Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 353 - MEDICAID MANAGED CARE
Subchapter I - STAR
Section 353.802 - Member Participation
Universal Citation: 1 TX Admin Code ยง 353.802
Current through Reg. 49, No. 38; September 20, 2024
(a) Enrollment in the State of Texas Access Reform (STAR) program is mandatory for Medicaid recipients who meet the criteria in one or more of the following categories:
(1)
individuals age 21 and over who are eligible for the Parents and Other
Caretaker Relatives program outlined in Subchapter G of Chapter 366 of this
title (relating to Medicaid for Parents and Caretaker Relatives
Program);
(2) pregnant women
receiving medical assistance with household income that meets the applicable
income limits specified in Subchapter C of Chapter 366 of this title (relating
to Pregnant Women's Medicaid);
(3)
newborns receiving medical assistance--Children through 12 months of age with
household income equal to or less than the FPL level specified in Subchapter E
of Chapter 366 of this title (relating to Children's Medicaid) or born to
Medicaid-eligible mothers;
(4)
children receiving medical assistance age 13 months through the month of his or
her 18th birthday with household income equal to or less than the FPL specified
in Subchapter E of Chapter 366 of this title;
(5) FFCC members age 21 through the month of
his or her 26th birthday; and
(6)
children who meet both of the following criteria:
(A) are receiving medical assistance through
the Texas Department of Family and Protective Services Adoption Assistance
Program, as described in Title 40 of the Texas Administrative Code, Chapter
700, Subchapter H (relating to Adoption Assistance Program); or Permanency Care
Assistance Program, as described in Title 40 of the Texas Administrative Code,
Chapter 700, Subchapter J, Division 2 (relating to Permanency Care Assistance
Program); and
(B) are not eligible
for STAR Kids, as described in Subchapter N of this chapter (relating to STAR
Kids).
(b) FFCC STAR Health members ages 18 through 20 may choose to transfer to the STAR program and remain enrolled through the month of his or her 26th birthday.
(c) MTFCY STAR Health members may transfer to the STAR program.
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