Get Tx H1014 2012-2025

The TX H1014 form is essential for applying for children's health-care benefits through CHIP and Children's Medicaid in Texas. This guide provides a clear and supportive step-by-step process to help you fill out the form correctly and efficiently.

Follow the steps to complete the TX H1014 form online.

1. Click ‘Get Form’ button to obtain the TX H1014 form and open it in the editor.
2. Begin by providing your personal details in the designated fields. Ensure you fill out your full name, Social Security number, date of birth, and contact information accurately.
3. Indicate whether you are applying for benefits related to a pregnancy. If so, fill out the required information about the pregnant woman, including her due date and health insurance status.
4. List all parents and stepparents residing with the children applying for benefits, ensuring to provide their names, dates of birth, and relationships to you.
5. Detail the information of all children aged 18 or younger living in your home, including citizenship status and Social Security numbers.
6. If applicable, provide details about any other health insurance the children may have and complete the necessary sections regarding past health insurance if applicable.
7. Fill out the income section by providing details about any money coming into the home from jobs, benefits, or other sources. Accurate information will help determine eligibility.
8. Complete the unpaid medical bills section if there are any, providing the necessary details to potentially obtain further assistance.
9. Designate an authorized representative if you wish to give someone else the ability to act on your behalf.
10. Review the entire form for accuracy, then sign and date it at the end. Make sure all required documents listed in the 'Items we need' section are included.
11. Submit your completed form via fax or mail. If applying online, ensure you only send the required documents and retain the form for your records.

Complete the TX H1014 form online to secure health-care benefits for your child today.