TX HHS Form H1869. Renewal for Health Care Benefits

The TX HHS Form H1869, Renewal for Health Care Benefits, is a crucial document that helps individuals continue receiving essential health coverage. This form is typically filled out by students who are still enrolled in college, university, medical or dental school, or technical institute, and need to renew their state health benefits.

The form requires the individual to provide personal information, including name, address, phone number, and details about their income and resources. Additionally, they must indicate whether they have changed any facts since the previous year, and if so, provide updated information. The form also asks about pregnancy status, health insurance, and voting registration preferences.

Key features of this form include the requirement to provide proof of ongoing education or enrollment in a school program, as well as details about income and resources. The form must be signed and dated by the individual, authorizing the release of information to Texas Health and Human Services (HHS) and other state and federal agencies for verification purposes.

• This form is used by students who need to renew their state health benefits while still enrolled in a college or university program.
• The form requires individuals to provide proof of ongoing education or enrollment in a school program.
• The form must be signed and dated by the individual, authorizing the release of information for verification purposes.