How to Report a Change to Medicaid in Texas
In Texas, a recipient of Medicaid who experiences a change in his status must report the change to the Texas Health and Human Services Commission (HHSC) within 10 days of the change's occurrence. The report is made on the Report of Change form, Form H1019, accessible through the Department of Aging and Disability Services. Reporting the change isn’t a complex process. You simply need to supply nonembellished, detailed information about the change or changes and make certain the form and proof of the change(s) reach your local HHSC representative.
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Instructions
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Go to the Texas Department of Aging and Disability Services: DADS Forms & Instructions website.
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Scroll to the Form H1019 link in the “Go To Form” field and click the link. The Texas DADS HHSC Forms and Instructions page for Form H1019 will open.
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Click the H1019.doc or H1019.pdf link to access a copy of the form and then print it out.
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Check the box on the first page of the form next to the section that applies to the Medicaid status within your household. If you’re reporting a change in an adult Medicaid household, check the box next to “1.” on the page. If you’re reporting a change in a child’s Medicaid household, check the box next to “2.” on the page.
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Write down the date and type of each change applicable to your situation, as well as the length of time you expect these changes to continue to affect the household status, on the second page of the form on the lines provided.
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Sign and date the form and write your telephone number in the box under the signature field.
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Call the HHSC representative who handles your Texas HHSC benefits case file at your local Texas HHSC benefits office. Explain that you have changes to report and that you have completed Form H1019. Drop off or mail the form and proof of the changes as directed by your representative.
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Tips & Warnings
If you can’t print out the form, ask your HHSC representative to mail you a copy of the form.
If you need a copy of the form in Spanish, select Form H1019-S from the “Go To Form” field in Step 2.
