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Revision 15-4; Effective October 1, 2015
CHIP, CHIP Perinatal
Households must report the following changes to:
- address;
- intent to reside in Texas;
- the individuals living in the home;
- income, including sources of income, regular hours worked, and pay rate;
- Modified Adjusted Gross Income (MAGI) expenses;
- pregnancy termination;
- a child being institutionalized or dying; and
- medical insurance coverage.
Exceptions: A child is disenrolled if the child reapplies and becomes eligible for Medicaid or at the end of the month of the child’s 19th birthday.
Process all other changes, including agency-generated changes, at the time of report.
D—1421 How to Report
Revision 15-4; Effective October 1, 2015
CHIP, CHIP Perinatal
Persons with case authority may report changes by one of the following means:
- online through YourTexasBenefits.com;
- in person at a Texas Health and Human Services Commission Benefits Office;
- telephone;
- mail;
- fax;
- Form H1019, Report of Change, and;
- signed Form H1028, Employment Verification.
A person with case authority is an individual who has the authority to apply on the child’s behalf, as explained in A-121, Receipt of Application, for Medical Programs.
D—1422 Receipts for Reported Changes
Revision 13-4; Effective October 1, 2013
CHIP, CHIP Perinatal
Households may request a receipt to acknowledge the change report. The receipt includes the type of change(s) and the date reported. If an individual requests a receipt, issue Form H1800, Receipt for Application/Medicaid Report/Verification/Report of Change.