TX HHS Form H1035. Pre-Screening Result for Medicaid

The Pre-Screening Result for Medicaid form (Form H1035) helps determine whether an individual is eligible for Medicaid benefits. This form is typically used in situations where a verbal conversation has taken place to assess eligibility, but a formal determination has not been made.

This form indicates that the applicant does not appear to be eligible for Medicaid, although it is not an official determination of eligibility. The form advises the applicant to file an application with their local office to determine if they are eligible for any type of assistance. Key information includes the local office address and telephone number, which can facilitate follow-up actions.

Key features of this form include the conclusion of the initial interview, the determination that the applicant does not meet Medicaid requirements, and the recommendation to file an application with the local office. This form is issued by Texas Health and Human Services (HHS) staff, highlighting their role in administering the Medicaid program.

• This form is used when a verbal conversation has taken place to assess eligibility but a formal determination has not been made.
• The applicant does not appear to be eligible for Medicaid, although it is not an official determination of eligibility.
• The form recommends filing an application with the local office to determine if the applicant is eligible for any type of assistance.