TX HHS Form 5023. HIPP Missing Check Stop Payment

The TX HHS Form 5023, "HIPP Missing Check Stop Payment", is a practical solution for individuals who have not received a check from the Health Insurance Premium Payment (HIPP) program. This form helps resolve issues related to missing or undelivered checks, providing a straightforward process for reporting and resolving these problems.

To complete this form, individuals are required to provide specific information, including the name, HIPP case number, street address, apartment, city, state, ZIP code, phone number, and email. They must also specify the month and year of the missing check and sign the form. The 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.

Key features of this form include the provision of a pre-paid envelope for mailing and the availability of support through the HIPP Helpline (1-800-440-0493) Monday to Friday, 7 a.m. to 7 p.m., Central Time. For individuals who are speech or hearing impaired, Relay Texas (7-1-1) is also available. By using this form, individuals can efficiently resolve issues related to missing checks and ensure timely receipt of their benefits.

• This form is used by individuals who have not received a check from the HIPP program.
• The form requires specific information, including name, case number, address, and contact details.
• The form can be submitted via fax, email, or mail.