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This document outlines the changes made to the Texas Women's Health Program Certification form effective May 1, 2012, including updates to the effective date of certification and the acceptance of
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How to fill out Texas Women's Health Program Certification Form

01
Obtain the Texas Women's Health Program Certification Form from the appropriate website or office.
02
Begin by providing your personal information including your name, address, and date of birth.
03
Fill out the section regarding your household size and income information to determine eligibility.
04
Check the boxes indicating the services you are requesting or interested in.
05
Review the form for any errors or omissions.
06
Sign and date the certification form at the designated area.
07
Submit the completed form to the specified location or via the recommended submission method.

Who needs Texas Women's Health Program Certification Form?

01
Women seeking preventive health services such as cancer screenings and family planning.
02
Individuals who meet income eligibility requirements for the program services.
03
Those who are not currently enrolled in other Texas health care programs.
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People Also Ask about

HTW: Who can Apply? Are a woman between the ages of 18 to 44 years old. Are a woman between the ages of 15 to 17 years old and have a parent or legal guardian apply, renew, and report changes to your case on your behalf. Are a U.S. citizen or a qualified immigrant. Are a resident of Texas. Don't have health insurance.
Income Guidelines for Medicaid for Pregnant Women Family SizeMonthly Family Income Family Size 1 Monthly Family Income $2,583 Family Size 2 Monthly Family Income $3,490 Family Size 3 Monthly Family Income $4,398 Family Size 4 Monthly Family Income $5,3052 more rows
The Healthy Texas Women program offers comprehensive healthcare, including birth control, pregnancy tests and counseling, and health screenings and treatment for hypertension, diabetes and cholesterol.
High school seniors, undergraduate, and graduate women students from Texas are eligible to apply for this scholarship if they are going into fields such as pre-law, political science, public health, medicine, and other related fields. Students must have a 3.0 GPA or higher to apply.
To see if a woman is enrolled in the program call the TMHP Contact Center at 800-925-9126 (Option 5) or check in the Texas Medicaid Provider section of the TMHP website. (Look for the "Go to TexMedConnect" button). Providers should make sure that a woman is enrolled in the program before billing.
HTW: Who can Apply? Are a woman between the ages of 18 to 44 years old. Are a woman between the ages of 15 to 17 years old and have a parent or legal guardian apply, renew, and report changes to your case on your behalf. Are a U.S. citizen or a qualified immigrant. Are a resident of Texas. Don't have health insurance.
The Texas Women's Health Program and Medicaid for pregnant women both provide a range of health care services, including office visits, prescription drugs, eye exams, dental care and more. If you are approved for the program, you will receive a Your Texas Benefits identification card in the mail.

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The Texas Women's Health Program Certification Form is a document that certifies a woman's eligibility for the Texas Women's Health Program, which provides access to various health services.
Women who wish to participate in the Texas Women's Health Program and receive its benefits must file the Texas Women's Health Program Certification Form.
To fill out the Texas Women's Health Program Certification Form, individuals should provide personal information, proof of income, and any other required documentation as specified on the form.
The purpose of the Texas Women's Health Program Certification Form is to determine eligibility for benefits and ensure that women receive necessary health services.
The Texas Women's Health Program Certification Form requires reporting of personal identification details, income levels, household size, and any other information relevant to eligibility for the program.
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