Revision 21-3; Effective July 1, 2021

 

W—510 General Policy

Revision 21-3; Effective July 1, 2021

 

To receive Healthy Texas Women (HTW) benefits, the recipient must be 15 through 44. An applicant is considered 15 the month of her 15th birthday and age 44 through the month of her 45th birthday. A parent or legal guardian must apply on behalf of minors 15 through 17.

Ten days prior to a woman turning 18 years old, she will receive Form H1871, HTW Client Turning 18 Years Old, to inform her she is now responsible for managing her own HTW Eligibility Determination Group (EDG). The form also provides information about how to report a confidential address.

Married minors are not eligible for HTW; the TF0001 will inform the minor of other services they may be eligible to receive.

Examples:

In these examples, the applicant has already been determined ineligible for full coverage Medicaid and the Children’s Health Insurance Program (CHIP) and is now being tested for HTW eligibility.

  • A woman turns 15 on Feb. 9. Her parent filed an application on Jan. 17. The woman is ineligible to receive HTW as she is not turning 15 in the application month. A parent or legal guardian must reapply in the month of February to meet the age requirements.
  • A woman turns 18 on July 27. Her parent filed an application on June 5. The woman is eligible for HTW if other eligibility criteria are met. Ten days prior to her 18th birthday on July 17, Form H1871 is generated to inform her once she turns 18 she is responsible for managing her own HTW EDG.
  • A woman turns 45 on May 5. She will no longer be eligible to receive HTW benefits effective June 1.

Age is self-declared. If questionable, verify the applicant's age using the Bureau of Vital Statistics (BVS). If unable to verify using BVS, attempt to contact the applicant to clear the discrepancy. Use information provided by the applicant on a previous EDG, if possible.

If the applicant is not eligible for full coverage Medicaid or CHIP and the application is received in a month the applicant:

  • is 14, and the application is processed in a month she becomes 15, deny the application because of age;
  • is 44, and the application is processed in a month she becomes 45, if otherwise eligible, certify for the month of application and the month of her 45th birthday; or
  • becomes 45, and the application is processed the month after her 45th birthday, if otherwise eligible, certify for the month of application only.

Use the following denial reason:

  • English — You do not meet the age requirement for the Healthy Texas Women program. To receive benefits under this program, you must be 15 through 44 years of age.
  • Spanish — Usted no llena los requisitos de edad del programa Healthy Texas Women. Para recibir beneficios bajo este programa, tiene que tener entre 15 y 44 años de edad.

Married minors 15 through 17 are not eligible for HTW. If the married minor is not eligible for Medicaid and CHIP, use the denial reason, “Denied 15-17 married minors” for HTW. The TF0001, Notice of Case Action, will include the following language:

English:

Notice Language –You are not able to get Healthy Texas Women services because you are an emancipated minor. You might be able to get services through other programs:

Medicaid or CHIP. Apply by: (1) going to YourTexasBenefits.com or (2) calling 2-1-1 or 877-541-7905 for an application (after you pick a language, press 2).

Family Planning Program services. Apply by: (1) going to HealthyTexasWomen.org or (2) calling 2-1-1 or 877-541-7905 (after you pick a language, press 2).

Spanish:

Notice Language – Usted no puede recibir servicios de Healthy Texas Women porque es una menor de edad emancipada. Es posible que usted pueda recibir servicios a través de otros programas:

Medicaid o CHIP. Para hacer la solicitud: (1) vaya a YourTexasBenefits.com o (2) llame al 2-1-1 o al 877-541-7905 para pedir una solicitud (después de seleccionar un idioma, oprima el 2).

Servicios del Programa de Planificación Familiar. Para hacer la solicitud: (1) vaya a HealthyTexasWomen.org o (2) llame al 2-1-1 o al 877-541-7905 (después de seleccionar un idioma, oprima el 2).

When a minor between 15 and 17 submits an application without a parent or guardian and the minor is not eligible for Medicaid or CHIP, use the denial reason of, “Denied 15 -17 without parent or legal guardian’s signature”. The TF0001, Notice of Case Action will include the following language: 

Notice Language–You are not able to get Healthy Texas Women services. A parent or legal guardian must apply for young women ages 15 to 17 -- that was not done in this case. You might be able to get services through other programs:

Medicaid or CHIP. Apply by: (1) going to YourTexasBenefits.com or (2) calling 2-1-1 or 877-541-7905 for an application (after you pick a language, press 2).

Family Planning Program services. Apply by: (1) going to HealthyTexasWomen.org or (2) calling 2-1-1 or 877-541-7905 (after you pick a language, press 2).

Spanish:

Notice Language – Usted no puede recibir servicios de Healthy Texas Women. Uno de los padres o un tutor deben llenar la solicitud para jovencitas de 15 a 17 años, lo cual no se hizo en este caso. Es posible que usted pueda recibir servicios a través de otros programas:

Medicaid o CHIP. Para hacer la solicitud: (1) vaya a YourTexasBenefits.com o (2) llame al 2-1-1 o al 877-541-7905 para pedir una solicitud (después de seleccionar un idioma, oprima el 2).

Servicios del Programa de Planificación Familiar. Para hacer la solicitud: (1) vaya a HealthyTexasWomen.org o (2) llame al 2-1-1 o al 877-541-7905 (después de seleccionar un idioma, oprima el 2).

Related Policy

Verification Sources, A-531
Reuse of an Application Form After Denial, B-111

 

W—520 Verification Requirements

Revision 07-0; Effective July 1, 2007

 

Accept self-declaration as verification of age.

 

W—530 Documentation Requirements

Revision 07-0; Effective July 1, 2007

 

Document the individual's self-declaration establishing her age.