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Form H1272-A Spousal Impoverishment Assessment Letter - Texas (English / Spanish)
What Is Form H1272-A?
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 H1272-A?
A: Form H1272-A is a Spousal Impoverishment Assessment Letter used in Texas.
Q: What is the purpose of Form H1272-A?
A: The purpose of Form H1272-A is to assess the financial situation of a spouse in relation to their eligibility for certain Medicaid programs.
Q: Who uses Form H1272-A?
A: Form H1272-A is used by individuals in Texas who are applying for Medicaid programs and have a spouse.
Q: Is Form H1272-A available in both English and Spanish?
A: Yes, Form H1272-A is available in both English and Spanish.
Q: Do I need to fill out Form H1272-A?
A: If you are applying for certain Medicaid programs in Texas and have a spouse, you will likely need to fill out Form H1272-A.
Q: What information is required on Form H1272-A?
A: Form H1272-A requires information about the spouse's income, assets, and expenses.
Q: How should I submit Form H1272-A?
A: You should submit Form H1272-A to the Texas Health and Human Services Commission by mail or in person.
Q: Are there any fees associated with filing Form H1272-A?
A: No, there are no fees associated with filing Form H1272-A.
Q: What happens after I submit Form H1272-A?
A: After submitting Form H1272-A, the Texas Health and Human Services Commission will review the information and determine the spouse's eligibility for Medicaid programs.
Form Details:
- Released on April 1, 2007;
- The latest edition provided by the Texas Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form H1272-A by clicking the link below or browse more documents and templates provided by the Texas Health and Human Services.
