In this subchapter, words and terms have the following meanings,
unless the context clearly indicates otherwise:
(1) Applicant--A person seeking assistance from a Medicaid
program to which this subchapter applies who:
(A) has never received Medicaid and is not currently
receiving Medicaid; or
(B) previously received Medicaid but subsequently was
denied and reapplies for Medicaid.
(2) Child--An adoptive, step, or natural child who
is under age 19.
(3) Federal Poverty Level (FPL)--The income guidelines
issued annually and published in the Federal Register by the United
States Department of Health and Human Services.
(4) HHSC--The Texas Health and Human Services Commission
or its designee.
(5) Household composition--The group of individuals
who are considered in determining eligibility for an applicant or
recipient for certain medical programs based on tax status, tax relationships,
living arrangements, and family relationships, referenced in 42 CFR §435.603(f)
as "household."
(6) Household income--The sum of the individual income
of every individual within an applicant's or recipient's household
composition, from which is subtracted the standard income disregard.
(7) Household size--The number of individuals in an
applicant's or recipient's household composition, plus the number
of unborn children if applicable, referenced in 42 CFR §435.603(b)
as "family size."
(8) Individual income--The sum of income received by
the individuals in a household composition, from which is subtracted
expenses, in compliance with 42 CFR §435.603(e), referenced as
"MAGI-based income."
(9) MAGI--Modified adjusted gross income.
(10) Non-custodial parent--A parent who does not have
custody of a child pursuant to a court order, or binding agreement
of separation or divorce.
(11) Parent--An individual who is the adoptive, step,
or natural parent of a child.
(12) Recipient--A person receiving Medicaid program
services, including a person who is renewing eligibility for a Medicaid
program subject to this subchapter.
(13) Sibling--An individual under age 19 who is an
adoptive, step, or natural sibling of a child.
(14) Spend down--The amount of income that an applicant
must apply toward incurred medical bills before the applicant can
be certified for the Medically Needy Program.
(15) Standard income disregard--An income disregard
equal to five percentage points of FPL for the applicable household
size.
(16) Tax dependent--An individual who expects to be
claimed as a dependent on a federal income tax return for the taxable
year in which Medicaid eligibility is requested.
(17) Taxpayer--An individual, or a married couple,
who expects:
(A) to file a federal income tax return for the taxable
year in which Medicaid eligibility is requested;
(B) if married, to file a joint federal income tax
return for the taxable year in which Medicaid eligibility is requested;
(C) that no other taxpayer will be able to claim him,
her, or them as a tax dependent on a federal income tax return for
the taxable year in which Medicaid eligibility is requested; or
(D) to claim a personal exemption deduction on his
or her federal income tax return for one or more applicants, who may
or may not include himself or herself and his or her spouse.
(18) Taxable year--The 12-month period between January
and December that an individual uses to report income for federal
income tax purposes.
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