# 1 Tex. Admin. Code § 366.215: 1 TAC § 366.215. Application Requirements and Processing, DIVISION 2. ELIGIBILITY REQUIREMENTS

> Texas · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_215

## Section

- **Citation:** 1 Tex. Admin. Code § 366.215
- **Heading:** 1 TAC § 366.215. Application Requirements and Processing, DIVISION 2. ELIGIBILITY REQUIREMENTS
- **Jurisdiction:** Texas
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Texas Administrative Code / Title 1 ADMINISTRATION / Part 15 TEXAS HEALTH AND HUMAN SERVICES COMMISSION / Chapter 366 MEDICAID ELIGIBILITY FOR WOMEN, CHILDREN, YOUTH, AND NEEDY FAMILIES / 1 TAC § 366.215

## Text

(a) An applicant, authorized representative, or someone
 acting responsibly for the applicant applies for presumptive eligibility
 at a qualified hospital or qualified entity site.
(b) The qualified hospital or qualified entity electronically
 submits the presumptive eligibility determination to HHSC.
(c) The qualified hospital or qualified entity must
 assist the individual in submitting an electronic Medicaid application
 to HHSC if the individual wishes to apply for regular Medicaid.
(d) For individuals determined to be presumptively
 eligible, the qualified hospital or qualified entity must notify the
 individual in writing and orally if appropriate that if a Medicaid
 application:
(1) is not filed by the last day of the month following
 the presumptive eligibility determination, then presumptive eligibility
 will end on that last day; and
(2) is filed by the last day of the month following
 the presumptive eligibility determination, then presumptive eligibility
 will end on the day that a decision is made on the Medicaid application.
(e) For individuals determined not to be presumptively
 eligible, the qualified hospital or qualified entity must notify the
 individual in writing and orally if appropriate:
(1) of the reason for the determination; and
(2) that he or she may file an application for Medicaid
 with HHSC.
(f) A recipient is limited to:
(1) one presumptive eligibility period per pregnancy;
 or
(2) no more than one presumptive eligibility period
 within two calendar years for children under age 19, parents and caretaker
 relatives, and former foster care children.

## Nearby sections

- [1 Tex. Admin. Code § 366.201 1 TAC § 366.201. Purpose and Scope, DIVISION 1. GENERAL](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_201.md)
- [1 Tex. Admin. Code § 366.203 1 TAC § 366.203. Definitions, DIVISION 1. GENERAL](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_203.md)
- [1 Tex. Admin. Code § 366.211 1 TAC § 366.211. General Eligibility Requirements, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_211.md)
- [1 Tex. Admin. Code § 366.213 1 TAC § 366.213. Eligible Group, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_213.md)
- [1 Tex. Admin. Code § 366.215 1 TAC § 366.215. Application Requirements and Processing, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_215.md)
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- [1 Tex. Admin. Code § 366.223 1 TAC § 366.223. Income Limits, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_223.md)
- [1 Tex. Admin. Code § 366.225 1 TAC § 366.225. Determination of Household Composition, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_225.md)
- [1 Tex. Admin. Code § 366.227 1 TAC § 366.227. Calculation of Household Income, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_227.md)
- [1 Tex. Admin. Code § 366.229 1 TAC § 366.229. Third-party Resources, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_229.md)
- [1 Tex. Admin. Code § 366.231 1 TAC § 366.231. Medicaid Eligibility Effective Date, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_231.md)
- [1 Tex. Admin. Code § 366.233 1 TAC § 366.233. Resident of an Institution for Mental Diseases, DIVISION 2. ELIGIBILITY REQUIREMENTS](https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_233.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/STATE_TX_TAC_T1_P15_C366_S366_215. Check the current official text before relying on it. Not legal advice.