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) Family size--The number of persons counted as members of an individual's household composition.
- (4) 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.
- (5) HHSC--The Texas Health and Human Services Commission or its designee.
- (6) MAGI--Modified adjusted gross income.
- (7) 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.
- (8) Parent--An individual who is the adoptive, step, or natural parent of a child.
- (9) Recipient--A person receiving Medicaid program services, including a person who is renewing eligibility for a Medicaid program subject to this subchapter.
- (10) Sibling--An individual under age 19 who is an adoptive, step, or natural sibling of a child.
- (11) 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.
- (12) 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.
(13) 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.
- (14) Taxable year--The 12-month period between January and December that an individual uses to report income for federal income tax purposes.
Source Note:The provisions of this §366.1103 adopted to be effective January 1, 2014, 38 TexReg 9467.