Texas Administrative Code
Title 1 - ADMINISTRATION
Part 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
Chapter 370 - STATE CHILDREN'S HEALTH INSURANCE PROGRAM
Subchapter B - APPLICATION SCREENING, REFERRAL, PROCESSING, RENEWAL, AND DISENROLLMENT
Division 4 - ELIGIBILITY CRITERIA
Section 370.49 - Pregnant CHIP Members
Current through Reg. 49, No. 38; September 20, 2024
A pregnant CHIP member may be determined eligible for Medicaid. A pregnant CHIP member who is determined to be Medicaid eligible will be disenrolled from CHIP. Medicaid coverage will be coordinated to begin when CHIP enrollment ends to avoid gaps in health care coverage. In the event HHSC or its designee remains unaware of a member's pregnancy until delivery, the delivery will be covered by CHIP. HHSC or its designee will set the mother's eligibility expiration date at the later of:
(1) the end of the twelfth month after the end of a pregnancy; or
(2) if the CHIP member voluntarily elects to end the member's CHIP enrollment during the member's extended postpartum period, the individual is not eligible to receive continuous eligibility in Medicaid for the remainder of the member's 12-month postpartum period.
