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If you need help confirming your identity, please try one of the following: Call 2-1-1 or 877-541-7905 (after you pick a language, press 2) Visit an HHSC benefits office and bring proof of identity such as a drivers license or other photo ID.
Proof of income from your job Last 3 pay stubs or paychecks, a statement from your employer, or self-employment records. Bank accounts The most current statement for all accounts. Medical costs Bills, receipts, or statements from health-care providers (doctors, hospitals, drug stores, etc.).
Phone. For help or questions with your HHSC benefits case or YourTexasBenefits.com, call 2-1-1 or 1-877-541-7905. After you pick a language, press 2.
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Purpose. To serve as an application and recertification form for Medicare cost-sharing programs and Medicaid community-based programs, except waiver programs. (Form H1200-EZ is an optional alternative to Form H1200 and Form H1200-A for these programs.)
Send in this form by fax, mail, or in person: Fax: 1-877-447-2839. If the form is 2-sided fax both sides. In person: At a benefit office.
Is it Time to Renew? Completing it online at Your Texas Benefits. Mailing it to: Texas Health and Human Services. P.O. Box 149024. Faxing it to 877-447-2839. Calling 2-1-1 and choosing Option 2 after picking a language. Visiting a local office or community partner. Find an HHSC office or community partner.
If you had medical coverage through the GBP, you can get your Form 1095-B online through your Blue Access for MembersSM account. Or, you can request a paper copy be mailed to you by calling your health plan provider.
Go to YourTexasBenefits.com, log in to your account and find the case you want to make changes to. Select Details, then Open Change Report. Or use the Your Texas Benefits app to log in to your account and select the case you want to make changes to. Select Open Change Report.

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