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English PDF: Form H1200. Spanish PDF: Form H1200-S. Instructions. English and Spanish forms can be found under the title "Form to apply for Medicaid for the Elderly and People with Disabilities or Medicare Savings Program" under section "Forms to apply for benefits".
- Forms | Texas Health and Human Services
Medicaid for the Elderly and People with Disabilities...
- Form H1205, Texas Streamlined Application
English and Spanish forms can be found under the title "Form...
- Forms | Texas Health and Human Services
You must apply for Medicare through a different agency - the Social Security Administration. To learn more, visit www.Medicare.gov or call 1-800-633-4227. Medicaid Buy-In Program. To ask for these forms, call 2-1-1 or 1-877-541-7905. Helps people who work and: (a) have a disability or (b) are age 65 or older.
Medicaid for the Elderly and People with Disabilities Handbook. Left Menu. Search this Handbook. Chapter A, General Information and MEPD Groups. Chapter B, Applications and Redeterminations. Chapter C, Rights and Responsibilities. Chapter D, Non-Financial. Chapter E, General Income.
Download and print the forms you need or ask us to mail them to you. All paper forms available. Forms to apply for benefits. Forms to give proof for benefits. Other forms. Forms you want mailed. Send All By Mail.
Fill out and download the Form H1200 Application for Benefits - People Age 65 and Older, People With Disabilities in Texas. Easily apply for benefits online and save as a printable PDF.
English and Spanish forms can be found under the title "Form to apply for: (1) Medicaid or CHIP, or (2) help paying for private health insurance" under section "Forms to apply for benefits".
If you want to apply for Medicaid for the Elderly and People with Disabilities, you need a different form. To get that form, call 2-1-1 (after you pick a language, press 2). All phone and fax numbers on this form are free to call. If you are deaf, hard of hearing, or speech impaired, you can call any number by calling 7-1-1 or 1-800-735-2989.
