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Get Tx H1200 2015

Rity Income (SSI) benefits. • Need to be in a nursing home or other place of care. or • Have a disability. There might be a better form to use, if any of these apply to you: • You no longer get SSI and you aren’t applying for the Medicaid Buy-In Program. (H1200-EZ) • You are applying only for a Medicare Savings Program. (H1200-EZ) • You live in a state supported living center. (H1200-PFS) • You live in a state hospital. (H1200-PFS) To ask for these forms, call 2-1-1 or 1-877-541-7.

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