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Form H1200-A June 2011 Texas Health and Human Services Commission Case No. BJN MC FOR AGENCY USE ONLY/SOLO PARA USO DE LA AGENCIA Prog. Date Form Rcv'd CCAD XIX QMB Date Remailed Date Ret'd SLMB Worker/Trabajador.

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Medical Expenses - Medical bills, receipts or statements from the provider. Insurance Policies - Copies of life and burial policies; statements from the insurance provider showing the current value. Rent/Mortgage - Copies of checks or check stubs, statement from mortgage lender or landlord.

Proof of income from your job – Last 3 pay stubs or paychecks, a statement from your employer, or self-employment records. Bank accounts – The most current statement for all accounts. Medical costs – Bills, receipts, or statements from health-care providers (doctors, hospitals, drug stores, etc.).

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Single applying for Medicaid Income LimitAsset LimitInstitutional / Nursing Home Medicaid$2,349 / month$2,000Medicaid Waivers / Home and Community Based Services$2,349 / month$2,000Regular Medicaid / Aged Blind and Disabled$783 / month$2,000 Feb 27, 2020

To be eligible for Texas Medicaid, you must be a resident of the state of Texas, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

To renew online, log in to your account at YourTexasBenefits.com and select Details for your case. Select Renew Benefits. We'll mail you a renewal packet if you haven't signed up to go paperless.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232