Form H1039 Medical Insurance Input - Texas

What Is Form H1039?

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 H1039?
A: Form H1039 is a document used in Texas to report information about medical insurance.

Q: Who needs to complete Form H1039?
A: The person or household receiving medical insurance benefits needs to complete Form H1039.

Q: What information is required on Form H1039?
A: Form H1039 requires information such as the name of the insurance company, policy number, and the type of coverage.

Q: Is Form H1039 mandatory?
A: Yes, completing Form H1039 is mandatory for individuals or households receiving medical insurance benefits in Texas.

Q: Are there any deadlines for submitting Form H1039?
A: The deadline for submitting Form H1039 is within 10 days of receiving a request from the Texas Health and Human Services Commission.

Q: What happens if I don't submit Form H1039?
A: Failure to submit Form H1039 or providing false information may result in the loss of medical insurance benefits.

Q: Can I make changes to Form H1039 after submitting it?
A: Yes, if there are changes to your medical insurance information, you should notify the Texas Health and Human Services Commission.

Q: Who can I contact for help with Form H1039?
A: You can contact the Texas Health and Human Services Commission or your local social services office for assistance with Form H1039.