SECTION 366.213. Eligible Group

To qualify for the Presumptive Medicaid Program, an applicant must:

(1) be--

(A) a pregnant woman with household income less than or equal to the limit for Pregnant Women's Medicaid as stated in §366.307 of this chapter (relating to Eligible Group);

(B) a newborn with household income less than or equal to the limit stated in §366.507(1) of this chapter (relating to Eligible Groups);

(C) a child age one through 18 years of age with household income less than or equal to the limit stated in §366.507(2) of this chapter;

(D) a parent or caretaker relative of a dependent child who receives Medicaid and meets the income eligibility criteria stated in §366.723 of this chapter (relating to Income Eligibility); or

(E) an individual who was under the conservatorship of this State upon attaining age 18, received Medicaid at the time he or she left foster care, and is 18 through 25 years of age as stated in §366.1011 of this chapter (relating to Eligible Group);

(2) not be currently receiving benefits under Medicaid or the Children's Health Insurance Program; and

(3) not have received a presumptive eligibility segment--

(A) during her current pregnancy; or

(B) within the past two calendar years for children under age 19, parents or caretaker relatives, or former foster care children.

Source Note: The provisions of this §366.213 adopted to be effective June 9, 2010, 35 TexReg 4661; amended to be effective January 18, 2015, 40 TexReg 31