COUNTY INDIGENT HEALTH CARE PROGRAM
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Chapter 61, Health and Safety Code,
passed by the First Called Special
Session of the Texas 69th Legislature (1985), is intended to ensure that
needy Texas residents, who do not qualify for other state or federal health care
assistance programs, receive health care services through the County Indigent Health
Care Program (CIHCP).
This law defines who is indigent, assigns responsibilities for indigent
health care, and establishes a state assistance fund to match expenditures for counties
that exceed certain spending levels and meet state requirements.
Texas Department of State Health Services (DSHS) must: |
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Establish the eligibility standards and application, documentation,
and verification procedures for counties, |
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Define basic and department-established optional health
care services, |
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Establish the payment standards for basic and department-established
optional health care services,
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Administer the state assistance fund for counties not
fully served by a public hospital or hospital district that spend more than 8% of
their general revenue tax levy (GRTL), and
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Resolve eligibility disputed between a provider and a
county, public hospitals, or hospital district.
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DSHS County Indigent Health Care Group (CIHCG) staff provides training
and technical assistance to counties, public
hospitals and hospital districts.
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ELIGIBILITY CRITERIA
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Residence. The applicant must live in the county in which he/she applies and must
intend to remain there. |
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Household. A CIHCP household is a person living alone or two or more persons living
together where
legal responsibility for support exits, excluding disqualified
persons.
A disqualified person is one who received or is categorically eligible to receive
Medicaid.
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Resources. A household is eligible if the total countable household resources do
not exceed $3,000.00 when a person who is aged or disabled and who meets relationship
requirements lives in the home or $2,000.00 for all other households. |
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Income.
A household is eligible if its monthly net income does not exceed the
current allowed percentage of the federal poverty guidelines (FPG) as set by the
Texas Dept. of State Health Services. |
CIHCP Monthly Income Standards
Effective
April
2013
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# of
Individuals
in
the
CIHCP Household
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21% FPG
Minimum
Income Standard
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50% FPG
Maximum
Income Standard
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1
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$202
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$479
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2
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$272
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$647
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3
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$342
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$814
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4
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$413
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$982
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5
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$483
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$1,149
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6
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$553
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$1,317
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7
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$624
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$1,484
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8
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$694
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$1,652
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9
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$764
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$1,819
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10
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$835
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$1,987
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11
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$905
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$2,154
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12
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$975
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$2,322
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BASIC HEALTH CARE SERVICES
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Physician
services include services ordered and performed
by a physician that are within the scope of practice of their profession as defined
by state law. |
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Annual physical exams
are examinations provided once per calendar year by a physician or a
physician assistant associated testing, such as mammograms, can be covered with
a physician referral. |
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Immunizations
are given when appropriate. |
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Medical Screening
services include blood pressure, blood sugar, and cholesterol screening. |
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Laboratory and x-ray
services are professional and technical services ordered and provided
under the personal supervision of a physician in a setting other than a hospital(inpatient
or outpatient). |
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Family Planning
services are preventive health care services that assist an individual
in controlling fertility and achieving optimal reproductive and general health. |
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Skilled Nursing Facility
(SNF) services must be medically necessary, ordered by a physician, and
provided in a SNF that provides daily services on an inpatient basis. |
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Prescriptions
This service includes up to three prescription drugs per month.
New and refilled prescriptions count equally toward this three prescription drugs
per month total. A physician or other practitioner within the scope of practice
must prescribe drugs under law. |
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Inpatient hospital
services must be medically necessary and provided in an acute care hospital
to hospital inpatients, by or under the direction of a physician, and for the care
and treatment of patients. |
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Outpatient Hospital
services must be medically necessary and provided in an acute care hospital
to hospital outpatients, by or under the direction of a physician, and must be diagnostic,
therapeutic, or rehabilitative. Outpatient hospital services include hospital-based
ambulatory surgical center (HASC) services. |
Optional Health Care Services
The county may require prior authorization from the
provider.
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Dental Services
must be medically necessary and provided by a DDS, DMD, or DDM. Items covered
are: an annual routine exam, annual routine cleaning, one set of annual x-rays,
and the least costly service for emergency dental conditions for the removal or
filling of a tooth due to abscess, infection, or extremem pain. |
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Diabetic
medical supplies and equipment must be prescribed
by a physician and include test strips, alcohol prep pads, glucometers, insulin
syringes, humulin pens, and needles required for the humulin pens.
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For Good Health Card Program or Family Practice
Clinic Information, please call (254) 750-8200
This application needs to be printed, signed and dated
to be considered a complete application
APPLICATION FOR HEALTH CARE ASSISTANCE
Mail signed or bring applications to:
McLennan County Health Services
204 N. 7th Street
Waco, Texas 76701
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McLennan County
Discount Prescription Drug Card Information |
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