TX HHS Form H1119. Medical Programs Income Worksheet

The TX HHS Form H1119, Medical Programs Income Worksheet, is a tool used to determine an individual's income eligibility for various medical programs. This form helps solve the problem of calculating total countable income, which is essential in determining program participation.

This form consists of several sections, including STEP 1-Earned/Unearned Income and STEP 3-Recognizable Needs Test or FPIL/MNIL Test. The user must provide information on earned and unearned income, as well as recognizable needs, to determine their eligibility for medical programs. Important sections include the calculation of total countable income (STEP 2-Income Deductions) and the determination of spend down amount (STEP 4-Determining Spend Down Amt.).

The form is designed for individuals seeking to participate in medical programs offered by Texas Health and Human Services (HHS). Common scenarios of use include applying for Medicaid or other government-sponsored healthcare programs. The form explicitly mentions conditions such as alimony and child support payments, which must be considered when calculating total countable income.