D-3650 Out-of-State Recipient Visiting Texas

Revision 09-4; Effective December 1, 2009

If a recipient who receives a money grant ( TANF , general assistance, state supplementary payments to SSI ) or Medicaid, including Medicare Savings Program benefits, from another state and applies for Medicaid in Texas, determine whether:

the recipient intends to continue receiving the money grant or Medicaid from the other state; and

Medicaid benefits are available to the recipient from that state.

Declaration to continue living in the other state — If the recipient declares the intent to continue living in the other state, the recipient is not eligible for Medicaid in Texas. Contact the out-of-state Medicaid agency to determine which services are covered and how providers file claims. Have the recipient inform any Texas Medicaid provider to send any claim to the out-of-state Medicaid agency in the recipient's state of residence.

Declaration to live in Texas — If a recipient who receives a money grant from another state (TANF, general assistance, state supplementary payments to SSI) makes a declaration of intent to live in Texas, this declaration does not automatically establish eligibility. Determine eligibility according to the requirements of the Texas Medicaid Program.

Impact on the medical effective date — If the intent to live in Texas is made by the recipient and the recipient meets Texas MEPD requirements, contact the out-of-state Medicaid agency of the recipient's former state of residence to determine the last day Medicaid claims will be paid by that state. The denial effective date is the last day for which the recipient 's former state of residence will pay Medicaid claims. This is not necessarily the denial effective date on the former state's computer system. The medical effective date for the recipient in Texas is no earlier than the day following the date the recipient 's former state of residence will pay Medicaid claims.