TX HHS Form 5842. TxHmL Financial Eligibility Information

The TX HHS Form 5842, TxHmL Financial Eligibility Information, is a crucial document used to determine financial eligibility for the Texas Home Living (TxHmL) Program. This form helps solve the problem of determining whether an applicant meets the financial criteria required for this program.

This form should be completed when an applicant has been denied Supplemental Security Income (SSI) or Medicaid, and is seeking enrollment in the TxHmL Program. The form requires the applicant's name, date of birth, mailing address, and other relevant information. Additionally, a copy of the SSI denial letter from the Social Security Administration or the Medicaid denial letter from the Health and Human Services Commission must be attached.

The key features of this form include the required information section, which includes the applicant's name, date of birth, mailing address, and other relevant details. The form also highlights the importance of attaching a copy of the SSI or Medicaid denial letter. This form is an essential tool for determining financial eligibility for the TxHmL Program, and should be used when an applicant has been denied SSI or Medicaid.