Administrative Renewal Process

All MEPD types of assistance (TOAs) go through the annual administrative renewal process. The system begins the administrative renewal process without staff action.

The automated administrative renewal process uses information from the existing case record and electronic data sources (ELDS) to determine if the person remains eligible for Medicaid benefits. The electronic data is requested the weekend before cutoff in the eighth month of the recipient’s certification period. The renewal packets are generated in the ninth month of the recipient’s certification period.

The administrative renewal process uses electronic data to automatically:

assess the verification required by program type;

determine the eligibility outcome; and

send the renewal correspondence to the recipient, the authorized representative (AR) or both.

Note: This automated process does not change the verification requirements for renewals.

If there is enough information to verify continued eligibility, the person’s eligibility is renewed without any staff action, and Form TF0001 is generated. If more information is required, the system automatically generates and mails a renewal form to the recipient, AR or both. The recipient has 30 days to return the signed renewal form and all required verification.

The system generates the applicable correspondence from the list below based on the eligibility outcome of the automated renewal process and the action needed by the person:

Form H1211, It Is Time to Renew Your Health Care Benefits Cover Letter;

Form H1233, Redetermination Cover Letter;

Form H1233-MBIC, Redetermination Cover Letter (Medicaid Buy-In for Children);

Form H1200 , Application for Assistance – Your Texas Benefits;

Form H1200-A , Medical Assistance Only (MAO) Recertification;

Form H1200-EZ , Application for Assistance;

Form H1200-MBIC-R, Application for Benefits – Medicaid Buy-In for Children;

Form H1200-PFS , Medical Application for Assistance (for Residents of State Facilities); or

Form H1206ME, Health-Care Benefits Renewal

The renewal cover letter informs the recipient that it is time to renew benefits, provides instructions on how to complete and return the renewal form, along with any required verification documents, and informs the recipient that the information must be returned within 30 days. If the recipient does not return the renewal form and required verification, eligibility is automatically terminated at cutoff in the 12th month for failure to provide the requested information effective the last day of the 12th month. A Form TF0001 is generated.

Recipients can submit a renewal form through any of the following channels:

online through YourTexasBenefits.com;

in the local office; or

by mail, fax or phone.

Notes: Form H1211 and Form H1206ME are generated when the automated renewal process results in Eligibility Approved. Form H1211 informs the recipient to review the information and only return Form H1206ME if the information is incorrect or if there has been a change to their case.

For MEPD programs that require a resource test, an AVS request is submitted with the ELDS request in the eighth month of the certification period.

When processing a renewal, if the AVS Screen does not include an Asset Verification – Automated Admin Renewal report processed on the 8 th month of the current renewal cycle, submit an AVS request for the month the renewal form was received and three months prior.

If the renewal form shows that the recipient wants to register to vote, complete the Voter Registration Information section of the Citizen tab in the Individual Demographics logical unit of work (LUW). Select Yes in the Send Voter Registration Application? dropdown to send form VR30, Texas Voter Registration Application , to the mailing address on file. If the recipient contacts the office declining to complete form VR30, mail Form H1350 , Opportunity to Register to Vote, to the recipient. Form H1350 records the recipient's decision about registering to vote.