Get H1200 Form

The H1200 Form is crucial for individuals seeking Medicaid assistance. This guide provides a step-by-step approach to successfully complete the form online, ensuring you can accurately convey your financial and property information.

Follow the steps to effectively fill out the H1200 Form online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by filling out the first section regarding the state facility resident. Include their full name as it appears on their Social Security card, race, date of birth, Social Security number, and contact information. Make sure to answer questions about Texas residency and citizenship status.
3. Proceed to fill in the family information section. You will need to provide the names, social security numbers, and employment status of the resident's parents or guardians. Be sure to include their contact information and any relevant details about property ownership or wills.
4. In the resources section, check all applicable boxes to indicate ownership of various assets. For items you own or are in the process of acquiring, include specifics such as account numbers, amounts, and names of institutions.
5. Complete the transfer of assets section by noting any significant transactions that have taken place in the last 60 months, including any sales or gifts of property.
6. Address the employment and income sections. Indicate any work earnings and other forms of income. Ensure accuracy in reporting amounts and sources.
7. Fill out the health/hospitalization insurance section, providing details about any coverage the resident may have. Include the name of the insurance company, policy number, and other relevant details.
8. Sign and date the application. If someone assisted you in completing the form, provide their information in the designated area.
9. Review the entire form for completeness and accuracy. Save changes, then download, print, or share the completed form as instructed.

Complete your documents online today to ensure timely processing of your Medicaid assistance application.