D-210, Application Procedures

D-210 Application Procedures

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Applications may be received in person, by telephone, fax, email, Internet or mail. Texas Health and Human Services Commission (HHSC) Benefits Offices are equipped with telephones, lobby computers and fax machines for applicants to submit applications.

Households can apply using any of the Medical Program application channels explained in A-113, Application Requests and Submissions.

If the applicant fails to provide a name, address or signature on a faxed or mailed application, consider it an invalid application.

No interview is required for the Children's Health Insurance Program (CHIP) or CHIP perinatal. Schedule an appointment only upon the household's request.

On the same day of the application receipt, advisors mail the applicant Form H0025, HHSC Application for Voter Registration. If the individual contacts HHSC to decline the opportunity to register to vote after receipt of Form H0025, the advisors mail Form H1350, Opportunity to Register to Vote, to the individual for a signature. Advisors send Form H1350 for imaging when the individual returns the form and retain the form for at least 22 months.

Related Policy

Application Processing, A-100
Registering to Vote, A-1521

D-211 Application Assistance

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

If an applicant needs help completing the application packet, a volunteer or staff member must help. The person helping the applicant complete an application must initial the part he/she completed, or sign the application showing that he/she helped complete it.

D-212 Applications Received by Fax, Email, Mail or Internet

Revision 20-4; Effective October 1, 2020

CHIP and CHIP Perinatal

The applicant's file date is the date the Texas Health and Human Services Commission (HHSC) or an HHSC agent receives an application that contains, at a minimum, the person's name, address and signature. A faxed or electronic signature (if using the online application available through YourTexasBenefits.com) is acceptable. A typed signature is not valid if the application is received via fax, mail or in person. If the application does not contain a signature, return the application with Form H1020, Request for Information or Action, requesting a signature.

The file date is the date an application is received at an HHSC Benefits Office or online through YourTexasBenefits.com during state business hours. For applications received outside of state business hours, the file date is established as the next business day.

Once the initial application disposition occurs, requests for coverage for additional types of assistance are handled separately and a new application is required.

D-213 Applications Received by Telephone

Revision 17-1; Effective January 1, 2017

CHIP, CHIP Perinatal

The file date is the date the applicant submits the application by telephone through 2-1-1, and the telephonic application contains the applicant's:

  • name;
  • address; and
  • signature by telephone.

An applicant may complete and sign an application by telephone following the policy for Medical Programs explained at A-122.1, Application Signature.

Related Policy

Application Signature, A-122.1

D-214 Withdrawal of an Application

Revision 13-4; Effective October 1, 2013

CHIP, CHIP Perinatal

A person with case authority may submit a request to voluntarily disenroll a member. The case authority person must sign and submit the request in writing.

D-215 Authorized Representatives (AR)

Revision 15-4; Effective October 1, 2015

A household may designate an individual or organization as an AR, following the policy explained in A-170, Authorized Representatives (AR).