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2012 Texas Medicaid Provider Procedures Manual

Volume 1, General Information : Section 4: Client Eligibility : 4.4 Restricted Medicaid Coverage : 4.4.2 Client Limited Program : 4.4.2.1 Limited Medicaid Identification

4.4.2.1
Limited Medicaid Identification
Clients with limited status receive the Your Texas Benefits Medicaid card with “LIMITED” printed on the card. The designated provider and pharmacy names are printed on the card under the word “LIMITED.” Only one client is identified on a LIMITED Your Texas Benefits Medicaid card.
The Limited Program may also alert providers by means of a message on the Your Texas Benefits Medicaid card website at www.YourTexasBenefitsCard.com, when the card was reportedly used by an unauthorized person or persons, or for an unauthorized purpose. In these cases, the provider is asked to verify the client’s identity by requesting personal identification that carries a photograph, such as a driver’s license.
When limited Texas Medicaid fee-for-service clients attempt to obtain nonemergency services from someone other than their designated primary care provider, the provider must do one of the following:
Attempt to contact the client’s designated primary care provider for a referral. If the provider is unable to obtain a referral, the provider must inform clients that they are financially responsible for the services.

Texas Medicaid & Healthcare Partnership
CPT only copyright 2011 American Medical Association. All rights reserved.