TX HHS Form 3065. Worksheet

The TX HHS Form 3065, Worksheet, is a crucial tool for determining eligibility for the County Indigent Health Care Program (CIHCP). This form helps solve the problem of ensuring that individuals receive necessary healthcare assistance by providing a structured process for evaluating applicant information.

This worksheet requires specific information, including the application date, case record number, and details about the applicant's household. It also includes conditions and responsibilities, such as verifying the completeness and consistency of application data and screening for potential Medicaid eligibility. The form outlines follow-up actions, like using the Medicaid screening tool at www.yourtexasbenefits.com, to ensure accurate processing.

The TX HHS Form 3065 is typically used by healthcare professionals and social workers who need to assess the eligibility of individuals for CIHCP assistance. Key features include:

• Required information: application date, case record number, household details
• Conditions: verifying application data completeness and consistency
• Situations where used: determining CIHCP eligibility for healthcare assistance