TX HHS Form H1200-MSP-D. Medicare Savings Program Denial Notice

The TX HHS Form H1200-MSP-D, Medicare Savings Program Denial Notice, is a document used to inform an individual that their application for the Medicare Savings Program has been denied. This program helps eligible individuals pay for monthly premiums, deductibles, and copays associated with Part A and Part B of Medicare.

The notice explains the reason(s) for denial, which may include not living in Texas or the United States, or having assets or resources exceeding the program's eligibility limits. The document also informs the individual of their right to appeal the decision within 90 days of receiving the notice. If they choose to appeal, they can represent themselves or have someone else, such as a friend, family member, or attorney, represent them.

The Form H1200-MSP-D provides information on how to appeal and the benefits that may be continued during the appeals process. It also includes contact details for legal aid services and instructions on how to request an interpreter if needed. This form is used when an individual's application for the Medicare Savings Program has been denied, and they wish to dispute the decision.