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TITLE 1 - ADMINISTRATION
PART 15 - TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 353 - MEDICAID MANAGED CARE
SUBCHAPTER L - TEXAS DUAL ELIGIBLES INTEGRATED CARE DEMONSTRATION PROJECT
SECTION/RULE §353.1105 - Eligibility
Chapter Review Date 04/25/2024

(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.

Source Note: The provisions of this §353.1105 adopted to be effective April 1, 2015, 40 TexReg 1705.

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