1 Tex. Admin. Code § 353.1105

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

Section 353.1105 - Eligibility

(a) Enrollment in the Dual Demonstration is optional for dual eligible individuals who live in the designated counties and meet the following criteria:

(1) eligible for STAR+PLUS, including those eligible for STAR+PLUS home and community-based waiver services;

(2) enrolled in Medicare Parts A, B, and D; and

(3) age 21 or older.

(b) The following dual eligible individuals cannot participate in the Dual Demonstration:

(1) under age 21;

(2) individuals not eligible for STAR+PLUS, including individuals:

(A) residing in an intermediate care facility for individuals with an intellectual disability or related conditions;

(B) receiving services under the following Medicaid 1915(c) waivers:

(i) Home and Community-based Services (HCS);

(ii) Community Living Assistance and Support Services (CLASS);

(iii) Texas Home Living (TxHmL); or

(iv) Deaf Blind with Multiple Disabilities (DBMD);

(C) not eligible for full Medicaid benefits; or

(D) in the conservatorship of the Texas Department of Family and Protective Services.

1 Tex. Admin. Code § 353.1105

Adopted by Texas Register, Volume 40, Number 12, March 20, 2015, TexReg 1705, eff. 4/1/2015