This is a clone of the Texas Administrative Code (TAC) for educational purposes. It is not the official version and should not be used for legal purposes. Site created Wed, 21 May 2025 21:16:36 GMT
The Texas Health and Human Services Commission uses a special income limit to determine income eligibility under circumstances established in this section. The special income limit for a person is equal to or less than 300 percent of the full individual Supplemental Security Income (SSI) federal benefit rate. The special income limit for a couple is twice the special income limit for an individual.(1) To qualify for the special income limit, a person or couple must have countable income that exceeds the reduced SSI federal benefit rate; and:(A) must:(i) reside in:(I) a Medicaid-certified long-term care facility for 30 consecutive days; or(II) a Medicaid-certified institution for mental diseases for 30 consecutive days, if the person is 65 years of age or older; and(ii) receive a level of care or medical necessity determination that qualifies the person or couple for Medicaid; or(B) must be approved by a Texas health and human services agency to receive services under a §1915(c) waiver program and receive the services within one month after approval.(2) The 30 consecutive days described in paragraph (1)(A) of this section are not disrupted if the person:(A) makes a three-day therapeutic home visit with a planned return to the facility;(B) is admitted to a hospital with a planned return to the facility; or(C) moves from a facility described in paragraph (1)(A)(i) of this section:(i) to a §1915(c) waiver program; or(ii) to another Medicaid-certified facility.(3) If a person dies before meeting the 30-consecutive-day requirement without moving to a noninstitutional setting, the person is considered to have met the requirement for application of the special income limit.