1. (a) To qualify for Medically Needy Program benefits, an applicant must:

   1. (1) be:

      1. (A) a pregnant woman with no child eligible for the Temporary Assistance for Needy Families (TANF) Program;
      2. (B) a child under 19 years of age; or

      3. (C) an adult caretaker, whom HHSC includes in the certified group, and who ordinarily receives and manages the benefits for the certified group, except that:

         1. (i) the caretaker's countable income exceeds TANF limits;
         2. (ii) the caretaker's 60-month time-limited TANF benefits are exhausted;
         3. (iii) the caretaker chooses Medicaid-only benefits; or
         4. (iv) the caretaker is disqualified from TANF for a reason that is not applicable to Medicaid; and
   2. (2) have countable income that meets the applicable income limit in §366.829 of this subchapter (relating to Income Limits).
2. (b) When determining eligibility for a pregnant applicant or recipient, HHSC includes the needs of her unborn child.
3. (c) A child's needs, income, and resources may be excluded when determining eligibility of the child's siblings if the caretaker chooses not to apply for Medicaid for the excluded child.

Source Note:The provisions of this §366.807 adopted to be effective June 9, 2010, 35 TexReg 4661.