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December 2016 Texas Medicaid Provider Procedures Manual

Section 4: Client Eligibility : 4.4 Restricted Medicaid Coverage : 4.4.2 Client Lock-in Program : 4.4.2.1 Lock-in Medicaid Identification

4.4.2.1
Clients with lock-in status receive the Your Texas Benefits Medicaid card with “Lock-in” printed on the card. The designated provider and pharmacy names are printed on the card under the word “Lock-in.”
When a Texas Medicaid fee-for-service client in the Lock-in Program attempts to obtain nonemergency services from someone other than their designated lock-in primary care provider, the provider must do one of the following:
Attempt to contact the client’s designated lock-in 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
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