Simplified Children's Medicaid
Simplified Children's Medicaid Frequently Asked Questions
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How is Simplified Children's Medicaid different than regular children's Medicaid?
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What's the difference between CHIP and Simplified Children's Medicaid?
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What are the eligibility requirements for Simplified Children's Medicaid?
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Why did only one of my children qualify for Simplified Children's Medicaid?
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I turned in my application — why haven't I been scheduled for an interview?
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My child is sick and I don't have my Medicaid letter; where can I get one?
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Why don't I have an option of receiving CHIP instead of Medicaid?
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How do I get a Simplified Children's Medicaid renewal application?
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Why are some parts of the state processing applications through call centers?
How is Simplified Children's Medicaid different than
regular children's Medicaid?
The two programs are the same. What has changed is that it is now easier for families
to apply for Medicaid for their children. On Jan. 1, 2002, several changes took
place, including:
- The application form is the same as the Children's Health Insurance Program (CHIP) application.
- You don't have to go to a DHS office for an interview.
- Your children are eligible for six months of coverage even if your income or assets increase.
- Parents new to Medicaid must attend an orientation to learn how to use Medicaid properly, and all children must receive check-ups and immunizations as described by the Texas Health Steps program.
Your children may be covered by CHIP if your income or assets increase and they are no longer eligible for Medicaid. | Top
What's the difference between CHIP and Simplified Children's
Medicaid?
The Children's Health Insurance
Program (CHIP) helps families who earn too much money to qualify for Medicaid,
but can't afford to buy private insurance. Families pay monthly premiums and
cost-sharing for
doctor
visits,
prescription
drugs, and emergency care. |
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What are the eligibility requirements for Simplified
Children's Medicaid?
To qualify, a child must:
- Be a Texas resident.
- Be a U.S. citizen or a certain category of legal resident. Note: This requirement may not apply to medical emergencies.
- Be under age 19.
- Live in a family with assets below established levels. This does not include the family's home, personal property, or primary vehicle.
- Either live in a family able to meet Medicaid income requirements, live alone, or live with someone else. | Top
How do I get a Simplified Children's Medicaid application?
You may contact your local DHS office or you can download the CHIP application
in PDF format by clicking here. |
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Why did only one of my children qualify for Simplified
Children's Medicaid?
Because Simplified Children's Medicaid income limits are determined according
to the child's age, it is possible that the combined family income would qualify
one child and not another. If this is the case, and you meet the income criteria
for CHIP, we notify the CHIP office. They will send you a packet of forms to complete
and return to them. If you have questions, please contact your local DHS office.
| Top
I turned in my application — why haven't I been
scheduled for an interview?
The new Simplified Children's Medicaid does not require a face-to-face interview.
This means that you no longer have to come to the office. You can send a copy
of your current pay stub along with your application and we will notify you by
mail whether or not you are eligible for Medicaid. If we need more information
or have questions, a DHS adviser will contact you by phone. If you cannot be reached
by phone, the adviser will send you a letter explaining what we need to certify
your Medicaid case(s). |
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How long is the renewal process?
If you are reapplying and have made no changes, processing your case will take
no more than 15 days. Our goal is to certify you as quickly as possible, so that
your children's coverage is uninterrupted. |
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My child is sick and I don't have my Medicaid letter;
where can I get one?
If your child is now covered by Medicaid, you can go to your nearest DHS office
for a temporary Medicaid letter. If you have not yet applied for Medicaid, please
contact your local DHS office. |
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I applied for CHIP. When I called the office, they told
me that they had mailed my application to you. Why haven't I received anything
from your office?
The CHIP office reviews your application; if they determine that you may be eligible
for Simplified Children's Medicaid, your application is forwarded to us. If you
have submitted all your information to CHIP and they have sent it to us, you will
receive a certification letter only when the case is processed. The Simplified
Children's Medicaid office will contact you only if additional information is
needed. | Top
Why don't I have an option of receiving CHIP instead
of Medicaid?
According to the federal legislation that established these programs, which program
your child will be enrolled in is based on the child's age as well as your family
income and resources. The younger the child, the more income you may have and
still qualify for Medicaid. Before a child can receive CHIP, he or she has to
be determined ineligible for Medicaid. Please note that while many people view
Medicaid as a welfare program it is not welfare. Rather, Medicaid provides health
care for people in need. |
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How do I get a Simplified Children's Medicaid renewal
application?
One will be mailed to you when it is time for renewal. If you don't receive one
within four months after your child was certified, please contact your local DHS
office or the Simplified Children's Medicaid call center in your area (see next
question). |
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Why are some parts of the state processing applications
through call centers?
Currently, three areas in the state are conducting Simplified Children's Medicaid
pilot programs:
- Houston (Harris and Brazoria counties)
- San Antonio (Bexar County)
- El Paso (All the counties in the El Paso and Lubbock regions)
The pilots are testing the effectiveness of using call centers to process Simplified Children's Medicaid applications. Call center employees specialize in that program and interact with clients via mail, phone, or fax. In all other parts of the state, applications are processed through local DHS offices.
If you live in Harris or Brazoria counties, you can mail your Simplified Children's Medicaid application to:
Texas Department of Human Services
Mail Code 176-3
P.O. Box 16017
Houston, TX 77222-6017
You can also call them at 713-266-5535.
If you live in Bexar County, you mail your Simplified Children's Medicaid application to:
Texas Department of Human Services
Mail Code 905-3
P.O. Box 23990
San Antonio, TX 78233
You can also call them at 210-871-6434 or 1-877-322-3233.
If you live in the El Paso or Lubbock regions, you can mail your Simplified Children's Medicaid to:
Texas Department of Human Services
Mail Code 778-1
PO BOX 981017
El Paso, TX 79998-9989
You can also call them at 1-866-KIDSMED (1-866-543-7633) | Top