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Make edits, fill in missing information, and update formatting in US Legal Forms—just like you would in MS Word.

Download a copy, print it, send it by email, or mail it via USPS—whatever works best for your next step.

Sign and collect signatures with our SignNow integration. Send to multiple recipients, set reminders, and more. Go Premium to unlock E-Sign.

If this form requires notarization, complete it online through a secure video call—no need to meet a notary in person or wait for an appointment.

We protect your documents and personal data by following strict security and privacy standards.
There are two ways to apply for the Gold Card during the COVID 19 pandemic and those are: Visit a Harris Health Eligibility Center to pick up an application. You can have an application mailed to you by contacting the Eligibility Information Line at 713.566. 6509. How do you get a gold card in Texas?
Harris Health Financial Assistance Program (Gold Card) Texas I.D. or drivers license stating the person lives in Harris County. Social Security Card. Citizenship(Passport or Birth Certificate) or Green Card. Proof of income (1 months check stubs) Any bills or bank statement (within 60 days) Income tax (if necessary)
The Harris Health Financial Assistance Program is a program that is available to Harris County residents whose gross family income, as it relates to family size, falls at or below at or below 150% of the Federal Poverty Level.
The Texas Department of Insurance (TDI) published its gold card rule for state-regulated plans, effective Sept. 1, 2022, which allows physicians to provide certain medical services without requesting preauthorization from the health plan.
Call the Eligibility Call Center at 713-566-6509 to check the status of your application.
Gold Card status will apply across UnitedHealthcare's Commercial, Individual Exchange, Medicare Advantage and Medicaid plans. Delegated membership is excluded from the program at this time.
Practices (defined by a single Tax ID) must meet all of the following criteria to qualify: Network participation for at least 1 line of business– Commercial, Medicare Advantage, Medicaid or Individual Exchange, A minimum annual volume of at least 10 eligible prior authorizations across participating lines of business ...