MEPD Revisions
26-3, September Quarterly Revision
Body
Revision Notice 26-3, Effective Sept. 1, 2026
Archived Revision 26-2, Effective June 1, 2026 (PDF)
Archived Revision 26-1, Effective March 1, 2026 (PDF)
Archived Revision 25-4, Effective Dec. 1, 2025 (PDF)
Archived Revision 25-3, Effective Sept. 1, 2025 (PDF)
Revisions
The following sections were revised in the Medicaid for the Elderly and People with Disabilities (MEPD) Handbook:
| Section | Title | Change |
|---|---|---|
| B-6300 | Institutional Living Arrangement | Clarifies 30 day stay policy. (All Programs) |
| E-6210 | Self-Employment Expenses | Incorporates policy from MEPD and TW Bulletin 26-05, Mileage Rate Increase, released on March 2, 2026. (All Programs) |
| E-8000 | Support and Maintenance | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8100 | General Information | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8140 | Exceptions to Counting Support and Maintenance | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8160 | Living Arrangement | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8211 | Contributing Less than Pro Rata Share | Changes title to Contributing Less than Pro Rata Share of General Household Expenses. Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8212 | Contributing an Earmarked Share of Shelter | Changes title to Contributing Less Than Pro Rata Share of Shelter. Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8213 | Contributing an Earmarked Share of Shelter Only | Changes title to Reserved for Future Use. (All Programs) |
| E-8220 | Ownership or Rental Liability | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8221 | Receipt of Support and Maintenance (S/M) from Inside the Household | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8222 | Receipt of Support and Maintenance from Outside the Household | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E- 8222.1 | Rental Subsidy-Receipt of Support and Maintenance (S/M) from Outside the Household | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8311 | Companion Case Not Contributing Pro Rata Share | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8312 | Companion Case Contributing Pro Rata Share | Changes title to Reserved for Future Use. (All Programs) |
| E-8313 | Couple Case Not Contributing Pro Rata Share | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8314 | Couple Case Contributing Pro Rata Share | Changes title to Reserved for Future Use. (All Programs) |
| E-8321 | Couple Case Not Contributing Pro Rata Share | Changes title to Couple Case Not Contributing Pro -Rata Share In Own Household. Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8322 | Companion Case Not Contributing Pro Rata Share In Own Household | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8500 | Change of Permanent Living Arrangement | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8610 | Excess Contributions Toward Household Expenses | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8620 | Child Living with Parents and Siblings Only | Clarifies support and maintenance policy. Edits section for formatting and clarity. (All Programs) |
| E-8630 | Child Living In Own Household | Clarifies support and maintenance policy. Additional edits for formatting and clarity. (All Programs) |
| E-8640 | Child Living with Parents in Household of Another Person | Clarifies support and maintenance policy. Additional edits for formatting and clarity. (All Programs) |
| H-6260 | Facility Administrator Responsibilities | Changes title to Reserved for Future Use. (All Programs) |
| J-7200 | Spousal Co-Payment | Incorporates policy from MEPD and TW Bulletin 26-10, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2026. (All Programs) |
| J-7400 | Spousal Impoverishment Dependent Allowance | Incorporates policy from MEPD and TW Bulletin 26-10, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2026. (All Programs) |
| O-1600 | Home and Community Based Services | Clarifies functional requirements for eligibility and provider responsibilities. (All Programs) |
| O-1800 | Texas Home Living | Clarifies functional requirements for eligibility and provider responsibilities. (All Programs) |
| R-1300 | Notices | Clarifies when ME Communication Tool is required. (All Programs) |
| R-3100 | Establishing Processing Deadlines | Clarifies 30 day stay policy. (All Programs) |
| R-3813 | People at Entered Address | Clarifies support and maintenance policy. Edits for formatting and clarity. (All Programs) |
| Appendix XIV | In-Kind Support and Maintenance Charts A through E; Worksheets A through D | Added updated terminology related to support and maintenance policy. (All Programs) |
| Appendix XXII | Home and Community-Based Services Waiver Program Co-Payment Worksheets | Incorporates policy from MEPD and TW Bulletin 26-10, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2026. (All Programs) |
| Appendix XXX | Medical Effective Dates (MEDs) | Corrects hyperlink and revises language. (All Programs) |
| Appendix L | 2026 Income Resources Reference Chart | Incorporates policy from MEPD and TW Bulletin 26-10, 2. Spousal Impoverishment Dependent Allowance, released on June 1, 2026. (All Programs) |
Documents and Notices
The following documents or notices were added in the MEPD Handbook:
| Title | Change |
|---|---|
| Notice of SSI Medicaid Ending Instructions | Added sample to handbook in Documents and Notices section on March 31, 2026. |
Retired Bulletins
The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:
| Release Date | Bulletin No. | Title |
|---|---|---|
| 03-20-26 | 26-07 | SNAP Purchase Restrictions |
| 03-02-26 | 26-05 | Mileage Rate Increase |
| 02-19-26 | 26-04 | 2026 Federal Poverty Level |
| 03-05-26 | 25-23 | Revised - Mandatory Shelter Costs Verification (PDF) |
| 09-02-22 | 22-15 | 1. TANF Maximum Grant Amounts 2. SNAP Income Limits Deductions and Allotments 3. SNAP-CAP Allotments 4. COVID-19 Update: Additional Emergency Allotment Supplement 5. Accessing The Work Number (TWN) Data Through the Centers for Medicare and Medicaid Services (CMS) Federal Data 6. Supplemental Nutrition Assistance Program Employment and Training (SNAP E&T) Provider Determinations 7. COVID-19 Update: Extended Supplemental Nutrition Assistance Program (SNAP) Certification Periods Attachment: SNAP Allotment Chart (PDF) |
| 08-27-21 | 21-16 | 1. COVID-19 Update: Pandemic Electronic Benefit Transfer (P-EBT) for Summer 2021 2. Afghan Special Immigrant Parolee (SI/SQ) and Lawful Permanent Resident (LPR) Status (PDF) |
26-2, June Quarterly Revision
Body
Revision Notice 26-2, Effective June 1, 2026
Archived Revision 26-1; Effective March 1, 2026 (PDF)
Archived Revision 25-4; Effective Dec. 1, 2025 (PDF)
Archived Revision 25-3; Effective Sept. 1, 2025 (PDF)
Archived Revision 25-2; Effective June 1, 2025 (PDF)
Revisions
The following sections were revised in the Medicaid for the Elderly and People with Disabilities (MEPD) Handbook:
| Section | Title | Change |
|---|---|---|
| F-4225.1 | Life Settlement | Incorporates policy from MEPD and TW Bulletin 26-01, AVS and Additional TIERS Updates, released on Jan. 30, 2026. (All Programs) |
| F-8200 | Tuition Savings Program (Qualified Tuition Programs) | Changes title to Tuition Savings Program and Qualified Tuition Programs. Incorporates policy from MEPD and TW Bulletin 26-01, AVS and Additional TIERS Updates, released on Jan. 30, 2026. (All Programs) |
| M-5200 | Medicaid Buy-In Income Limits | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| M-7100 | Post Eligibility-Premium Budgets | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| N-6330 | Ineligible Sibling Exclusion | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026). (All Programs) |
| N-6351 | Examples of Budgeting Steps | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Q-2500 | QMB Income Limits | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Q-3200 | SLMB Income Limits | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Q-5200 | QI Income Limits | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Q-6200 | QDWI Income Limits | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Appendix IX | Medicare Savings Program Information | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Appendix XVI | Documentation and Verification Guide | Incorporates policy from MEPD and TW Bulletin 26-01, AVS and Additional TIERS Updates, released on Jan. 30, 2026. (All Programs) |
| Appendix XXII | Home and Community-Based Services Waiver Program Co-Payment Worksheets | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Appendix XXIX | Special Deeming Eligibility Test for Spouse to Spouse | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Appendix XXXI | Budget Reference Chart | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Appendix XXXIX | MBI Screening Tool and Worksheets | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Appendix XLVII | Simplified Redetermination Process | Changes title to Reserved for Future Use. Incorporates policy from MEPD and TW Bulletin 26-01, AVS and Additional TIERS Updates, released on Jan. 30, 2026. (All Programs) |
| Appendix L | 2025 Income and Resources Reference Chart | Incorporates policy from MEPD and TW Bulletin 26-04, 2026 Federal Poverty Level, released on Feb. 19, 2026. (All Programs) |
| Glossary | I | Updates the definition of In-kind. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| Glossary | P | Adds entry for Presumed Maximum Value. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All programs) |
| Glossary | S | Updates the definition of Support and Maintenance. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All programs) |
Retired Bulletins
The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:
| Release Date | Bulletin No. | Title |
|---|---|---|
| 02-05-26 | 26-02 | H.R. 1 SNAP Alien Eligibility Impact (PDF) |
| 12-29-25 | 25-24 | Federal Benefits 2026 Cost-of-Living Adjustment (COLA) |
| 11-10-25 | 25-21 | Partial November SNAP Allotments (PDF) Attachment: SNAP Allotment Chart November 2025 Partial Benefits (PDF) |
| 11-10-25 | 25-20 | Low-Income Home Energy Assistance Act of 1981 - LIHEAA (PDF) |
| 11-04-25 | 25-19 | 1. Remove Interview Requirement for Medicaid for Parents and Caretaker Relatives (PDF) 2. SNAP Treatment of Application and Recertification Timeframes - START (PDF) |
| 04-01-25 | 25-07 | 1. Removal of Fixed Certification Periods for Texas Works Medicaid Programs (PDF) 2. Processing Time Frames for MAGI Renewals Update (PDF) |
| 03-31-23 | 23-06 | COVID-19 Update: COVID-19 Assistance Payments (PDF) |
26-1, March Quarterly Revision
Body
Revision Notice 26-1, Effective March 1, 2026
Archived Revision 25-4; Effective Dec. 1, 2025 (PDF)
Archived Revision 25-3; Effective Sept. 1, 2025 (PDF)
Archived Revision 25-2; Effective June 1, 2025 (PDF)
Archived Revision 25-1; Effective March 1, 2025 (PDF)
Revisions
The following sections were revised in the Medicaid for the Elderly and People with Disabilities (MEPD) Handbook:
| Section | Title | Change |
|---|---|---|
| D-9410 | Examples of Sponsor-to-Alien Income Deeming | Incorporates policy from MEPD and Texas Works (TW) Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| E-7400 | Special Income Exemptions Used in Deeming | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8000 | Support and Maintenance | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8100 | General Information | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8110 | One-Third Reduction Rule | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8120 | One-Third Reduction +$20 Rule | Changes title to Presumed Maximum Value Rule. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8121 | Community Attendant Services | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8130 | Support and Maintenance Items | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8140 | Exceptions to Counting Support and Maintenance | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8212 | Contributing an Earmarked Share of Food and Shelter | Changes title to Contributing an Earmarked Share of Shelter. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8213 | Contributing an Earmarked Share of Either Food or Shelter | Changes title to Contributing an Earmarked Share Shelter Only. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8214 | Separate Food Purchases | Changes title to Reserved for Future use. |
| E-8221 | Receipt of Support and Maintenance from Inside the Household | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8223 | Receipt of Support and Maintenance from Inside and Outside the Household | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8311 | Companion Case not Contributing Pro Rata Share | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8312 | Companion Case Contributing Pro Rata Share | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8314 | Couple Case Contributing Pro Rata Share | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8322 | Companion Case Not Contributing Pro-Rata Share | Changes title to Companion Case Not Contributing Pro-Rata Share In Own Household. Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8323 | Companion Case with Contributions | Deletes section. |
| E-8400 | Rent-Free Shelter | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8630 | Child Living in Own Household | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8640 | Child Living with Parents in Household of Another | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8700 | Long-Term Care Facilities | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| E-8800 | Verification and Documentation | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| F-3610 | Persons Impacted by Substantial Home Equity Disqualification | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| G-1310 | Community-Based Programs Using SSI Limits | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| G-1320 | Special Income Limits | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| G-2311.2 | Examples of Spouse-to-Spouse Deeming | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| G-2312.1 | Examples of Parent-to-Child Deeming | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| G-4310 | Computing Social Security Cost-of-Living Increases | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| H-1800 | Medicare Part B Premium | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| H-2140 | Deductions for Insurance Premiums | Incorporates policy from MEPD and TW Bulletin 25-18, Allowing Limited Scope Policy Premiums as Incurred Medical Expense, released Oct. 24, 2025. (All Programs) |
| H-2900 | IME Notices | Incorporates policy from MEPD and TW Bulletin 25-18, Allowing Limited Scope Policy Premiums as Incurred Medical Expense, released Oct. 24, 2025. (All Programs) |
| H-6000 | Co-Payment for SSI Cases | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| J-7200 | Spousal Co-Payment | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| J-7300 | ICF_IID Spousal Companion Cases | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| M-7100 | Post Eligibility- Premium Budgets | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Q-1300 | MSP Resource Limits | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix VIII | Summary of Effects of Institutionalization on Supplemental Security Income (SSI) Eligibility | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix IX | Medicare Savings Program Information | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XII | Nursing Facility and Home and Community-Based Services Waiver Information | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XIV | In-Kind Support and Maintenance Charts and Worksheets | Incorporates policy from MEPD and TW Bulletin 25-17, Aligning Federal and State In-Kind Support and Maintenance Policies, released Oct. 20, 2025. (All Programs) |
| Appendix XXII | Home and Community-Based Services Waiver Program Co-Payment Worksheets | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XXIX | Special Deeming Eligibility Test for Spouse to Spouse | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XXXI | Budget Reference Chart | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XXXVI | QITs and MEPD Information | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XXXVIII | Pickle Disregard Computation Worksheet | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix XXXIX | MBI Screening Tool and Worksheets | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix L | Income and Resources Reference Chart | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
| Appendix LIII | Sponsor to Alien Deeming Worksheet | Incorporates policy from MEPD and TW Bulletin 25-24, Federal Benefits 2026 Cost-of-Living Adjustment (COLA), released Dec. 29, 2025. (All Programs) |
Forms
The following forms were revised in the MEPD Handbook:
| Form | Title | Change |
|---|---|---|
| H1053-IME Instructions | Provider Notice of Incurred Medical Expense Decision | Incorporates policy from MEPD and TW Bulletin 25-18, Allowing Limited Scope Policy Premiums as Incurred Medical Expense, released Oct. 24, 2025. (All Programs) |
Retired Bulletins
The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:
| Release Date | Bulletin No. | Title |
|---|---|---|
| 11-21-25 | 25-23 | Mandatory Shelter Costs Verification (PDF) |
| 11-14-25 | 25-22 | Federal Government Shutdown Update (PDF) |
| 11-10-25 | 25-21 | Partial November SNAP Allotments (PDF) Attachment: SNAP Allotment Chart November 2025 Partial Benefits (PDF) |
| 11-10-25 | 25-20 | Low-Income Home Energy Assistance Act of 1981 - LIHEAA (PDF) |
| 11-04-25 | 25-19 | 1. Remove Interview Requirement for Medicaid for Parents and Caretaker Relatives (PDF) 2. SNAP Treatment of Application and Recertification Timeframes - START (PDF) |
| 10-24-25 | 25-18 | Allowing Limited Scope Policy Premiums as Incurred Medical Expenses (PDF) |
| 10-20-25 | 25-17 | Aligning Federal and State In-Kind Support and Maintenance Policies (PDF) |
| 10-01-25 | 25-16 | House Resolution 1 ABAWD Exceptions and Age Limit Change (PDF) Attachment: SNAP Work Rules Informing Script - English (PDF) Attachment: SNAP Work Rules Informing Script - Spanish (PDF) |
| 09-05-25 | 25-15 | 1. TANF Maximum Grant Amounts (PDF) 2. SNAP Income Limits, Deductions, and Allotments (PDF) 3. SNAP-CAP Shelter Threshold and Allotments (PDF) Attachment: SNAP Allotment Chart (PDF) |
| 07-22-25 | 25-13 | Compacts of Free Association (COFA) Eligibility (PDF) |
25-4, December Quarterly Revision
Body
Revision Notice 25-4, Effective Dec. 1, 2025
Archived Revision 25-3; Effective Sept. 1, 2025 (PDF)
Archived Revision 25-2; Effective June 1, 2025 (PDF)
Archived Revision 25-1; Effective March 1, 2025 (PDF)
Archived Revision 24-4; Effective Dec. 1, 2024 (PDF)
The following sections were revised in the Medicaid for the Elderly and People with Disabilities (MEPD) Handbook:
| Section | Title | Change |
|---|---|---|
| B-6200 | Financial Management | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| B-7300 | MEPD Eligibility Pending a Decision of SSI Application | Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| B-8200 | Redetermining Eligibility | Removes outdated cross-reference to B-8440 from Related Policy. (All Programs) |
| B-8460 | Changes and Program Transfers | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| C-2230 | Verification and Documentation | Updates LOOP hyperlink. (All Programs) |
| C-8000 | Responsibility to Provide Information and Report Changes | Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| D-6000 | Social Security Number and Application for Other Benefits | Changes section title to Social Security Number. Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| D-6300 | Application for Other Benefits Requirement | Deletes section. |
| D-6310 | Other Benefits Subject to the Application Requirement | Deletes section. |
| D-6320 | Other Benefits Subject to the Application Requirement | Deletes section. |
| D-6330 | Payments That Are Not Other Benefits | Deletes section. |
| D-6340 | Supplemental Security Income (SSI) | Deletes section. |
| D-6350 | Veterans Benefits | Deletes section. |
| D-6351 | VA Pension or Compensation | Deletes section. |
| D-6352 | VA Wartime Periods | Deletes section. |
| D-6353 | VA Payments for Dependents | Deletes section. |
| D-6354 | Requirement to Apply for Apportionment of Augmented VA Benefit | Deletes section. |
| D-6400 | Treatment of Other Benefits | Deletes section. |
| D-6410 | Deeming Situations | Deletes section. |
| D-6420 | Payment Options for Other Benefits | Deletes section. |
| D-6421 | Survivor’s Benefits for Spouses and Other Dependents | Deletes section. |
| D-6422 | Lump Sum or Annuity Payment Option | Deletes section. |
| D-6430 | Electing the Month of Entitlement | Deletes section. |
| D-6440 | Establishing Eligibility After Denial | Deletes section. |
| D-6500 | Exceptions to the Application for Other Benefits Requirement | Deletes section. |
| D-6600 | When Not to Refer for Other Benefits | Deletes section. |
| E-4310 | Augmented and Apportioned VA | Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| E-4311 | VA Pensions | Consolidates policy from E-4311.1, 1979 VA Pension Plan, and E-4311.2, $90 VA Pension and Institutional Setting. Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| E-4311.1 | 1979 VA Pension Plan | Deletes section. |
| E-4311.2 | $90 VA Pension and Institutional Setting | Deletes section. |
| E-4312 | VA Compensation | Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| E-4315 | VA Aid and Attendance and Housebound Payments | Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| E-6500 | Self-Employment Income Examples | Removes duplicated text. (All Programs) |
| F-4100 | Types of Liquid Resources | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| F-4101 | Financial Accounts | Creates new section. Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| F-4120 | Bank Accounts | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| F-4180 | Uniform Transfers to Minors and Uniform Gifts to Minors | Creates new section. Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| F-4190 | Custodial Retirement | Creates new section. Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| F-6300 | Trusts (August 11, 1993 and After) | Updates title to Trusts - Aug. 11, 1993 and After. Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| F-8300 | Uniform Transfers to Minors | Changes title to Reserved for Future Use. |
| H-2160 | Pre-Eligibility IMEs | Clarifies policy for who and how IME deductions can be requested for pre-eligibility medical expenses. (All Programs) |
| I-5100 | Transfer of Assets Divisor | Incorporates policy from MEPD and TW Bulletin 25-14, Transfer of Assets Divisor, released on Aug. 1, 2025. (All Programs) |
| J-7200 | Spousal Co-Payment | Incorporates policy from MEPD and TW Bulletin 25-12, 2. Spousal Impoverishment Dependent Allowance, released on July 1, 2025. (All Programs) |
| J-7400 | Spousal Impoverishment Dependent Allowance | Incorporates policy from MEPD and TW Bulletin 25-12, 2. Spousal Impoverishment Dependent Allowance, released on July 1, 2025. (All Programs) |
| M-5200 | Medicaid Buy-In Income Limits | Updates text. (All Programs) |
| N-6351 | Examples of Budgeting Steps | Corrects example. (All Programs) |
| R-1300 | Notices | Removes link to MEPD Communication Tool. This is now located in TIERS PT Inquiry. (All Programs) |
| R-3400 | Merge and Separate Client or Individual Numbers | Updates text. (All Programs) |
| R-3740 | Asset Verification System (AVS) | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| R-3742 | AVS Requests | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| R-3743 | AVS Responses | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| R-3744 | Consideration of AVS Information | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. (All Programs) |
| Appendix VIII | Summary of Effects on Institutionalization on Supplemental Security Income (SSI) Eligibility | Updates the LOOP hyperlink. (All Programs) |
| Appendix XIV | In-Kind Support and Maintenance Charts A through E; Worksheets A through D | Updates the LOOP hyperlink. (All Programs) |
| Appendix XVI | Documentation and Verification Guide | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Update - Asset Verification System and TIERS Updates, released July 1, 2025. Incorporates policy from MEPD and TW Bulletin 25-11, Requirement to Apply for Other Benefits, released on June 13, 2025. (All Programs) |
| Appendix XVII | System Generated IEVS Worksheet Legends for IRS Tax Data | Updates the LOOP hyperlink. (All Programs) |
| Appendix XVIII | IRS Tax Code, Sections 7213, 7213A, and 7431 | Updates the LOOP hyperlink. (All Programs) |
| Appendix XX | Deeming Noninstitutional Budgets - Couple Living in the Same Household | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXII | Home and Community-Based Services Waiver Program Co-Payment Worksheets No. 2 and No. 5 | Incorporates policy from MEPD and TW Bulletin 25-12, 2. Spousal Impoverishment Dependent Allowance, released on July 1, 2025. (All Programs) |
| Appendix XXIII | Procedure for Designated Vendor Number to Withhold Vendor Payment | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXV | Accessibility to Income and Resources in Joint Bank Accounts | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXVI | ICF/IID Vendor Payment Budget Worksheets | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXVII | Worksheet for Expanded SPRA on Appeal | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXVIII | Worksheet for Spouse's Income (Post-Expanded SPRA Appeals) | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXXI | Budget Reference Chart | Incorporates policy from MEPD and TW Bulletin 25-12, 1. Spousal Impoverishment Dependent Allowance, released on July 1, 2025 and from MEPD and TW Bulletin 25-14, Transfer of Assets Divisor, released on Aug. 1, 2025. (All Programs) |
| Appendix XXXIV | Burial Resources | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXXV | Treatment of Insurance Dividends | Updates the LOOP hyperlink. (All Programs) |
| Appendix XXXVI | Qualified Income Trusts (QITs) and Medicaid for the Elderly and People with Disabilities (MEPD) Information | Changes title to QITs and MEPD Information. Incorporates policy from MEPD and TW Bulletin 25-14, Transfer of Assets Divisor, released on Aug. 1, 2025. (All Programs) |
| Appendix XXXVIII | Pickle Disregard Computation Worksheet | Updates the LOOP hyperlink. (All Programs) |
| Appendix XLVII | Simplified Redetermination Process | Updates the LOOP hyperlink. (All Programs) |
| Appendix XLVIII | Medicaid Buy-In for Children (MBIC) Denial Codes | Updates the LOOP hyperlink. (All Programs) |
| Appendix XLII | Variable Income Worksheet | Updates the LOOP hyperlink. (All Programs) |
| Appendix XLIX | Medicaid Buy-In for Children Program Forms Chart | Updates the LOOP hyperlink. (All Programs) |
| Appendix L | 2025 Income and Resources References Chart | Incorporates policy from MEPD and TW Bulletin 25-12, 2. Spousal Impoverishment Dependent Allowance, released on July 1, 2025 and from MEPD and TW Bulletin 25-14, Transfer of Assets Divisor, released on Aug. 1, 2025. (All Programs) |
| Appendix LIII | Sponsor to Alien Deeming Worksheet | Updates the LOOP hyperlink. (All Programs) |
| Appendix LIV | Description of Alien Resident Cards | Updates the LOOP hyperlink. (All Programs) |
Retired Bulletins
The following bulletins are deleted from the MEPD Handbook since the information has either been incorporated into the handbook or is no longer necessary:
| Release Date | Bulletin No. | Title |
|---|---|---|
| 08-01-25 | 25-14 | Transfer of Assets Divisor |
| 07-01-25 | 25-12 | 1. Update - Asset Verification System and TIERS Updates 2. Spousal Impoverishment Dependent Allowance |
| 06-13-25 | 25-11 | Requirement to Apply for Other Benefits |
| 06-02-25 | 25-10 | Update - Continuous Eligibility for Medicaid for Children Under 19 - Department of Family and Protective Services (DFPS) |
| 03-21-25 | 25-06 | Timely Change Reporting (PDF) |