Document checklist
Texas HHSC denies more applications for missing pages than for any other reason. Tick each item as you gather it, and attach a scan so everything travels with your plan.
Identity & Residency
- Texas Driver's License or DPS IDCritical
Front and back, current address visible.
- Social Security card
Original card or SSA verification letter.
- Birth certificate or U.S. PassportCritical
Proves citizenship. Naturalization papers are also accepted.
Medical Necessity
- Form H3037 — Physician's medical-necessity statementCritical
Doctor must certify need for help with 3+ ADLs or skilled nursing.
- Current medication list
Prescriber, dose, frequency for each medication.
- Diagnosis summary
Especially for Alzheimer's or dementia — required for 24-hour supervision claims.
Financial — The Big Three
- Bank statements (last 3 months)Critical
All accounts: checking, savings, CDs. Every page, including blank ones.
- Bank statements (60-month look-back, if requested)
Only if HHSC flags a transfer. Be prepared with the full 5 years.
- Social Security award letterCritical
Current year. The annual COLA letter works.
- Pension / VA / retirement income letters
Most recent award or 1099.
- Life insurance policy schedule pageCritical
Must show face value and cash surrender value. Required if total face value > $1,500.
Asset Safeguards
- Irrevocable burial contract
If purchased — required to claim the exemption.
- Property deed and last tax statement
Confirms home equity and supports the Intent-to-Return claim.
- Vehicle title(s)
For the exempt vehicle and any additional vehicles.
- IRA / 401(k) RMD distribution schedule
Proves payout status — if in payout, the principal is not counted.
Forms
- Form H1200 — Application for AssistanceCritical
Generated from your eligibility-check answers.
- Form H1200-A — Authorized Representative
Required when a family member or facility files on the applicant's behalf.
The most common denial reasons
- A single missing page in a multi-page bank statement.
- Life insurance not disclosed when the bank statement shows a premium payment.
- Doctor signed Form H3037 but did not list 3 specific ADLs.
- Authorized representative form (H1200-A) signed but not dated.