Revision 12-1; Effective March 1, 2012
Form H0055, Verification of Long-Term Care Partnership Policy, is used to request and verify information about a person's LTCP insurance policy.
Form H0056, Notification of Opportunity to Designate Countable Resources, is used to provide a person an opportunity to select the countable resource(s) and the amount of the countable resource(s) the person wishes to designate for the LTCP disregard. It also serves as the written resource designation for any available LTCP disregard.
Form H0057, Long-Term Care Partnership Resource Worksheet, is used as the LTCP resource calculation worksheet.
The LTCP Tracking Spreadsheet is used to track LTCP information for HHSC purposes and to meet federal reporting requirements. This spreadsheet is available on the internal OES MEPD website at http://reg03.dhs.state.tx.us/mepd/.