Insurance Program for Children (CHIP)

Harris County, TX

Official Website: https://www.medicaid.gov/chip/index.html

Forms & Documents

Browse all Insurance Program for Children (CHIP) government forms

All 17 forms

Form Title Topics
All-State Medicaid and CHIP Call
Application for Health Coverage & Help Paying Costs
Coverage Learning Collaborative
Department of Health and Human Services Centers for Medicare & Medicaid Services
Draft Model Renewal Form and Considerations for MAGI Medicaid/CHIP Renewals
Electronic Visit Verification FMAP Reduction Process
Eligibility and Enrollment Pending Actions Resolution Planning
It is time to renew your Medicaid coverage
MBES Line definitions for the 64.9 BASE form
MDP MONTHLY AMP FILE FORMAT
MDP PRODUCT DATA FILE SUBMISSION TO CMS Form CMS-367c
Medicaid and Children’s Health Insurance Program Eligibility and Enrollment Data Specifications for Reporting During Unwinding
Medicaid and CHIP Unwinding Planning Efforts
NATIONAL AVERAGE DRUG ACQUISITION COST (NADAC) REQUEST FOR MEDICAID REIMBURSEMENT REVIEW
Strategies States and the U.S. Territories Can Adopt to Maintain Coverage of Eligible Individuals as They Return to Normal Operations
Streamlined Eligibility and Enrollment for Non-MAGI Populations
Training Template for Qualified Hospitals

Contact Information & Office Locations

1 contact point

Centers for Medicare and Medicaid Services

Address:
7500 Security Boulevard
Baltimore, MD 21244-1850

Phone numbers:
  • (877) 267-2323 (toll free)
  • (410) 786-3000 (main)
  • (800) 877-8339 (tyy)
  • (410) 786-0727 (tyy)
Emails:
  • Medicaid.gov@cms.hhs.gov

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