1 Tex. Admin. Code § 353.802

Current through Register Vol. 49, No. 48, November 29, 2024

Section 353.802 - Member Participation

(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.

1 Tex. Admin. Code § 353.802

The provisions of this §353.802 adopted to be effective March 1, 2012, 37 TexReg 1283; Amended to be effective September 1, 2014, 39 TexReg 5880; Amended by Texas Register, Volume 42, Number 34, August 25, 2017, TexReg 4274, eff. 9/1/2017