N-1310 MBIC and Nursing Facilities

Revision 21-4; Effective December 1, 2021

Medicaid Buy-In for Children (MBIC) is a community-based Medicaid program. If an MBIC recipient enters a nursing facility or an intermediate care facility for people with intellectual disability or related condition (ICF/IID), contact the authorized representative (AR) to determine how long the recipient’s is expected to remain in the facility. 

If the facility stay is expected to be less than 90 days, no action is required. 

If the facility stay is expected to be more than 90 days, obtain any additional eligibility verifications needed and complete a program transfer to facility Medicaid.

N-1320 MBIC and Home and Community-Based Services Waivers

Revision 21-3; Effective September 1, 2021

Home and Community-Based Services waiver services such as Community Living Assistance and Support Services, are not paid under the MBIC systems eligibility codes. The exception is Texas Home Living (TxHmL). Therefore, if a referral for any other waiver is received, get a new Form H1200, Application for Assistance – Your Texas Benefits (PDF). Then gather any other verification needed to determine eligibility for ME-Waivers and complete a program transfer if all eligibility criteria are met.

Note: Medicaid Buy-In for Children (MBIC) will pay for TxHmL waiver services under MBIC systems eligibility codes.

N-1330 MBIC and Medicare Savings Programs

Revision 11-3; Effective September 1, 2011

An MBIC-eligible applicant/recipient can also have:

  • Qualified Medicare Beneficiary (QMB)
  • Specified Low-Income Medicare Beneficiary (SLMB)

An MBIC-eligible applicant/recipient cannot have:

  • Qualifying Individuals-1 (QI-1). The applicant/recipient must choose between MBIC and QI-1.
  • Qualified Disabled Working Individuals

Reminder: Resource information is required for Medicare Savings Programs (MSP). Parental deeming of income and resources and support and maintenance applies to MSP.

N-1340 Medicaid Estate Recovery Program (MERP)

Revision 11-3; Effective September 1, 2011

Due to the age of these recipients, the Medicaid Estate Recovery Program (MERP) does not apply to MBIC.