Children or pregnant women who are medically needy due to high medical bills People who get Supplemental Security Income (SSI) from the Social Security Administration People who have low inco... ...

How will the Texas Medicaid estate recovery program work?

The program will recover part or all of the Medicaid costs associated with providing long-term care services to certain clients by filing a claim against the estate after the client's death. The state's claim would follow the requirements in the Texas Probate Code and will most likely rank behind other claims such as funeral expenses, mortgage liens, child support and taxes.

Where do I find the rules on how Texas Medicaid pays RHCs?

The rules on how Texas pays the RHC Medicaid Prospective Payment System (PPS) encounter rate can be found in the Texas Adminstrative Code at www.sos.state.tx.us . You can reach it by going through these parts to get to the RHC Reimbursement information. Title 1 Administration Part 15 Texas Health and Human Services Commission Chapter 355 Reimbursement Rates Subchapter J Purchased Health Services Division 6 Rural Health Clinics Rule 355.8101 Reimbursement

What are some of the options clients and providers hear when they call the 24-hour, Texas Medicaid Nurse Advice Line number, 1-800-777-1178?

Callers will hear a recording and must select an option for information in English or Spanish. Medicaid clients are given the option to: Speak to a nurse about the asthma, diabetes, heart or lung program. Speak to a nurse immediately if they are sick or hurt. Listen to information available in the audio help library. Providers are given the option of leaving a message, which will be returned within one business day. 7.
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