TX HHS Form H1833. Your Medicaid Benefits Are Ending Cover Letter

The TX HHS Form H1833, "Your Medicaid Benefits Are Ending: Cover Letter," helps individuals who are nearing the end of their Medicaid benefits. This form is typically used in situations where patients with breast or cervical cancer need continued treatment beyond the initial Medicaid coverage period.

This form provides key information and instructions for individuals to apply for the Medicaid for Breast and Cervical Cancer program, which offers extended benefits for eligible patients. The form outlines specific requirements, including the need for a diagnosis or confirmation of ongoing treatment from a doctor, as well as the submission of additional documentation such as health insurance cards.

To apply, individuals can either visit a Breast and Cervical Cancer Services office or complete the application (H2340) that comes with this letter. Key steps include filling out and signing the application, obtaining a "Treatment Verification Form" (H1551) from their doctor, and providing proof of other health insurance coverage. For assistance with the application process, individuals can call toll-free 2-1-1 or 1-877-541-7905.

• This form is used for patients with breast or cervical cancer who need continued treatment beyond initial Medicaid coverage.
• The form provides instructions and requirements for applying to the Medicaid for Breast and Cervical Cancer program.
• Eligible individuals must have a diagnosis or confirmation of ongoing treatment from a doctor, as well as provide additional documentation.