Form 5021 Health Insurance Premium Payment (HIPP) Consent - Texas

What Is Form 5021?

This is a legal form that was released by the Texas Health and Human Services - a government authority operating within Texas. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form 5021?
A: Form 5021 is a Health Insurance Premium Payment (HIPP) Consent form specific to Texas.

Q: What is the purpose of Form 5021?
A: The purpose of Form 5021 is to give consent for the Texas Health and Human Services Commission to pay health insurance premiums on behalf of qualified individuals.

Q: Who needs to fill out Form 5021?
A: Form 5021 needs to be filled out by individuals who meet the eligibility criteria for the Health Insurance Premium Payment (HIPP) program in Texas.

Q: What are the eligibility criteria for the HIPP program in Texas?
A: To be eligible for the HIPP program in Texas, individuals must have Medicaid, be enrolled in a Medicaid managed care plan, and have access to employer-sponsored health insurance.

Q: Is there a deadline for submitting Form 5021?
A: While there is no specific deadline mentioned, it is recommended to submit Form 5021 as soon as possible to ensure timely processing of health insurance premium payments.

Q: Are there any fees associated with the HIPP program?
A: No, there are no fees associated with the HIPP program in Texas.

Q: What happens after I submit Form 5021?
A: After submitting Form 5021, the Texas Health and Human Services Commission will review the information provided and determine eligibility for the HIPP program. If eligible, they will begin making health insurance premium payments on behalf of the individual.

Q: Can I opt out of the HIPP program after submitting Form 5021?
A: Yes, individuals can choose to opt out of the HIPP program at any time by contacting the Texas Health and Human Services Commission.