Emergency Services Social
Resume:
Proof Of Eligibility
State Form 53549 (R2 / 6-20) FI 2430 / IEDSS
Mailing Date: OCTOBER 17, 2024
Agency Information
Family and Social Services Administration Document Center PO Box 1810
Marion, Indiana 46952
Telephone: 1-800-***-****
Case Information
Full Name: Corey J Textor Date of Birth: 09/26/1991 Case Number: 601*******,600-***-****,600-***-**** Mailing Address: Home Address: 930 S 1025 E
Knox IN 46534-8745
Scheduled Appointment
Appointment Type Appointment Date Scheduled Time Office Location Pending Applications
Programs Applied For Date Application Received Case Number Cash SEPTEMBER 30, 2024 T198205633
G0000001000003000001
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*FSS409AE0024BQXV5J8*
Assistance Groups
Type of Assistance: Hoosier
Care Connect or Traditional
Medicaid
Aid Category: MASI Emergency Services Only: No
Details
Status: Approved EBT Card Benefit Available Date:
Case Number: 600-***-**** Current Month Amount:
AG Number: 19102833 Next Month Amount:
Effective Date: JANUARY 01, 2019 Redetermination Month: End Date: Monthly Liability (Health Coverage):
Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible JANUARY 01, 2019
Kendra M Whitt Ineligible JANUARY 01, 2019
Kaiden L Whitt Eligible JANUARY 01, 2019
Authorized Representative
Primary Name Primary Address
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Assistance Groups
Type of Assistance: SNAP Aid Category: SNAP Emergency Services Only: N/A Details
Status: Approved EBT Card Benefit Available Date: JUNE 19, 2020 Case Number: 600-***-**** Current Month Amount: $274.00 AG Number: 21182071 Next Month Amount: $274.00
Effective Date: FEBRUARY 28, 2024 Redetermination Month: JANUARY 2025 End Date: Monthly Liability (Health Coverage):
Previous Months Benefit Amount: September: $306.00; August: $306.00; July: $306.00 Assistance Group Clients
Names Participation Status Effective Date End Date Kaiden L Whitt Eligible FEBRUARY 28, 2024
Kendra M Whitt Eligible FEBRUARY 28, 2024
Jordan J Overmyer Ineligible FEBRUARY 28, 2024
Corey J Textor Eligible FEBRUARY 28, 2024
Amber F Textor Eligible FEBRUARY 28, 2024
Debbie K Humes Ineligible FEBRUARY 28, 2024
Victor A Humes Ineligible FEBRUARY 28, 2024
Authorized Representative
Primary Name Primary Address
Assistance Groups
Type of Assistance: Hoosier
Healthwise
Aid Category: MA 2 Emergency Services Only: No
Details
Status: Approved EBT Card Benefit Available Date:
Case Number: 600-***-**** Current Month Amount:
AG Number: 19102825 Next Month Amount:
Effective Date: MAY 01, 2023 Redetermination Month: APRIL 2025 End Date: Monthly Liability (Health Coverage):
Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible MAY 01, 2023
Kendra M Whitt Eligible MAY 01, 2023
Kaiden L Whitt Ineligible MAY 01, 2023
Authorized Representative
Primary Name Primary Address
00000002000003000002
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Assistance Groups
Type of Assistance: The
Healthy Indiana Plan
Aid Category: MASP Emergency Services Only: No
Details
Status: Denied EBT Card Benefit Available Date:
Case Number: 601******* Current Month Amount:
AG Number: 34924235 Next Month Amount:
Effective Date: Redetermination Month:
End Date: Monthly Liability (Health Coverage):
Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible
Authorized Representative
Primary Name Primary Address
Assistance Groups
Type of Assistance: SNAP Aid Category: SNAP Emergency Services Only: Details
Status: Denied EBT Card Benefit Available Date:
Case Number: 601******* Current Month Amount:
AG Number: 32387363 Next Month Amount:
Effective Date: Redetermination Month:
End Date: Monthly Liability (Health Coverage):
Previous Months Benefit Amount:
Assistance Group Clients
Names Participation Status Effective Date End Date Andrew L Dutcher Ineligible
Corey J Textor Ineligible
Authorized Representative
Primary Name Primary Address
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Assistance Groups
Type of Assistance: Hoosier
Care Connect or Traditional
Medicaid
Aid Category: MA D Emergency Services Only: No
Details
Status: Denied EBT Card Benefit Available Date:
Case Number: 600-***-**** Current Month Amount:
AG Number: 37468065 Next Month Amount:
Effective Date: Redetermination Month:
End Date: Monthly Liability (Health Coverage):
Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible
Kendra M Whitt Ineligible
Kaiden L Whitt Ineligible
Authorized Representative
Primary Name Primary Address
Assistance Groups
Type of Assistance: The
Healthy Indiana Plan
Aid Category: MARP Emergency Services Only: No
Details
Status: Closed EBT Card Benefit Available Date:
Case Number: 601******* Current Month Amount:
AG Number: 31935990 Next Month Amount:
Effective Date: NOVEMBER 01, 2020 Redetermination Month: End Date: MARCH 31, 2024 Monthly Liability (Health Coverage): Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible NOVEMBER 01, 2020 MARCH 31, 2024 Authorized Representative
Primary Name Primary Address
00000003000003000003
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Assistance Groups
Type of Assistance: The
Healthy Indiana Plan
Aid Category: MASP Emergency Services Only: No
Details
Status: Closed EBT Card Benefit Available Date:
Case Number: 600-***-**** Current Month Amount:
AG Number: 19152355 Next Month Amount:
Effective Date: OCTOBER 01, 2018 Redetermination Month: End Date: MARCH 31, 2019 Monthly Liability (Health Coverage): Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible OCTOBER 01, 2018 MARCH 31, 2019 Authorized Representative
Primary Name Primary Address
Assistance Groups
Type of Assistance: The
Healthy Indiana Plan
Aid Category: MARP Emergency Services Only: No
Details
Status: Closed EBT Card Benefit Available Date:
Case Number: 600-***-**** Current Month Amount:
AG Number: 37468070 Next Month Amount:
Effective Date: APRIL 01, 2024 Redetermination Month: End Date: OCTOBER 31, 2024 Monthly Liability (Health Coverage): Previous Months Benefit Amount: N/A
Assistance Group Clients
Names Participation Status Effective Date End Date Corey J Textor Ineligible APRIL 01, 2024 OCTOBER 31, 2024 Kendra M Whitt Ineligible APRIL 01, 2024 OCTOBER 31, 2024 Kaiden L Whitt Ineligible APRIL 01, 2024 OCTOBER 31, 2024 Authorized Representative
Primary Name Primary Address
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