Form H2064 Gap in Enrollment for Medicaid Managed Care Members - Texas

What Is Form H2064?

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 H2064 Gap in Enrollment for Medicaid Managed Care Members?
A: Form H2064 Gap in Enrollment for Medicaid Managed Care Members is a document in Texas that is used to report any gaps in enrollment for Medicaid managed care members.

Q: Who uses Form H2064?
A: Form H2064 is used by Medicaid managed care members in Texas.

Q: What is the purpose of Form H2064?
A: The purpose of Form H2064 is to report any gaps in enrollment for Medicaid managed care members.

Q: What information is required on Form H2064?
A: Form H2064 requires information such as member's name, Medicaid number, date of birth, managed care organization, reason for gap in enrollment, and dates of enrollment gap.

Q: What should I do if I have a gap in enrollment for Medicaid managed care?
A: If you have a gap in enrollment for Medicaid managed care, you should fill out Form H2064 and submit it to the appropriate authority.

Q: Is there a deadline to submit Form H2064?
A: Yes, there is a deadline to submit Form H2064. It should be submitted within 60 days of the gap in enrollment.

Q: What happens if I don't submit Form H2064?
A: If you don't submit Form H2064, you may experience difficulties in accessing Medicaid managed care services.

Q: Are there any fees associated with submitting Form H2064?
A: No, there are no fees associated with submitting Form H2064.