TX HHS Form H0054. Medicaid Buy-In Eligibility Notice

The Medicaid Buy-In Eligibility Notice (Form H0054) is a crucial document that helps individuals determine their eligibility for the Medicaid Buy-In program. This form is typically used in situations where an individual's premium payment has been received, making them eligible for coverage. The notice outlines the requirements and responsibilities necessary to maintain eligibility.

The key features of this form include the requirement to pay a monthly premium amount, which must be paid in full by the 20th of every month to continue Medicaid Buy-In program coverage. A monthly payment notice with a payment coupon and postage-paid return envelope will be mailed to individuals on the first of every month. It is essential to only submit payments with the coupons provided and not make partial premium payments, as these will be refunded.

Individuals who fail to pay their premiums in full may be denied coverage and must pay all past due premiums before reapplying. The Texas Health and Human Services Commission (HHS) issues this form, which provides important information for individuals seeking Medicaid Buy-In program coverage. Key points to note include:

• Premium payments must be made in full by the 20th of every month.
• Partial premium payments will not be accepted and will be refunded.
• Failing to pay premiums may result in denial of coverage and require payment of past due premiums before reapplying.