Skip to main content
Dismiss notification

ALERT! We now encourage our patients to save their spot in line before coming into the clinic.

Expand notification
Dismiss notification

Postpartum Medicaid and CHIP Coverage Extension | Learn more

Expand notification

What you will need to get started

Send copies of these items. We only need items that apply to your case. We need these 3 bulleted items for: (a) the children applying for benefits (not for their parents) and (b) for pregnant women who are U.S. citizens or legal immigrants applying for benefits related to the pregnancy.

  • Social Security number – Social Security numbers (SSN) for each person applying for benefits. If a child doesn’t have a SSN, send proof that you applied for one (Form SSA 2853 or Form SSA 5028). If you need help applying for an SSN or need proof that you applied for an SSN, call 1-800-772-1213.
  • Citizenship – U.S. passport, Certificate of Naturalization, U.S. birth certificate, hospital record of birth (copies of the front and back), or Medicare card. If the person applying was born in Texas, we might be able to look up their birth record.
  • Immigration status – Resident card (I-551), arrival/departure form (I-94), or papers from the U.S. Citizenship and Immigration Services. We need copies of the front and back of these forms.

Proof showing money coming into the home (income):

  • Proof of money from a job – Pay check stub from the past 60 days showing the amount paid before taxes or deductions (gross pay), last tax return, or a statement signed and dated by the employer and showing the employer’s name, address, and phone number. Your proof should show the amount you usually get paid.
  • Proof you work for yourself (self-employment) – Last tax return or self-employment records.
  • Child support you get – Child support check stub or receipt.
  • Social Security, Supplementary Security Income (SSI), or pension benefits – Award letter or pay stub.
  • Veterans’ benefits, workers’ compensation, or unemployment – Award letter or a pay stub.

Proof showing costs to take care of others (expenses):

  • Child support you pay – Court papers that show what you must pay for child support (for example: divorce decree, court order, or district clerk record). Canceled checks or a statement from the Office of the Attorney General.
  • Child care or other costs you pay to take care of others – Receipts, canceled checks, or a signed statement from the person you pay. A signed statement must show when and how much you pay.
  • Alimony you pay – Copy of a canceled check or a signed and dated letter from the person you pay.