Gethipptexas 2026

1. Click ‘Get Form’ to open the gethipptexas application in the editor.
2. Begin by providing details about the individual eligible for health insurance. Fill in their first name, last name, Medicaid ID number (if applicable), Social Security number, address, city, email, best phone number, date of birth, state, and ZIP code.
3. Next, describe the health insurance or COBRA benefits available to this person. Include the health insurance company name, address, policy ID number, group number, policy start date (if applicable), monthly premium amount, and indicate if it is COBRA insurance.
4. Provide information about the employer or company offering the health insurance. Fill in the employer's name, phone number, address, city, state, and ZIP code.
5. Enter your family's Medicaid case number found on your Medicaid ID card. Then list family members receiving Medicaid by providing their first names and Medicaid ID numbers. Indicate if any are pregnant and provide due dates where applicable.
6. Finally, submit your completed form along with your employer’s Summary of Benefits and Rate Sheet. For faster service, fax them to 1-866-409-1188 or mail them to HIPP Program – P.O. Box 201120 Austin, TX 78720-9774.

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