TX HHS Form 5024. HIPP Change of Address

The TX HHS Form 5024, "HIPP Change of Address", is a crucial document for individuals who need to update their address information for the Health Insurance Premium Payment (HIPP) program. This form helps solve the problem of ensuring accurate contact information for participants in the HIPP program.

To complete this form, you will need to provide required information such as your name, case number, street address, apartment, city, state, and ZIP code. You must also sign the form and include proof of your new address, which can be demonstrated through various documents like utility bills or lease receipts. The form should be used when you have a change of address that requires updating your information in the HIPP program.

This form is available for faxing to 1-866-409-1188 (toll-free), emailing to [email protected], or mailing to P.O. Box 201120 Austin, TX 78720-9774. For assistance with completing the form or addressing any questions, you can contact the HIPP Helpline at 1-800-440-0493 (Monday to Friday, 7 a.m. to 7 p.m., Central Time) or use Relay Texas for speech or hearing impaired individuals.