TX HHS Form 5024. HIPP Change of Address

The TX HHS Form 5024, HIPP Change of Address, helps individuals update their address information for the Health Insurance Premium Payment (HIPP) program. This form is typically used by those who have a new residential or mailing address and need to notify the Texas Department of Health and Human Services (HHS) of the change.

To complete this form, individuals must provide required information including their name, HIPP case number, street address, apartment number, city, state, ZIP code, phone number, and email. Additionally, they must sign the form and submit proof of their new address, which can be demonstrated through various documents such as utility bills, lease agreements, or government-issued IDs.

Once completed, the form should be sent to HIPP as soon as possible using one of the provided methods: pre-paid envelope, fax (1-866-409-1188), email ([email protected]), or mail (P.O. Box 201120 Austin, TX 78720-9774). For assistance with the form or to report changes in your address, you can contact HIPP's Helpline at 1-800-440-0493 or visit their website at www.GetHIPPTexas.com.

• Required information: name, HIPP case number, street address, apartment number, city, state, ZIP code, phone number, and email
• Proof of new address required; acceptable documents include utility bills, lease agreements, or government-issued IDs
• Form should be submitted as soon as possible using one of the provided methods: pre-paid envelope, fax, email, or mail