Tex. Health & Safety Code Section 62.101
Eligibility


(a)

A child is eligible for health benefits coverage under the child health plan if the child:

(1)

is younger than 19 years of age;

(2)

is not eligible for medical assistance under the Medicaid program;

(3)

is not covered by a health benefits plan offering adequate benefits, as determined by the commission;

(4)

has a household income that is less than or equal to the income eligibility level established under Subsection (b); and

(5)

satisfies any other eligibility standard imposed under the child health plan program in accordance with 42 U.S.C. Section 1397bb, as amended, and any other applicable law or regulations.

(a-1)

A child who is the dependent of an employee of an agency of this state and who meets the requirements of Subsection (a) may be eligible for health benefits coverage in accordance with 42 U.S.C. Section 1397jj(b)(6) and any other applicable law or regulations.

(b)

The executive commissioner shall establish income eligibility levels consistent with Title XXI, Social Security Act (42 U.S.C. Section 1397aa et seq.), as amended, and any other applicable law or regulations, and subject to the availability of appropriated money, so that a child who is younger than 19 years of age and whose household income is at or below 200 percent of the federal poverty level is eligible for health benefits coverage under the program.

(b-1)

Repealed by Acts 2015, 84th Leg., R.S., Ch. 1, Sec. 3.1639(25), eff. April 2, 2015.

(c)

The executive commissioner shall evaluate enrollment levels and program impact at least annually and shall submit a finding of fact to the Legislative Budget Board and the Governor’s Office of Budget, Planning, and Policy as to the adequacy of funding and the ability of the program to sustain enrollment at the eligibility level established by Subsection (b). In the event that appropriated money is insufficient to sustain enrollment at the authorized eligibility level, the executive commissioner shall:

(1)

suspend enrollment in the child health plan;

(2)

establish a waiting list for applicants for coverage; and

(3)

establish a process for periodic or continued enrollment of applicants in the child health plan program as the availability of money allows.
Added by Acts 1999, 76th Leg., ch. 235, Sec. 1, eff. Aug. 30, 1999. Amended by Acts 2003, 78th Leg., ch. 198, Sec. 2.46, eff. Sept. 1, 2003.
Amended by:
Acts 2007, 80th Leg., R.S., Ch. 1353 (H.B. 109), Sec. 3, eff. June 15, 2007.
Acts 2011, 82nd Leg., 1st C.S., Ch. 7 (S.B. 7), Sec. 1.03(a), eff. September 28, 2011.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.0196, eff. April 2, 2015.
Acts 2015, 84th Leg., R.S., Ch. 1 (S.B. 219), Sec. 3.1639(25), eff. April 2, 2015.

Source: Section 62.101 — Eligibility, https://statutes.­capitol.­texas.­gov/Docs/HS/htm/HS.­62.­htm#62.­101 (accessed Jun. 5, 2024).

62.001
Objective of the State Child Health Plan
62.002
Definitions
62.003
Not an Entitlement
62.004
Federal Law and Regulations
62.051
Duties of Executive Commissioner and Commission in General
62.052
Authority of Commission Relating to Health Plan Provider Contracts
62.053
Authority of Commission Relating to Eligibility and Medicaid Coordination
62.054
Duties of Texas Department of Insurance
62.055
Contracts for Implementation of Child Health Plan
62.056
Community Outreach Campaign
62.058
Fraud Prevention
62.060
Health Information Technology Standards
62.101
Eligibility
62.102
Continuous Coverage
62.103
Application Form and Procedures
62.104
Eligibility Screening and Enrollment
62.105
Coverage for Qualified Aliens
62.106
Suspension and Automatic Reinstatement of Eligibility for Children in Juvenile Facilities
62.107
Notice of Certain Placements in Juvenile Facilities
62.151
Child Health Plan Coverage
62.152
Application of Insurance Law
62.153
Cost Sharing
62.154
Waiting Period
62.155
Health Plan Providers
62.156
Health Care Providers
62.157
Telemedicine Medical Services, Teledentistry Dental Services, and Telehealth Services for Children with Special Health Care Needs
62.158
State Taxes
62.159
Disease Management Services
62.0531
Authority of Commission Relating to Third Party Administrator
62.0582
Third-party Billing Vendors
62.1011
Verification of Income
62.1015
Eligibility of Certain Children
62.1511
Coverage for Maternal Depression Screening
62.1551
Inclusion of Certain Health Care Providers in Provider Networks
62.1561
Prohibition of Certain Health Care Providers
62.1571
Telemedicine Medical Services, Teledentistry Dental Services, and Telehealth Services

Accessed:
Jun. 5, 2024

§ 62.101’s source at texas​.gov