X-1810, General Policy

Revision 15-4; Effective October 1, 2015

Before certifying applicants and processing reviews, complete the following:

  • Ensure the applicant completes each item and signs and dates Form H1034, Medicaid for Breast and Cervical Cancer, the application for assistance.
  • During processing, note if the applicant indicates changes on Form H1034 or during the interview, if an interview is requested. Document the nature of the change and when the individual expects the change to occur. If other programs exist for the individual, report the change to the appropriate office.
  • Give or mail the applicant Form H1019, Report of Change. Explain that she must report changes involving her address or creditable coverage within 10 days after knowing about the change. Indicate the appropriate reporting requirement on Page 1.
  • Refer the applicant to other programs for which she might be eligible such as Family Planning; Supplemental Security Income or other benefits from the Social Security Administration; and Women, Infants and Children (WIC). Refer aged and individuals with disabilities who are ineligible for Medical Programs for children and families to the Texas Health and Human Services Commission's (HHSC's) Medicaid for the Elderly and People with Disabilities (MEPD) programs.
  • Inform the applicant of her right to appeal any HHSC action that affects her eligibility.
  • Inform the applicant that the information she provided is subject to verification by third parties.
  • Instruct individuals to report any accident-related injuries requiring medical care or accident-related unsettled legal claims within 60 days.
  • Mail Form H0025, HHSC Application for Voter Registration, with all applications and renewals. If the individual contacts the local office to decline the opportunity to register based on receipt of Form H0025, use Form H1350, Opportunity to Register to Vote, to acknowledge the declination. Mail Form H1350 to the individual for her signature and, upon receipt, file a copy in the case record.