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Form 1024, Individual Status Summary

Medicaid No. Enter the individual’s Medicaid number. CARE or Unique ID No. If the individual is enrolled in HCS, enter the individual’s Client Assignment and Registration (CARE) Identification number; if CARE has transitioned out of use, enter the Unique ID number assigned to the individual by Texas Medicaid & Healthcare Partnership (TMHP). Enter N/A if no CARE or Unique ID number exists. Date of Birth Enter the individual’s date of birth using the mm/dd/yyyy format. Service Area Enter the managed care service area the individual resides in. If the individual is not enrolled in HCBS, enter N/A. Link to service areas: https://hhs.texas.gov/sites/default/files//documents/services/health/medicaid-chip/programs/managed-care-service-areas-map.pdf

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