Out-Stationed and HHSC Eligibility Office Staff Process

The chart below explains procedures staff must follow to determine appropriate action.

If an applicant… then staff must: provides Form H3038-P only , and was active on CHIP perinatal at the time of the delivery, fax Form H3038-P to 877-447-2839 . provides an application requesting Medicaid only , provides Form H3038-P, and was active on CHIP perinatal at the time of delivery, follow policy for receipt of duplicate or identical application and fax Form H3038-P to 877-447-2839. provides an application requesting Medicaid and other benefits (SNAP, Medicaid, TANF), provides Form H3038-P, and was active on CHIP perinatal at the time of delivery, certify the TP 36 coverage when determining eligibility for the other requested programs (including TP 45) following existing policy, if eligible; or fax only Form H3038-P to 877-447-2839 if the mother is ineligible for Emergency Medicaid based on the current information. provides an application and Form H3038-P stamped with “Received (Date) CCC,” process the request for Medicaid following normal application procedures. was not active on CHIP perinatal at the time of delivery, process the Emergency Medicaid request per existing policy and certify TP 45 if appropriate.

Notes:

Fax the bar-coded Form H3038-P to 877-447-2839. If Form H3038-P is not bar-coded, write the mother's case and CHIP perinatal EDG number on the top of the form.

If the applicant requests the fax number for Form H3038-P, instruct the applicant to fax the form to 877-447-2839 .