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D-1431 Address Change Processing
Revision 13-4; Effective October 1, 2013
CHIP, CHIP Perinatal
The case address is updated when the household reports an address change.
If the household reports a change of address, the individual is mailed form VR30, Texas Voter Registration Application, to register to vote based on the new address. If the individual declines the opportunity to register to vote after receipt of form VR30, mail Form H1350, Opportunity to Register to Vote, to the individual for their signature. Send Form H1350 for imaging when the individual returns Form and retain Form for at least 22 months.
Related Policy
Registering to Vote, A-1521
D-1432 Moves
Revision 13-4; Effective October 1, 2013
CHIP, CHIP Perinatal
For moves within Texas, the case is updated to reflect the newly reported address.
For moves outside of Texas, the case is updated to reflect the:
- temporary address, if the move is temporary.
- address and disenrolls the child as soon as possible, if the move is permanent.
D-1433 Household Composition Changes
Revision 15-4; Effective October 1, 2015
CHIP Perinatal
No action is taken on a request to add or remove a non-certified person from an existing perinatal Eligibility Determination Group (EDG).
D-1433.1 Adding a New Child
Revision 23-2; Effective April 1, 2023
CHIP, CHIP Perinatal
A separate application is required;
- to start benefits for a new child being added if there is not an existing Medicaid or Children's Health Insurance Program (CHIP) EDG on the case; and
- if a household requests benefits for a sibling of a child released from a juvenile facility whose TP 44 eligibility is reinstated to a denied or newly created case.
CHIP
When a household reports a new child in the household, determine if the new child and other children in the household that are certified for CHIP meet Medicaid eligibility criteria. Certify the children for Medicaid if they are eligible. A new application is not required.
When a household reports a new child in the household and the child is potentially eligible for CHIP, third-party resources (TPR) requirements must be addressed following application procedures. Deny the CHIP EDG if the child has an active TPR but does not meet any of the good cause exemptions.
Note: If the Texas Juvenile Justice Department (TJJD) or Juvenile Probation Department (JPD) reports by the TJJD or JPD Released Logical Unit of Work (LUW) that a child was released from a juvenile facility and is now living in the household, TIERS automatically tests the child's eligibility for Medicaid.
If the new child is ineligible for Medicaid but eligible for CHIP and has siblings or a parent currently enrolled in the program, they are considered to meet good cause. TIERS calculates the new child's effective date of coverage for the next possible month following cutoff. The new child will receive the remaining months of coverage with the siblings or parent. The coverage end date is the same date as the child's currently enrolled siblings or parent. The new child may not receive the full 12 months of coverage and is required to renew coverage along with the child’s siblings or parent on the scheduled renewal date.
Once the new child is determined eligible for CHIP, TIERS notifies the Enrollment Broker via an interface. The Enrollment Broker generates and mails a welcome letter to the household.
CHIP Perinatal
Income Above the Limit for Medicaid for Pregnant Women (TP 40)
A child born to a CHIP perinatal mother whose household income is above 198 percent of the federal poverty level (FPL), which is the applicable income limit for Pregnant Women Medicaid (TP 40), will have an effective date beginning with the date of birth and continuing through the remainder of the 12-month CHIP perinatal enrollment segment. The mother's perinatal coverage ends the last day of the child's birth month or the pregnancy's termination month. The mother will receive two postpartum visits even if they are beyond the birth month.
Example: A pregnant mother is approved for CHIP perinatal effective June 1. The child is born on Oct. 4. The newborn's effective date of coverage is Oct. 4, and the end date is May 30. The mother's perinatal coverage ends Oct. 31.
A perinatal child whose coverage ends, and who has siblings currently enrolled in CHIP, meets good cause upon determination of CHIP eligibility. The child's enrollment start date is the first day of the month following the perinatal end date. The child's CHIP end date is the end date of the existing CHIP enrollment segment. The child may not receive the 12 months of CHIP coverage and must renew eligibility in accordance with the existing CHIP redetermination date.
Income at or Below the Limit for Medicaid for Pregnant Women (TP 40)
A child born to a CHIP perinatal mother whose household income is at or below 198 percent of the FPL, which is the applicable income limit for Pregnant Women Medicaid (TP 40), and who receives Emergency Medicaid to cover the labor with delivery charges, will be enrolled in TP 45 coverage effective the date of birth. The mother's perinatal coverage ends the last day of the child's birth month or the pregnancy's termination month. The mother will receive two postpartum visits even if they are beyond the birth month.
Related Policy
Receipt of Application, A-121
CHIP Perinatal Application Process, A-128.3
Neonatal Intensive Care Unit (NICU) Newborn Process, A-126.3.1
Federal Poverty Level (FPL), C-131.1
D-1433.2 Child Leaves the Home
Revision 24-2; Effective April 1, 2024
CHIP
A certified child leaving the home may or may not affect their continued eligibility for CHIP based on their tax status, tax relationships, and family relationships under MAGI household composition rules. This is explained in A-240, Medical Programs.
When a child dies, terminate the child’s eligibility effective the last day of the month the child died.
Follow policy in B-510, Termination of Medical Coverage for People Confined in a Public Institution, if the child is confined in any public institution, including a juvenile facility.
Related Policy
Termination of Medical Coverage for People Confined in a Public Institution, B-510
Persons Confined in a Texas County Jail, B-542
Child Placed in a Juvenile Facility, B-543
D-1433.3 Child Institutionalized
Revision 13-4; Effective October 1, 2013
CHIP, CHIP Perinatal
When a certified child enters a state hospital or institution for a temporary absence, the child remains enrolled for the remainder of the 12-month period. See A-920, Temporary Absence From the Home, to determine if stay is considered a temporary absence.
D-1433.4 Head of Household
Revision 20-1; Effective January 1, 2020
CHIP, CHIP Perinatal
Under MAGI household composition rules, explained in A-240, Medical Programs, a head of household leaving the home may or may not affect eligibility depending on that person’s tax status, tax relationships, and family relationships.
When the current head of household dies or leaves the home, change the head of household to another responsible adult household member without requiring the remaining household members to reapply for benefits. An adult household member is someone 19 years or older.
If there is no responsible adult member identified in the household, and a child in the household is receiving benefits, send Form H1020 to notify the household that a responsible adult who is caring for the child must apply for benefits if the child continues to need assistance. If an application is not submitted by the Form H1020 due date, deny benefits since the whereabouts of the child is unknown.
Related Policy
Who Is Included, D-321
New Head of Household, D-1632.1
D-1434 Demographic Changes
Revision 15-4; Effective October 1, 2015
CHIP, CHIP Perinatal
A demographic change is a change to a person's identifying information, such as date of birth, Social Security number (SSN), gender or name.
Process these changes and do not interrupt the child’s continuous coverage.
D-1435 Pregnancy Reports
Revision 26-1; Effective Jan. 1, 2026
CHIP
When a household reports a CHIP child's pregnancy before her CHIP end date, test the pregnant child for Medicaid for Pregnant Women (TP 40) and request verification of the pregnancy. Accept a verbal or written statement of pregnancy from the pregnant child, head of household, or authorized representative that includes the pregnancy start month, number of children expected, and the anticipated date of delivery. If eligible and the household provides the pregnancy verification, terminate CHIP and certify the pregnant child for Medicaid.
If the pregnant child is determined ineligible for Medicaid for Pregnant Women (TP 40), she remains continuously eligible for CHIP through the end of the 12-month postpartum period, unless she:
- voluntarily withdraws;
- no longer lives in Texas;
- is ineligible due to agency error or fraud, abuse or perjury attributed to the person; or
- dies.
If the household does not report a CHIP child’s pregnancy until she gives birth or later, the child remains on CHIP, and the CHIP child’s newborn is tested for Medicaid eligibility. If eligible, the newborn is certified for Children Under Age One Medicaid (TP 43). If not eligible, the newborn is enrolled in the mother’s CHIP health plan. The effective date of the newborn’s CHIP coverage is the next possible month following cutoff. The newborn’s CHIP coverage ends with the household’s current enrollment segment.
If a new pregnancy is reported for a CHIP child during her 12-month postpartum period, update the Pregnancy Logical Unit of Work (LUW) to test for and transition the pregnant child to Medicaid for Pregnant Women (TP 40), if eligible. If ineligible for Medicaid for Pregnant Women (TP 40) but eligible for CHIP, start a new CHIP certification period for the pregnant child based on the new pregnancy. If the pregnant child is only eligible for CHIP Perinatal based on the new pregnancy, keep the pregnant child’s original CHIP certification period through the end of the 12-month postpartum period.
If a CHIP child voluntarily withdraws from CHIP or moves out of Texas during her pregnancy or postpartum period, terminate CHIP coverage. If the child later reapplies, process the application and certify the appropriate coverage.
Note: The child is not eligible for the rest of her initial 12-month postpartum coverage. Based on the new application, she may be eligible for a new CHIP certification period on a basis other than pregnancy.
Exceptions: If a CHIP child becomes eligible for one of the following types of assistance during her pregnancy or postpartum period, transition the child and terminate CHIP coverage:
- Supplemental Security Income (SSI);
- Medicaid for the Elderly and People with Disabilities (MEPD);
- Department of Family and Protective Services (DFPS);
- Children’s Medicaid; or
- Medicaid for Breast and Cervical Cancer (MBCC).
Related Policy
D-1436 Income and Deduction Changes
Revision 21-2; Effective April 1, 2021
CHIP
When a household reports a change in income, test the child or children for Medicaid eligibility. A new application is not required. If the child is still eligible for CHIP and the household requests that its cost share responsibilities be recalculated, refer the household to the Enrollment Broker.
D-1437 Third Party Resources Changes
Revision 15-4; Effective October 1, 2015
CHIP
If a household reports that they have obtained health insurance during the continuous enrollment period, document the change and process the change at the next redetermination.
Related Policy
Health Insurance, D-1632.2
CHIP Perinatal
Do not take any action if a woman reports private health insurance coverage during her certification period.