TX HHS Form H1252. Designation of Burial Funds

The TX HHS Form H1252, Designation of Burial Funds, is a crucial document that helps individuals designate their burial funds for the purpose of funeral expenses. This form is typically used in situations where an individual wants to ensure that their burial expenses are taken care of according to their wishes.

This form requires the client or responsible party to provide specific information, including the name of the life insurance company, policy number, and cash value. Additionally, the client must designate financial accounts and specify their balance on the date of designation. The form also includes a condition that the designated funds will not be used for any other purpose than burial expenses, and that using them for another reason may affect Medicaid eligibility.

By completing this form, individuals can ensure that their burial expenses are taken care of according to their wishes. It is essential to understand the responsibilities involved in designating burial funds, including the potential impact on Medicaid eligibility. If you have any questions or concerns about your information or the correction process, please contact your local Health and Human Services Commission office.

• This form is used for individuals who want to designate their burial funds for funeral expenses.
• The form requires specific information, including life insurance company name, policy number, and cash value.
• The designated funds must be used only for burial purposes, and using them for another reason may affect Medicaid eligibility.