HHSC determines the Medicaid eligibility effective date for
an applicant as follows:
(1) Medicaid coverage begins on the earliest day of
the application month on which the applicant meets all eligibility
criteria.
(2) Retroactive coverage may begin as early as three
months before the application month, except that a newborn's coverage
begins no earlier than the child's date of birth.
(3) A recipient is continuously eligible for Medicaid
for six months or through the month of the recipient's 19th birthday,
whichever is earlier. A recipient who is a newborn has continuous
eligibility through the month of his or her first birthday. If the
applicant is eligible in the application or process month, the child
is eligible for continuous coverage beginning the first month the
applicant meets the eligibility criteria.
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