TX HHS Form H1275. Request for Expanded Protected Resource Assessment

The TX HHS Form H1275, Request for Expanded Protected Resource Assessment, is a tool used to increase the monthly income of a community spouse in Medicaid eligibility applications. This form helps solve the problem of ensuring that a community spouse's needs are met while maintaining their Medicaid eligibility.

This form requires the client/responsible party to review and agree with the Spousal Protected Resources Assessment (SPRA) provided by an eligibility specialist, which determines the maximum allowable amount of non-resource produced monthly income. The client must also certify that this SPRA is accurate and accept it as their new assessment. Important sections include the request for expanded SPRA and the certification statement.

The form should be used when a community spouse's needs cannot be met with the initial SPRA, and they require an increased monthly income up to the Minimum Monthly Maintenance Needs Allowance (MMMNA) as provided by §1924(d) of the Social Security Act. The form must be completed in accordance with the instructions and submitted to the relevant authorities for processing.