CSHCN Services Program 2010 > Client Benefits and Eligibility

Client Benefits and Eligibility

3.1 Client Benefits 3-2

3.1.1 Hearing Aid Benefits Now Administered by TMHP 3-3

3.1.2 Prescription Benefits Processed by the Texas Medicaid/CHIP Vendor
Drug Program (VDP) 3-3

3.1.3 Services Provided by the Medical Transportation Program (MTP) 3-3

3.1.4 Services Provided Outside of Texas 3-3

3.1.4.1 Fifty or Fewer Miles From the Texas State Border 3-3

3.1.4.2 More Than Fifty Miles From the Texas State Border 3-4

3.1.5 CSHCN Services Program Services and Supplies Limitations and Exclusions 3-4

3.1.6 CSHCN Services Program Procedure Limitations and Exclusions 3-5

3.2 Client Eligibility 3-7

3.2.1 Financial Eligibility Criteria 3-7

3.2.2 CSHCN Services Program PAF/Medical Eligibility Criteria 3-8

3.3 CSHCN Services Program Eligibility Form 3-8

3.3.1 Case Restrictions 3-9

3.3.2 CSHCN Services Program Eligibility Form Sample 3-10

3.4 Waiting List Information 3-11

3.5 Clients Eligible for CHIP and CSHCN Services Program Benefits 3-11

3.6 Clients Eligible for Medicaid and CSHCN Services Program Benefits 3-12

3.6.1 Medically Needy Program (MNP) 3-12

3.6.2 MNP Spend Down Processing 3-13

3.6.2.1 CSHCN Services Program and MNP Spend Down Processing 3-13

3.6.2.2 Provider Assistance to Clients with Spend Down 3-13

3.6.3 Claims Filing Involving a Medicaid Spend Down 3-14

3.7 TMHP-CSHCN Contact Center 3-14