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Medicaid / Texas

Medicaid for Home Care in Texas

Medicaid Certified Home Care Agency in Texas

Medicaid reimbursement in Texas isn’t possible if the caregiver agency isn’t a certified HHA (Home Health Agency). The agency must be certified along with having a license to deliver care services within the state. Detailed information regarding the requirements is offered by the Bureaus of Licensing and Certification.

Governing Body: Texas Medicaid


Medicaid in Texas is jointly funded by the state and federal governments to provide health coverage to residents, including seniors, pregnant women, parents, children, blind people, disabled people, and caregivers. The Managed Care Organizations (MCOs) provide most of the Medicaid plans in Texas.

Medicaid Programs:

  • Star Plus Waiver
  • Community First Choice (CFC) Program
  • Primary Home Care
  • Day Activity and Health Services

Income Requirements:

  • For pregnant women, the income of $1,990 per month for a family of one and $4,749 per month for a family of five. $690 for an additional person
  • For a parent/caretaker, income less than $103 per month for a family of one and $310 per month for a family of five
  • For two parents or relative caretakers, an income of $161 per month for a family of two and $332 per month for a family of five. $52 for an additional person
  • For individuals ages 18 to 25 years and who were in foster care in Texas on their 18th birthday, income up to $4,151 per month for a family of one and $9,906 per month for a family of five. $1,439 for additional person

Application Process:

The application process for accessing Medicaid for Texas residents is easy, and anyone can apply for the available Medicaid programs by visiting Your Texas Benefits website.

Medicaid with CareSmartz360

Home care businesses require advanced solutions to integrate Medicaid into their services, and Caresmartz has been doing that across the states for home care agencies, private-duty care providers, and home care franchisors for several years. CareSmartz360 is a complete software solution to manage a home care business, and it supports all Medicaid payers, allowing businesses to focus on other operations and processes.

  • Effective and comprehensive management of the revenue cycle.
  • Allows agencies to fulfill billing requirements for Medicaid, Medicare, Insurance, and Private Pay.
  • Built-In feature to submit claims electronically.
  • Quickly create, review, approve and submit claims in paper invoice or 837P, 837I format.
  • Helps in generating error-free claims to save time and efforts.
  • Identify and manage accounts and claims that are overdue.
  • Robust reporting to evaluate financial performance.
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