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TITLE 1ADMINISTRATION
PART 15TEXAS HEALTH AND HUMAN SERVICES COMMISSION
CHAPTER 370STATE CHILDREN'S HEALTH INSURANCE PROGRAM
SUBCHAPTER DELIGIBILITY FOR UNBORN CHILDREN
RULE §370.401Perinates

(a) An unborn child, also referred to as a "perinate," is eligible for CHIP if:

  (1) the mother of the perinate is not eligible for Medicaid; and

  (2) he or she meets CHIP income eligibility requirements in §370.44 of this chapter (relating to Income and Assets) and Subchapter I of this chapter (relating to Modified Adjusted Gross Income Methodology).

(b) A perinate who is CHIP eligible under subsection (a) of this section is:

  (1) eligible for a 12-month continuous period if the household income is greater than 185% of FPL;

  (2) exempt from the 90-day waiting period in §370.46 of this chapter (relating to Waiting Period);

  (3) exempt from cost sharing in §370.321 of this chapter (relating to Requirements and Exemptions); and

  (4) exempt from the requirements in §370.70 of this chapter (relating to Income Eligibility Check in 6th Month of Coverage).

(c) HHSC's designee is required to expedite eligibility and enrollment for perinates so as to allow quick access to healthcare.

(d) The Applicant for a perinate has the right to file a Medicaid application at any time after the child is born. If the child is eligible for Medicaid, the child will be enrolled in Medicaid.


Source Note: The provisions of this §370.401 adopted to be effective April 30, 2006, 31 TexReg 3527; amended to be effective September 1, 2007, 32 TexReg 5359; amended to be effective September 1, 2010, 35 TexReg 7726; amended to be effective January 1, 2014, 38 TexReg 9477

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