TX HHS Form H5020-MBIC. Hardship Waiver Denied (Medicaid Buy-In for Children)

The TX HHS Form H5020-MBIC, Hardship Waiver Denied, is a document used to notify individuals that their Medicaid Buy-In for Children (MBIC) hardship waiver has been denied. This form helps resolve the issue of denied benefits due to non-payment or other reasons, providing clarity on the next steps and responsibilities.

The form outlines specific conditions and requirements, including the need to continue making payments to maintain benefits. It also provides contact information for individuals who may have concerns about their treatment or believe they have been discriminated against based on certain characteristics. Key features of this form include the requirement to pay outstanding amounts by due dates and the availability of assistance through HHSC's Office of Civil Rights.

If you are facing a denied hardship waiver, this form provides essential information on what to do next. You can use this document to understand your responsibilities and take necessary follow-up actions. Key points to note include:

• The need to continue making payments to maintain benefits
• The requirement to pay outstanding amounts by due dates
• Contact information for HHSC's Office of Civil Rights and the U.S. Department of Health and Human Services' Office for Civil Rights