Form H-1010R December 2012 Your Texas Benefits Renewal Form Case Number 1234567890 How to Renew Questions You can renew online at www. YourTexasBenefits. com. Call 2-1-1 or 1-877-541-7905. After you pick a language press 2 to Ask question about this form. If you don t want to renew online fill out this form Find where to get help filling out this form. 1. If you need to correct anything on this form a cross it out and b update it. Check the status of this form* 2. Sign and date page s 9 10 3....
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Who needs a Form H-1010-R?

Any person whose household (family members) is participating in Texas Benefits program should use Form H-1010-R, Texas Benefits: Renewal Form to apply for another program different from the one in which a person is already involved.

What is Form H-1010-R for?

The Program allows a person to apply for the following types of benefits:

  • SNAP food benefits. This program helps a person to buy food for good health.

  • Healthcare. This is a Medicaid and Children’s Health Insurance, which provides help with paying hospital’s and doctor’s bills.

  • Cash support for families (TANF). General help for paying applicant’s food, clothing, and housing.

  • Medicare Saving Programs. It helps to manage the current Medicare insurance and cover some costs of extra payments the Medicare needs.

Each time the participant wants to switch on another program from the list or to add participation in one more part of the program, the Texas Benefits: Renewal Form must be filed.

Is Form H-1010-R accompanied by other forms?

A submitter must send pay stubs or statement of all money their household spent for the last 60 days before the form submission. If a submitter works for himself, proof of income and expenses must be attached as well.

How do I fill out Form H-1010-R?

Provide the following information to complete the form:

  • Personal information and address of the submitter;
  • Information on people renewing their benefits (indicating their relations to the submitter and their birth date);
  • List of anyone who lives with the submitter, but isn’t listed in the previous block.
  • Information about the money coming into the submitter’s home;
  • Information on housing costs, costs on people who depend on the submitter, medical costs, etc.

Where do I send Form H-1010-R?

When you complete and sign the form, direct it to the following address: HHSC, P.O. Box 14700, Midland, TX 79711-9907.

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If you're like most of us, you've got a lot going on. Between work and family, there's not much extra time in the day. That's why the Texas Health and Human Services Commission created YourTexasBenefits.com. It gives you a convenient way to apply for and manage SNAP food benefits, Medicaid, the Children's Health Insurance Program, and TAN-F cash help for families. Using YourTexasBenefits.com is easy. You can... apply for benefits, upload important documents, check the status of your case and more. If you're applying for benefits, you'll need to answer questions about everyone in your family who is applying. Be prepared to share information about your identity, citizenship and immigration status, money your family gets, property you own, and bills you pay. And there's no need to make an extra trip to our office. It's fine to fax the required paperwork, or upload your documents right to YourTexasBenefits.com. In fact, most people who apply for benefits don't even need to come in for an interview. We can usually do it all over the phone. Once you have received benefits, you can use YourTexasBenefits.com to check on your account. The website lets you... manage your case, renew benefits, report changes, and print Medicaid cards. Best of all, YourTexasBenefits.com is available from any computer with an internet connection, so you can manage your benefits day or night, whether you're at home, at a friend's house, a public library, or with one of the community partners that helps you and your family. Ready to see what Your Texas Benefits can do for you? Visit the website now to get started! Brought to you by the Texas Health and Human Services Commission.