Client Eligibility

Fee for Service (FFS) Program

The Title V Fee for Service (FFS) Contracts Program pays health care providers for a limited selection of outpatient services for those persons meeting the Program's eligibility criteria. The Title V FFS will pay for selected prenatal services, infant/child/adolescent health care services, and dental services for children, adolescents, and pregnant women when provided by contracted Title V FFS providers. 

Title V Eligibility Criteria

An individual is considered eligible for Title V allowable direct health care/enabling services if the individual is:

  1. a child age 0 through 21 with a family income at or below 185% of the most recent Federal Poverty Level (FPL) as seen below.
  2. a pregnant female of any age with a family income at or below 185% of the most recent Federal Poverty Level (FPL) as seen below
  3. a Texas resident
  4. otherwise uninsured for the same service provided
  5. not eligible for Medicaid or CHIP.

Individual client eligibility will be determined on an annual basis, and at other times as necessary, based upon change in pregnancy status or income.

Eligible Income - 2016 Federal Poverty Income Guidelines (185%)

Family Size

Annual Maximum

Monthly Maximum

1 Person

$21,978

$1,832

2 People

$29,637

$2,470

3 People

$37,296

$3,108

4 People

$44,955

$3,747

5 People

$52,614

$4,385

6 People

$60,273

$5,023

7 People

$67,951

$5,663

8 People

$75,647

$6,304

 Effective March 1, 2016

Welfare Reform

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), P.L. 104-193 restricts the access of certain categories of immigrants to specified Federal benefits. However, this law does not apply to Title V programs.

For More information on eligibility, contact a Title V provider near you.

 

Contact Information

Texas Department of State Health Services
Office of title V & Family Health
1100 W. 49th St.
PO Box 149347, MC 1922
Austin, TX 78714-9347
Phone: 512-776-7373
Fax: 512-776-7658

  

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Last updated June 16, 2016