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Este documento proporciona información sobre las opciones de atención a largo plazo disponibles en Texas, incluyendo servicios específicos y asistencia para personas que reciben Medicaid.
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How to fill out form h1204

01
Obtain a copy of form H1204 from the official website or your local agency.
02
Read the instructions carefully to understand the eligibility requirements.
03
Fill out your personal information in the designated sections, including name, address, and contact information.
04
Provide any requested financial information or supporting documentation as per the form's requirements.
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Review your completed form for accuracy and completeness.
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Sign and date the form where required.
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Submit the form as instructed, either online, by mail, or in person.

Who needs form h1204?

01
Individuals seeking assistance or benefits related to specific programs governed by the guidelines of form H1204.
02
Applicants who meet the eligibility criteria for the programs associated with H1204.
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Make and document an eligibility decision on an application as soon as all required verification is received. Time frame for eligibility determination: Make an eligibility decision within 45 days on applications from applicants 65 years or older.
Call 866-566-8989 8 a.m. to 5 p.m. Central Time, Monday through Friday and speak to someone that day.
Call 866-566-8989 8 a.m. to 5 p.m. Central Time, Monday through Friday and speak to someone that day.
Make and document an eligibility decision on an application as soon as all required verification is received. Time frame for eligibility determination: Make an eligibility decision within 45 days on applications from applicants 65 years or older.
Who is eligible for Texas Medicaid? Household Size*Maximum Income Level (Per Year)1$28,8692$39,0463$49,2234$59,4004 more rows
Call toll-free at 800-252-8263, 2-1-1 or 877-541-7905. Choose English or Spanish. Choose option 2. The person you speak with can help you find out if you have Medicaid or not.
Forms FormTitleForm H1228Title Application LetterForm H1228-ATitle Medicaid for the Elderly and People with Disabilities -- Application InformationForm H1230Title Notification of Eligibility -- Regular Medicaid BenefitsForm H1232Title Notification of Ineligibility134 more rows
Most people who have Medicaid in Texas get their coverage through the STAR managed care program. STAR covers low-income children, pregnant women and families. STAR members get their services through health plans they choose.

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Form H1204 is a specific form used by certain government agencies, typically related to health and social services, for reporting and documenting information relevant to programs or benefits.
Individuals or entities seeking benefits or participating in programs that require this specific reporting are generally required to file Form H1204.
To fill out Form H1204, individuals should follow the instructions provided with the form, ensuring that all required information is accurately completed, including personal details, income, and any relevant supporting documentation.
The purpose of Form H1204 is to gather necessary information to assess eligibility for certain programs, benefits, or services and to ensure compliance with regulatory requirements.
Information that must be reported on Form H1204 typically includes personal identification details, income information, household composition, and any other data relevant to the specific program or benefits being applied for.
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