TX HHS Form 5023. HIPP Missing Check Stop Payment

The TX HHS Form 5023, "HIPP Missing Check Stop Payment", is a crucial document for individuals who have not received a check from the Health Insurance Premium Payment (HIPP) program. This form helps to resolve the issue of missing checks by providing a means to report and stop payment on the missing check.

To use this form, you will need to provide essential information such as the name, HIPP case number, street address, apartment, city, state, ZIP code, phone number, and email. You will also be required to specify the month and year of the missing check. The form can be completed online or by mail, with the option to fax it to 1-866-409-1188 (toll-free) or email it to [email protected].

For assistance with completing this form or resolving issues related to your HIPP benefits, you can contact the HIPP Helpline at 1-800-440-0493, Monday to Friday from 7 a.m. to 7 p.m., Central Time. Additionally, for those who are speech or hearing impaired, Relay Texas is available by dialing 7-1-1.