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December 2016 Texas Medicaid Provider Procedures Manual

Section 4: Client Eligibility : 4.7 Medicaid Buy-in for Children (MBIC) Program

4.7
The MBIC program is mandated by S.B. 187, 81st Legislature, Regular Session, 2009, to provide acute care Medicaid coverage for children who are 18 years of age and younger and have disabilities. This program creates a state option for children who are ineligible for Supplemental Security Income (SSI) for reasons other than disability.
Children with disabilities must meet the following requirements to be eligible for MBIC:
Exception:
Clients who are enrolled in the MBIC program before they enter a nursing facility or Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) will continue to receive MBIC benefits until eligibility for the appropriate institutional Medicaid program is determined.
MBIC clients will be enrolled as Medicaid fee-for-service. MBIC clients are identified by Type Program (TP) 88 on the Your Texas Benefits Medicaid card. MBIC clients have access to the same benefits as Medicaid clients who have disabilities. Claims and prior authorization requests for MBIC clients may be submitted according to current guidelines for Medicaid fee-for-service as indicated in this manual.
MBIC benefits are available to enrolled clients through the end of the month that contains their nineteenth birthday. Clients whose birthday falls on the last day of February of a leap year (e.g., February 29, 2004) will be eligible for benefits through the end of March following their nineteenth year.

Texas Medicaid & Healthcare Partnership
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