A-110, Application Procedures

A—111 Pre-Application Process

Revision 15-4; Effective October 1, 2015

TANF

Before the Application process begins, staff deliver an up-front Texas Works message to the Temporary Assistance for Needy Families (TANF) applicants explaining that:

  • TANF is temporary and has time limits;
  • there are other alternatives and options for the applicant instead of TANF benefits;
  • an applicant should consider jobs and other resources (such as child support) before pursuing TANF;
  • if an applicant chooses to apply for assistance, the individual is requesting help finding a job; and
  • even if an applicant chooses not to apply for TANF, the individual still may apply for Medicaid and the Supplemental Nutrition Assistance Program (SNAP) to support employment while working toward self-sufficiency.

Staff must consider and determine which messages are appropriate for a particular applicant.

A—112 Application Assistance

Revision 15-4; Effective October 1, 2015

All Programs

If an applicant needs help completing the application packet, a volunteer or staff member must help. Anyone helping the applicant complete a paper application must initial the completed sections or sign the form showing that  a volunteer or staff person helped complete the application.

A—113 Application Requests and Submissions

Revision 15-4; Effective October 1, 2015

All Programs

Applications must be given to anyone who requests the form. Each household has the right to file an application on the same day the household contacts the office during office hours. The local office must ensure that a person can obtain an application packet within 15 minutes of coming into the office.

Staff must advise the household  that an applicant does not have to be interviewed before filing the application. The household may file an incomplete application as long as the form contains the applicant's name, address, and signature as explained in A-121, Receipt of Application.

Program Ways to Request an Application* Ways to Submit an Application Applications
TANF
  • Online through YourTexasBenefits.com;
  • In the local office;
  • By mail;
  • By fax; or
  • By phone.
  • Online through YourTexasBenefits.com;
  • In the local office;
  • By mail; or
  • By fax.
  • YourTexasBenefits.com
  • Form H1010, Texas Works Application for Assistance — Your Texas Benefits:
    • Staff must also provide the following forms with the application:
      • Form H1830, Application/Review/Expiration/Appointment Notice;
      • Form H0025, HHSC Application for Voter Registration;
      • Form H0050, Parent Profile Questionnaire, for each absent parent;
      • Appropriate program pamphlets; and
      • A postage-paid return envelope.
SNAP
  • Online through YourTexasBenefits.com;
  • In the local office;
  • By mail;
  • By fax; or
  • By phone.
  • Online through YourTexasBenefits.com;
  • In the local office;
  • By mail; or
  • By fax.
  • YourTexasBenefits.com
  • Form H1010, Texas Works Application for Assistance — Your Texas Benefits:
    • Staff must also provide the following forms with the application:
      • Form H1830, Application/Review/Expiration/Appointment Notice;
      • Form H0025, HHSC Application for Voter Registration;
      • Appropriate program pamphlets; and
      • A postage-paid return envelope.
Note: Form H1805, SNAP Food Benefits: Your Rights and Program Rules, must be included in the application packet or given to the applicant during the interview.
Medical Programs
  • Online through YourTexasBenefits.com;
  • In the local office;
  • By mail;
  • By fax; or
  • By phone.
  • Online through YourTexasBenefits.com;
  • In the local office;
  • By mail;
  • By fax; or
  • By phone.
  • YourTexasBenefits.com
  • Form H1010, Texas Works Application for Assistance — Your Texas Benefits:
    • Staff must also provide the following forms with the application:
      • Form H1830, Application/Review/Expiration/Appointment Notice (if applicable);
      • Form H0025, HHSC Application for Voter Registration;
      • Appropriate program pamphlets; and
      • A postage-paid return envelope.
  • Form H1205, Texas Streamlined Application:
    • Staff must also provide the following forms with the application:
      • Form H1830, Application/Review/Expiration/Appointment Notice (if applicable);
      • Form H0025, HHSC Application for Voter Registration;
      • Appropriate program pamphlets; and
      • A postage-paid return envelope.

* Staff must give the applicant an application on the same day it is requested. If a household contacts the local office by telephone and does not wish to come to the designated office to file an application on the same day of the request and prefers receiving the application by mail, staff send an application packet on the same day of the telephone request. For written requests, including those received electronically or by fax, staff mail an application packet on the same day the request is received.

The Texas Health and Human Services Commission (HHSC) must accommodate reasonable requests to receive communications by alternative means or at alternative locations. The individual must specify in writing the alternate mailing address or means of contact, and include a statement that using the home mailing address or normal means of contact could endanger the individual.

Note: Individuals applying for Medical Programs may also use the Marketplace-only applications explained in A-113.1, Application Forms. These applications can be submitted to HHSC in person, by fax, by mail, or via an account transfer explained in A-118, Coordination with the Federal Marketplace.

Related Policy

Registering to Vote, A-1521

A—113.1 Application Forms

Revision 19-4; Effective October 1, 2019

YourTexasBenefits.com

The online application on YourTexasBenefits.com integrates HHSC programs into one single application flow. Applicants only see the questions relevant to the programs they request. A PDF copy of the application information is created for applicants and staff to view. 

YourTexasBenefits.com can be used to apply for the following benefits:

  • SNAP food benefits;
  • TANF cash help for families;
  • health care for:
    • children;
    • adults caring for a child;
    • adults not caring for a child (if this is selected, YourTexasBenefits.com will allow applicants to identify themselves as a refugee; if they are not a refugee, they will be redirected to HealthCare.gov);
    • pregnant women;
    • people age 65 or older or with a disability; and
    • people under age 26 who were in foster care in Texas and receiving federally funded Medicaid at age 18 or older; and
    • people under age 21 who were in foster care in Texas or had an Interstate Compact on the Placement of Children (ICPC) agreement at age 18 or older;
  • Medicare Savings Programs; and
  • long-term services and supports for:
    • people with intellectual or developmental disabilities; and
    • people with no intellectual or developmental disabilities.

Form H1010, Texas Works Application for Assistance — Your Texas Benefits

Form H1010 integrates Texas Works programs into one single application.

The addendum to Form H1010 — Form H1010-M, Applying for or Renewing Medicaid or CHIP? — captures the information needed to make an eligibility determination for Medicaid or the Children's Health Insurance Program (CHIP).

Form H1010 can be used to apply for the following benefits:

  • SNAP food benefits;
  • TANF cash help for families; and
  • health care for:
    • children;
    • adults caring for a child;
    • adults not caring for a child;
    • pregnant women;
    • people under age 26 who were in foster care in Texas and receiving federally funded Medicaid at age 18 or older; and
    • people under age 21 who were in foster care in Texas or had an ICPC agreement at age 18 or older.

Form H1205, Texas Streamlined Application

Form H1205 can only be used to apply for health care benefits.

Form H1205 can be used to apply for the following benefits:

  • health care for:
    • children;
    • adults caring for a child;
    • adults not caring for a child;
    • pregnant women; and
    • people under age 26 who were in foster care at age 18 or older; and
    • people under age 21 who were in foster care in Texas or had an ICPC agreement at age 18 or older. 

Applications Solely Used by the Marketplace

The online Marketplace application is a single interactive application based on an applicant's selections. In addition, there are three paper applications for the Marketplace:

  • Application for Health Coverage — for anyone who needs health coverage, but does not need help paying for health insurance costs.
    • Used by applicants who want to purchase a Qualified Health Plan (QHP) through the Marketplace.
  • Application for Health Coverage & Help Paying Costs (Short Form) — for single adults who need help paying for health care coverage (mostly for states offering Medicaid expansion coverage to single adults ages 19 through 64) and who:
    • are not married, do not claim any tax dependents, and cannot be claimed as a tax dependent on someone else's federal income tax return;
    • were not formerly in the foster care system; and
    • are not American Indian (AI)/Alaska Native (AN).
  • Application for Health Coverage & Help Paying Costs — for anyone who needs help paying for health care coverage, including:
    • people who are married, have tax dependents, or can be claimed as a tax dependent on someone else's federal income tax return;
    • people with or without current health care coverage;
    • families that include immigrants; and
    • people who were formerly in the foster care system.

Since these applications do not contain additional questions that were included on Form H1205, Texas Streamlined Application, send out Form H1020, Request for Information or Action, to request any additional information necessary to make an eligibility determination. 

A—114 Applications Causing Conflicts of Interest

Revision 15-4; Effective October 1, 2015

All Programs

The advisor must avoid the appearance of impropriety or conflict of interest when determining eligibility. The advisor is not allowed to work on a case if the individual is a relative (by blood or marriage), roommate, dating companion, supervisor, or someone under the advisor's supervision. The advisor may never work on a case in which the advisor is a case participant or an authorized representative (AR).

The advisor:

  • may provide anyone with an application and information about how and where to apply for benefits;
  • may help a person gather any documents needed to verify eligibility; but
  • must not take any other role in determining eligibility.

The advisor must consult with the supervisor if the individual is a friend, acquaintance or coworker. Generally, the advisor should not work on cases involving these individuals, but the degree and nature of the relationship should be taken into account. In remote areas where it is impractical for another person to process the application, the unit supervisor should be contacted to determine the best method to process the application.

A—114.1 Applications Submitted by Texas Works or Medicaid for the Elderly and People with Disabilities Employees

Revision 18-1; Effective January 1, 2018

All Programs

Give special handling to applications and redeterminations submitted by Texas Works and Medicaid for the Elderly and People with Disabilities employees.

  • A Texas Works or MEPD employee at the next higher administrative position must complete the eligibility determination for another Texas Works employee.
  • A designated supervisor must complete the eligibility determination for a Texas Works or MEPD supervisor or higher position.
  • The employee's immediate supervisor or someone in the direct line of supervision may not process the Texas Works or MEPD employee's application.

A—115 Applications Filed in Hospitals and Clinics

Revision 19-1; Effective January 1, 2019

All Programs

Facility work is the primary assignment for Outstationed Worker Program (OWP) staff. Staff will process workload following the OWP Hierarchy order below:

  • OWP Lobby Facility Workload
  • OWP Statewide Facility Workload
  • Regional EWMS Teams (Supplemental) Workload

Staff follow the most current business processes found in the Eligibility Operations Procedures Manual to complete this workload.

The file date is the date HHSC receives the application from the contracted facility.

A—116 Special Application Processes

Revision 12-2; Effective April 1, 2012

A—116.1 Reserved for Future Use

Revision 20-2; Effective April 1, 2020

A—116.2 Applications from Residents of a Homeless Shelter

Revision 22-1; Effective January 1, 2022

SNAP

People staying in homeless shelters are potentially eligible for SNAP, regardless of the number of meals the facility provides, if the homeless shelter is an approved institution. A homeless shelter is an approved institution if it is a:

  • public or private, nonprofit shelter for the homeless; or
  • certified SNAP retailer.

Verify the homeless shelter is an approved institution, if questionable.

People staying in homeless shelters that are not approved institutions are potentially eligible for SNAP if the facility provides half of their meals or less. Consider this when determining if a person staying in a facility is institutionalized.

Homeless households must meet the same household composition, income, and resource standards as other households. If the household pays for room in a shelter, consider the payments as shelter expenses.

Related Policy

Nonmembers, A-232.1
Prepared Meals for Homeless, B-462
Homeless Shelter Standard, A-1427
Determining Whether a Person Who Resides in a Facility Is Institutionalized, B-490

A—116.3 Applications for Babies Born to Women in Prison

Revision 15-4; Effective October 1, 2015

Medical Programs

A pregnant woman who enters the state prison system is sent to the Texas Department of Criminal Justice women's facility. Before the baby is born, the prison social worker assists the pregnant woman to arrange for a responsible individual to pick up the baby from the hospital. The pregnant woman is sent to a prison section of the University of Texas Medical Branch (UTMB) in Galveston a few weeks before she is due to deliver, unless an emergency occurs earlier. If an emergency does occur, she will deliver at a closer facility when necessary. Before releasing the baby from the hospital, UTMB requires the individual who picks up the baby to complete an application for Medicaid. Designated Texas Works advisors ensure that the baby is certified for Medicaid using special application processing procedures and follow-up activities.

The designated advisors coordinate Medicaid certification by other advisors in special situations when the newborn needs to be added to an active case. Upon request by the designated advisors, which must be documented in the case record, an advisor must certify the newborn:

  • for Medicaid (TP 43) from the date of birth (DOB), not the day the caretaker brought the baby home from the hospital; or
  • after normal application time frames have passed. If needed, staff may follow procedures to request a timeliness exception.

State law requires Medicaid coverage for Texas newborns for at least 28 days after birth and possibly longer if the child is hospitalized at that time. If the hospital followed required procedures before releasing the baby, but the baby does not meet eligibility requirements for Medicaid, the designated advisor and State Office Data Integrity (SODI) staff certify the baby for TA 62, MA - State-Paid Coverage. Examples of not meeting eligibility requirements are:

  • the individual caring for the child does not reside in Texas, and the baby will be taken out of state;
  • the individual caring for the child refuses to apply for Medicaid; or
  • the household is over the income limit.

Related Policy

Documentation Requirements, A-190
Medical Programs, A-240

A—116.4 Reserved for Future Use

Revision 20-4; Effective October 1, 2020

A—116.5 Food Distribution Program on Indian Reservation (FDPIR)

Revision 11-3; Effective July 1, 2011

For application processing related to FDPIR, refer to the policy in B-421, Food Distribution on Indian Reservation (FDPIR).

A—116.6 Joint SSI-SNAP Applications

Revision 11-3; Effective July 1, 2011

For application processing related to joint Supplemental Security Income (SSI)-SNAP applications, refer to the policy in B-420, Joint SSI-SNAP Applications.

A—116.7 Types of Assistance Administered by Centralized Benefit Services (CBS)

Revision 11-3; Effective July 1, 2011

A—116.7.1 SNAP-CAP and SNAP-SSI

Revision 15-4; Effective October 1, 2015

For application processing related to SNAP-Combined Application Project (CAP) and SNAP-SSI, refer to the policy in B-475, Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP), and B-474.1.1.1, SNAP-Supplemental Security Income (SSI) Caseload.

A—116.7.2 Applications for SNAP-CAP

Revision 15-4; Effective October 1, 2015

For application processing related to SNAP-CAP, refer to the policy in B-475, Supplemental Nutrition Assistance Program Combined Application Project (SNAP-CAP).

A—116.7.3 Medicaid for Transitioning Foster Care Youth (MTFCY) (TP 70)

Revision 15-4; Effective October 1, 2015

For application processing related to MTFCY, staff should refer to policy in B-474.1.2, Medical Programs, 2; and Other Medical Programs, Part M, Medicaid for Transitioning Foster Care Youth (MTFCY).

A—116.7.4 Medicaid Coverage for Children Placed in or Released from a Juvenile Facility

Revision 20-4; Effective October 1, 2020

For application processing related to Medicaid for children placed in the custody of or released from the Texas Juvenile Justice Department or Juvenile Probation Department, refer to policy in B-543, Child Placed in a Juvenile Facility, and B-546, Notification of Actual Release from a Juvenile Facility.

A—116.7.5 Medicaid for Breast and Cervical Cancer (MBCC)

Revision 15-4; Effective October 1, 2015

For application processing related to MBCC, staff should refer to policy in B-474.1.2, Medical Programs, 4; and Other Medical Programs, Part X, Medicaid for Breast and Cervical Cancer (MBCC).

A—116.7.6 Reserved for Future Use 

A—116.7.7 Former Foster Care in Higher Education (FFCHE) (TA77)

Revision 11-3; Effective July 1, 2011

For application processing related to FFCHE, refer to policy in Other Medical Programs, Part F, Former Foster Care in Higher Education (FFCHE).

A—116.7.8 Former Foster Care Children (FFCC)

Revision 15-4; Effective October 1, 2015

For application processing related to FFCC, refer to policy in Other Medical Programs, Part E, Former Foster Care Children (FFCC).

A—117 Applications Filed Online through YourTexasBenefits.com

Revision 15-4; Effective October 1, 2015

When the household submits an application online, a process formats the information entered on the online application and imports certain data into TIERS. The process creates the PDF file of the application that is stored in the image repository and is viewable in the State Portal.

TIERS edits the data passed by YourTexasBenefits.com. The fields must contain valid characters and be valid values to be imported into TIERS. Dates must be in the correct format, fields that are numeric must contain only numbers and data must be in accepted ranges for fields with values such as Yes or No, or ZIP codes.

Applications that do not contain required data or have data that may be invalid may be rejected. When an application is rejected for electronic processing into TIERS, the system creates a non-SSP Application Registration Task List Manager (TLM) task.

Applications that are valid and accepted as electronic input into TIERS have an Application Registration TLM task created for them. The task is routed to the appropriate office based on Type of Assistance (TOA) and individual ZIP code for the clerk to perform the Application Registration process task.

A—117.1 Application Registration

Revision 15-4; Effective October 1, 2015

Clerks select the Application Registration task and review the application. Staff will perform Application Registration using certain pre-filled data from the online application that was entered by the individual. All online applications must have Application Registration processed even if the case is approved. It is important to associate the online application to the existing case.

A logical unit of work (LUW) is in Application Registration; Self-Service Application Search. Clerks search for the self-service application using any of the fields in the search area. The search results will be displayed by the head of household name even when the search was not on the head of household.

After successful Application Registration, an appointment or process task will be created for Data Collection, depending upon the programs requested on the online application.

The Application T number is changed to a case number upon clicking Submit in Application Registration.

A—117.2 Data Collection

Revision 15-4; Effective October 1, 2015

When performing Data Collection, the data entered in the online application is displayed for the advisor either as:

  • pre-filled TIERS fields and a message at the top of the page stating that the fields are pre-filled from self-service data (for new applications); or
  • YourTexasBenefits.com information that must be addressed, which displays in a comparison pop-up window (existing cases).

Click on the C icon in the Details page to access the comparison pop-up.

The comparison pop-up window displays the current data in TIERS and the data from the online application to allow the advisor to select the correct data to use in Data Collection.

The advisor may choose to:

  • accept all TIERS data,
  • accept all YourTexasBenefits.com data, or
  • select each data element to be used individually from the comparison pop-up.

These comparison windows are displayed on most Data Collection pages through Resources. There is no YourTexasBenefits.com information or comparison windows in the Program, Income or Expenses pages. The advisor must complete the Data Collection driver flow.

A screen is added in the driver flow just before Run Eligibility. This screen is a summary screen that displays each LUW with YourTexasBenefits.com comparison data and the status of that data. Once the case is disposed, all YourTexasBenefits.com comparison data that was not resolved or processed will be marked completed by the system.

A—118 Coordination with the Federal Marketplace

Revision 15-4; Effective October 1, 2015

Medical Programs

HHSC and the federal Marketplace coordinate eligibility determinations for Texas Works Medicaid and CHIP. Information provided by the applicant or verified for the applicant is sent through an interface between the Marketplace and HHSC. The two systems — the Marketplace and HHSC — transfer an applicant's information from one system to the other. The transfer of application information is referred to as an account transfer. An account transfer is the way in which a client's information moves between the Marketplace and HHSC.

A—118.1 Applications Received from the Marketplace

Revision 15-4; Effective October 1, 2015

Medical Programs

The Marketplace sends the individual's or household's information electronically to HHSC via an account transfer when:

  • the Marketplace determines the applicant is potentially eligible for Medical Programs available through HHSC; or
  • the applicant requests a final eligibility determination for Texas Works Medicaid or CHIP from HHSC. This is referred to as a "full determination."

Applications sent via account transfers from the Marketplace are received by staff in the same manner as an application from YourTexasBenefits.com

When an application is sent to HHSC via an account transfer, a PDF is populated with information provided by the applicant on the Marketplace application, along with a "Verifications" section that provides information on any verifications performed by the Marketplace. Advisors should enter the information provided on the PDF into TIERS.

Individuals cannot be required to provide the same information more than once, regardless of whether they apply through the Marketplace or through HHSC. This applies to any information provided on an application, as well as any verification materials provided by the applicant.

Related Policy

Verifications Provided by the Marketplace, A-118.1.2

A—118.1.1 Non-MAGI Account Transfers

Revision 15-4; Effective October 1, 2015

Medical Programs

A non-Modified Adjusted Gross Income (non-MAGI) account transfer is an account transfer that is sent from the Marketplace to HHSC when the Marketplace has identified that an applicant may be eligible for Medicaid for the Elderly and People with Disabilities (MEPD) because the applicant reported being age 65 or older, having a disability, or being blind. In order for an individual to apply for MEPD programs, they must submit an MEPD application, Form H1200, Application for Assistance — Your Texas Benefits.

Advisors must deny the application as "Filed in Error" and send the applicant Form H1200 if:

  • the PDF included in the account transfer indicates "Medicaid Non-MAGI Eligibility" in the Referral Activity Eligibility Reason for an individual on the application;
  • a "full determination" is not requested; and
  • a determination for Texas Works Medicaid or CHIP is not listed for any other applicant on the application.

A—118.1.2 Verifications Provided by the Marketplace

Revision 15-4; Effective October 1, 2015

Medical Programs

For Marketplace account transfers, the PDF also includes a "Verifications" section. Advisors should use the verification section as follows:

  • If the Marketplace has verified the applicant's Social Security number (SSN) or citizenship status using data from the Social Security Administration (SSA), advisors can identify that information in TIERS as "Verified by SSA."
  • If the Marketplace has verified the applicant's alien status using data from the Department of Homeland Security (DHS), advisors can identify that information in TIERS as "Verified by DHS."
  • All other applicant information, such as income, must be verified by an HHSC advisor according to HHSC procedures explained in C-900, Verification and Documentation. If the Marketplace has verified the information according to HHSC procedures, then that data must be treated as verified.

A—118.2 Applications Sent to the Marketplace

Revision 15-4; Effective October 1, 2015

Medical Programs

When HHSC determines that a client is ineligible for Texas Works Medicaid or CHIP (due to Texas eligibility requirements), or that the client is only eligible for TP 56, Medically Needy with Spend Down; TP 32, Medically Needy with Spend Down-Emergency; or three months prior Medicaid, HHSC transfers that individual's account information to the Marketplace to be assessed for eligibility for other health care coverage programs. Form TF0001, Notice of Case Action, informs the client that they have been transferred to the Marketplace.

A—119 Correspondence Options

Revision 15-4; Effective October 1, 2015

A—119.1 Electronic Correspondence

Revision 15-4; Effective October 1, 2015

All Programs

The head of household or authorized representative (AR) for a case may each choose at any time to receive most eligibility correspondence electronically rather than through the mail. By selecting this option, applicable forms and notices are posted to the client's or AR's YourTexasBenefits.com case account, and the client or AR receives a cell phone text message or email reminder each time a new form or notice has been posted to their account. Clients may print a copy of the correspondence from their account or request that a paper copy be mailed to them. Any forms or notices that are not available electronically will continue to be mailed to the client. 

Once a head of household or AR has opted to receive electronic correspondence through their case account on YourTexasBenefits.com or by indicating that preference to staff through 2-1-1 (Option 2), a confirmation cell phone text message or email reminder will be sent to the client. The head of household or AR must enter the code provided in that confirmation message in their YourTexasBenefits.com case account in order to confirm their choice to receive electronic correspondence. Once confirmed, Form H1013, Electronic Correspondence Confirmation Letter, will automatically be mailed to the head of household or AR to further confirm the selection and to provide instructions about how to opt out of receiving electronic correspondence.

After a failed delivery of a text or email alert, the client is automatically unsubscribed from electronic correspondence. The eligibility system then automatically prints and mails to the client a paper copy of the correspondence that failed to reach the client with the original generation date, attached to Form H1015, Electronic Correspondence Failed Delivery. The client will receive future correspondence through the mail. However, the client may opt to subscribe again to receive electronic correspondence and start over the confirmation process.

A—119.2 Preferred Language for Correspondence

Revision 15-4; Effective October 1, 2015

All Programs

The head of household or AR for a case has the ability to choose the language in which certain forms and notices are generated from the eligibility system. The head of household or AR can select their primary household language from the following options:

  • English
  • Spanish
  • Both English and Spanish
  • Vietnamese*

* Clients who select Vietnamese as their primary household language will receive correspondence in English, and the eligibility system will automatically attach to the form or notice the Vietnamese Translation Interpreter Form, which directs clients to translation services.

Once a primary household language is selected, both the head of household and AR will receive correspondence in that language.