TX HHS Form 5025. HIPP Authorization for Use and Release of Health Insurance Information

The TX HHS Form 5025, "HIPP Authorization for Use and Release of Health Insurance Information," is a crucial document that enables clients to authorize Texas Health and Human Services (HHS) to release and access their employer-sponsored health insurance benefits and coverage information. This form helps solve the problem of determining eligibility for enrollment or re-enrollment in the Health Insurance Premium Payment (HIPP) program.

This authorization form requires clients to provide essential information, including name, date of birth, Medicaid number (if known), and Social Security number. The form is divided into three sections: Client Information, Client Authorization, and Notices to Client. Clients must sign the form to authorize HHS to release their information, which may include health information, insurance information, and insurance premiums.

The TX HHS Form 5025 should be used when clients need to determine eligibility for enrollment or re-enrollment in the HIPP program. This form is not required for enrollment, as clients can obtain the necessary information directly from their employer and provide it to the HIPP program. However, by signing this authorization form, clients can expedite the process and ensure that HHS has the necessary information to make informed decisions about their health insurance benefits.