Community Based

Type Program MED ME – Pickle Three months prior (3MP) policy applies (Form H1200, Application for Assistance – Your Texas Benefits, file date). ME – Disabled Adult Child 3MP policy applies (Form H1200, Application for Assistance – Your Texas Benefits, file date). ME – Disabled/Early Aged Widow(er) 3MP policy applies (Form H1200, Application for Assistance – Your Texas Benefits, file date). ME – SSI Prior Medicaid coverage automatically begins with the month before the first month of SSI payment for certified SSI clients. The MED may be as early as the first day of the month, two months before the SSI gap month. (SSI Begin Date = Payment Month) The MED may be as early as the three months before the SSI application month for denied SSI applicants. ME – Waivers For waiver eligibility, the effective date for medical assistance is either the first day of the month: of nursing facility (NF), intermediate care facility for individuals with intellectual disabilities or related conditions (ICF/IID); of state supported living center entry if the applicant filed a Medicaid application during that month, then requested a program transfer before being certified, and met all eligibility criteria; or the first day of the month if the applicant meets all Waiver Eligibility Component and Financial Medicaid Eligibility Component criteria. Refer to Section O-1100, Application for Waiver Programs. Notes: Consider potential eligibility three months before the application file date if the individual entered an NF, ICF/IID or state supported living center and then transitioned into a waiver setting before being certified. Refer to Institutional Based section of this appendix. Also, refer to B-6300, Institutional Living Arrangement ; B-7400, Application for Institutional Care ; and J-4310, Determining the Assessment Date for a Home and Community-Based Services Waiver . The MED information for waivers does not apply if the waiver requires Medicaid eligibility before waiver services consideration. For example, Texas Home Living. ME – Community Attendant Use the first day of the month: that the application was filed, if the provider started services during that month; services started, if the application was filed by that date; or that the eligibility decision was made. MC – SLMB MED is the first day of the month that the application is filed if all eligibility factors are met. MED can be the first of any of the three months prior. MC – Qualifying Individuals (QI-1) MED is the first day of the month that the application is filed if all eligibility factors are met. MED can be the first of any of the three months prior. 3MP cannot include the previous calendar year unless the application was filed in the previous year. MC – QMB MED is the first day of the month following the month the case is processed and disposed in the eligibility system unless ensuring continuous QMB. ME – A and D - Emergency MED is the date the emergency condition began, as documented by the practitioner on Form H3038, Emergency Medical Services Certification. The practitioner will also list the emergency condition end date on Form H3038. These are open and close cases.