TX HHS Form 5022. HIPP Direct Deposit

The TX HHS Form 5022, "HIPP Direct Deposit", is a crucial document for individuals who receive payments from the Health Insurance Premium Payment (HIPP) program. This form allows users to set up direct deposit of their HIPP payments into a designated bank account.

To complete this form, users must provide essential information about their bank account, including the name on the account, routing number, and account number. Additionally, they must provide their best phone number and email address for communication purposes. The person whose name appears on the check from HIPP must sign and date the form to authorize the direct deposit.

This form should be used by individuals who receive HIPP payments and want to set up a convenient and efficient way to receive their funds. It is essential to complete this form accurately and thoroughly, as it will facilitate the direct deposit of HIPP payments into the designated bank account. The completed form can be faxed to 1-866-409-1188 (toll-free), emailed to [email protected], or mailed to P.O. Box 201120 Austin, TX 78720-9774. For assistance with this process, users can contact the HIPP Helpline at 1-800-440-0493 or visit the website at www.GetHIPPTexas.com.