TX HHS Form 3060. CSHCN Eligibility Exemption Request

The TX HHS Form 3060, CSHCN Eligibility Exemption Request, is a crucial document for parents or guardians of children with special health care needs (CSHCN) who may not need to apply for the TexCare Partnership's Children's Health Insurance Program (CHIP). This form helps solve the problem of determining eligibility and exemption from CHIP coverage.

This form is typically filled out by parents or guardians of CSHCN in situations where their child already has Medicaid coverage, is already enrolled in a CHIP health plan, or does not qualify for coverage due to age or citizenship status. The form requires clients to provide information about their child's name and Medicaid/CHIP details, as well as attach relevant documentation such as insurance cards or denial letters.

Key features of the form include the required client information, specific exemption reasons, and follow-up actions. Parents or guardians must acknowledge that the provided information is true and correct, and deliberately giving false information may result in termination of services for their child. If assistance is needed completing the form, parents can call CSHCN at 1-800-222-3986.

• This form is used by parents or guardians of children with special health care needs (CSHCN) who may not need to apply for CHIP coverage.
• The form requires clients to provide information about their child's name, Medicaid/CHIP details, and attach relevant documentation.
• Exemption reasons include having Medicaid coverage, being already enrolled in a CHIP health plan, or not qualifying due to age or citizenship status.