TMPPM 2007 >7.3.1.3 Client Eligibility

HHSC has targeted these client groups within the Texas Medicaid population for STAR+PLUS Program enrollment:

•

Enrollment for category 01, 03, 04 (SSI aged, blind and disabled clients) and the following program types are mandatory for STAR+PLUS:


Type Program	Description
03	Denied SSI clients who are Medicaid-eligible under Pickle provisions.
12	SSI client.
13	SSI client.
14	Note: Only those client that have been determined eligible for the 1915 (c) STAR+PLUS Waiver (SPW) will be enrolled in STAR+PLUS. All other clients in TP 14 are excluded from participation.
18	Disabled adult children denied SSI dues to increase in Social Security benefits.
22	Denied SSI clients who receive widow/widower Social Security benefits.
51	Medicaid and community-based nursing care services.

•

Enrollment for category 03 and 04, SSI blind and disabled children, and type program 19, Medicaid and community-based waiver program for children younger than age 21 years, may enroll in a STAR+PLUS HMO.

Refer to: "Client Enrollment" for more information on eligibility effective dates.