1 Tex. Admin. Code § 361.103 - Definitions
The following words and terms, when used in this chapter, have the following meanings, unless the context clearly indicates otherwise:
(1) Applicant--A person
seeking Medicaid benefits under MBIC who is not currently receiving Medicaid
services.
(2) Authorized
representative--An individual:
(A) who
assists and represents a person in the application or eligibility
redetermination process, and who is familiar with that person and that person's
financial affairs; or
(B) who is a
representative payee for an applicant or recipient for another federal
benefit.
(3) CFR--Code
of Federal Regulations.
(4)
Child--An unmarried person under 19 years of age.
(5) Child with disabilities--A child who
meets the Supplemental Security Income (SSI) program's definition of disability
for children, as explained in
20 C.F.R.
416.906.
(6) Eligibility certification month--Month in
which MBIC eligibility is established.
(7) Family--A unit consisting of an applicant
or recipient and the applicant's or recipient's parents and siblings who live
in the same household as the applicant or recipient.
(8) Federal Poverty Level (FPL)--The
household income guidelines issued annually and published in the Federal
Register by the U.S. Department of Health and Human Services. Percentages of
these guidelines are used to determine income eligibility for MBIC and certain
other public assistance programs. In other programs, the FPL may be referred to
as the Federal Poverty Income Level or the Federal Poverty
Guidelines.
(9) HHSC--The Texas
Health and Human Services Commission.
(10) Income--Funds a person receives that can
be used to meet his or her need for food or shelter.
(11) In-kind support and maintenance--The
value of food or shelter furnished to an applicant's or recipient's
family.
(12) Intermediate care
facility for persons with mental retardation (ICF/MR)--A Medicaid-certified
facility that provides care in a 24-hour specialized residential setting for
persons with mental retardation or a related condition. An ICF/MR includes a
state supported living center and a state center.
(13) MBIC--Medicaid Buy-In for Children. A
Medicaid buy-in program that provides Medicaid benefits to children with
disabilities who are not eligible for SSI for reasons other than
disability.
(14) Medicaid--A state
and federal cooperative program, authorized under Title XIX of the Social
Security Act and the Texas Human Resources Code, that pays for certain medical
and health care costs for people who qualify. Also known as the medical
assistance program.
(15) Parent--A
child's natural or adoptive parent or the spouse of the natural or adoptive
parent.
(16) Premium--A monthly
payment to be made by a family to HHSC or its designee to buy MBIC
coverage.
(17) Recipient--A person
receiving Medicaid benefits under MBIC, including a person whose Medicaid
eligibility is being redetermined.
(18) Sibling--A child's unmarried brother or
sister (natural, adoptive, or step).
(19) U.S.C.--United States Code.
Notes
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