Form H1024, also known as the “Self-Declaration Notice,” is a document used by the Texas Health and Human Services Commission (HHSC) to verify key information needed to renew a child’s Medicaid coverage by mail. The form focuses on two areas where HHSC needs clarification: the child's Texas Health Steps checkup status and the parent or guardian’s Health Care Orientation status.
Form H1028 is an official Texas Health and Human Services Commission (HHSC) document used to verify a person’s employment status, income, and work-related benefits. HHSC relies on this form when determining eligibility for state assistance programs such as SNAP, Medicaid, TANF, and other public benefits. The form must be completed by the employer, not the employee, and returned to HHSC by the specified deadline.
The Employment Verification form (Form H1028-A) is used by the Texas Health and Human Services Commission (HHSC) to confirm wages for individuals applying for benefits under Aged and Disabled Programs. Because financial eligibility is determined primarily by accurate income reporting, employers play a crucial role in certifying the applicant’s earnings, employment status, insurance availability, and any recent changes that may affect eligibility.
Form H1004 is a notice sent by the Texas Health and Human Services Commission (HHSC) when someone submits a benefits application on behalf of another person and claims to be their authorized representative. The letter explains that HHSC cannot process the application until proof of this authorization is provided. In many cases, Form H1004 is the applicant’s first indication that additional documentation is required to validate their role.
Form H1019, issued in October 2024, is the official Texas Health and Human Services Commission (HHSC) document for reporting changes that may affect your benefits. This form ensures that households receiving TANF, Medicaid, CHIP, Healthy Texas Women, or SNAP benefits maintain accurate and up-to-date information with the state. Timely reporting helps prevent overpayments, penalties, or interruptions in benefits.
This document is used by Texas Health and Human Services (HHS) to formally notify an insurance company that the State of Texas must be listed as the preferred remainder beneficiary on an annuity owned by a Medicaid applicant. Although the form itself is short, its implications are significant, because it affects eligibility for long-term care Medicaid and determines who receives remaining annuity funds after the annuitant’s death.
The TX HHS Form H1036, Refugee Cash Assistance Verification Form, is a crucial tool for tracking and verifying the financial assistance provided to refugees. This form helps solve the problem of ensuring that refugee cash assistance is accurately recorded and distributed, thereby supporting the resettlement process.
The Pre-Screening Result for Medicaid form (Form H1035) helps determine whether an individual is eligible for Medicaid benefits. This form is typically used in situations where a verbal conversation has taken place to assess eligibility, but a formal determination has not been made.
The TX HHS Form H1030, Supplemental Nutrition Assistance Program (SNAP) Lone Star Card Assistance, helps individuals who have not used their Lone Star Card in the past three months to purchase food. This form is typically filled out by those experiencing difficulties using their card or those who have not received their card.
The Texas Health and Human Services Commission's Form H1028-MBIC, Employment Verification (Medicaid Buy-In for Children), is a crucial document that helps determine the eligibility of households applying for assistance. This form is used in situations where an individual's employment status affects their application or another household member's application.
