Form H1139 Medical Expense Verification - Texas (English / Spanish)

What Is Form H1139?

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 H1139?
A: Form H1139 is a Medical Expense Verification form used in Texas.

Q: What is the purpose of Form H1139?
A: The purpose of Form H1139 is to verify medical expenses for individuals applying for or receiving benefits in Texas.

Q: Who needs to fill out Form H1139?
A: Individuals applying for or receiving benefits in Texas may be required to fill out Form H1139.

Q: Is Form H1139 available in Spanish?
A: Yes, Form H1139 is available in both English and Spanish.

Q: What information is required on Form H1139?
A: Form H1139 requires information about the individual's medical expenses, including the type of expense, amount paid, and providers.

Q: Are there any documents that need to be attached to Form H1139?
A: Yes, supporting documentation such as receipts or bills for the medical expenses should be attached to Form H1139.

Q: What happens after submitting Form H1139?
A: After submitting Form H1139, the information and supporting documents will be reviewed by the Health and Human Services Commission to determine eligibility or benefit amount.

Q: Is there a deadline for submitting Form H1139?
A: There may be a deadline for submitting Form H1139, so it is important to check with the Health and Human Services Commission or program guidelines.