Get Presumptive Eligibility Forms Texas

Filling out the Presumptive Eligibility Forms in Texas is an essential step for individuals seeking Medicaid coverage during pregnancy. This guide will provide you with a clear, step-by-step approach to completing the form online, ensuring you have the necessary support throughout the process.

Follow the steps to complete the Presumptive Eligibility Forms online.

1. Click ‘Get Form’ button to obtain the form and open it in your desired document editor.
2. Enter the name of the applicant in the designated field at the top of the form. Ensure that you provide the correct legal name.
3. Fill in the address section. Include the street address, city, state, and ZIP code of the applicant to ensure accurate identification.
4. If available, provide the social security number of the applicant. This information is essential for processing the application.
5. Fill in the home telephone number of the applicant. This will be used for any necessary follow-up communications.
6. Respond to the preliminary screening questions by selecting 'Yes' or 'No' as applicable. This will determine the eligibility status and guide the next steps.
7. For the budget section, input the total number of people in the standard budget group, which includes unborn children.
8. Report the total monthly earned income for the standard budget group. Exclude any income from household members not included in this group.
9. Subtract $120 for each employed member of the standard budget group from the total monthly earned income.
10. Subtract any dependent care paid each month for dependents under age 2 and dependents age 2 or older as indicated on the form.
11. Subtract the cost of producing self-employment income from the total earned income.
12. Calculate the total net earned income by following the instructions and summarizing the figures written above.
13. Fill in the total monthly unearned income for the standard budget group, ensuring to exclude non-budget group members' income.
14. Deduct any applicable child support from the total unearned income and calculate the total net unearned income.
15. Sum the total net earned income and total net unearned income to find the overall total.
16. Deduct allowable payments made by members of the budget group to determine the total net income.
17. Compare the total net income with the maximum income limit for the size budget group to see if eligibility requirements are met.
18. If the applicant does not qualify, have them sign the statement provided regarding their choice to withdraw the application.
19. Ensure the signature of both the applicant and authorized staff is included, along with the date of the presumptive eligibility determination.
20. Finally, save the changes, download, print, or share the completed form as necessary based on your specific needs.

Start completing your Presumptive Eligibility Forms online today for prompt assistance with Medicaid coverage.