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Application Forms:

Program Application Update

The Texas Health and Human Services Commission is in the process of revising the program application form/s per Senate Bill 1677 and Texas Health and Human Services Commission Policy. This requires HHSC to include model language regarding additional benefits and services for eligible veterans. EFFECTIVE IMMEDIATELY WE ARE REQUIRED TO SHARE THE ATTACHED INFORMATION WITH APPLICANTS UNTIL HHSC GIVES US NOTICE TO BEGIN USING UPDATED APPLICATION FORM/S.  

Please click here to view Additional Benefits and Services for Eligible Veterans.

* 101 West Main St. Mail Unit 14 Room B104 *
* Fredericksburg, TX 78624-3700 *
* Phone 830-990-7567 * Fax 830-992-2621 *

Indigent Health Care Program Office
        Applications may be picked up (or downloaded from the left column) and returned to Rosa "Linda" Lowe-Hough, IHCP Coordinator at the Gillespie County Courthouse, 101 W Main St, Mail Unit #14, Room 104-B (Basement) Monday, Wednesday, Thursday, and Friday between the hours of 8:00 a.m. and 5:00 p.m.  
    Gillespie County Indigent Healthcare Program is a county program that provides medically necessary health care benefits to individuals who meet the income, resource, residency, and household criteria; and who are categorically ineligible for the Texas Medicaid Program. 
    Please stop by the County Indigent Healthcare Office in the Courthouse or call 830-990-7567 to make an appointment to fill in an application and leave your name, mailing address and phone number if leaving a message.
    GCIHC pays for covered services. Some services require prior approval to be covered. All services must be medically necessary. You may be responsible to pay for some services if you choose to receive services that are not covered or are not considered medically necessary.
    Gillespie County is the payor of last resort. Applicants are not eligible for IHC benefits if they are eligible for any other Federal, State, or private benefits, i.e.: Medicaid, Medicare, VA, CHIPS or other insurance. Program rules and eligibility standards are set by the State of Texas.
Gillespie County will use rules and procedures found in the County Indigent Health Care Program Handbook published by the Texas Department of State Health Services.

The rules are as follows:

1. Application forms must be completed.
2. Verification of income, residence, household composition, and resources are required.
3. Net income cannot exceed 21% of the eligible Federal Poverty Guideline.
4. Liquid resources and assets cannot exceed $2000. The equity value of a vehicle greater than $4650 is counted against the $2000 limit. Personal property and homestead are exempt assets.
5. Eligible persons must be a resident of Gillespie County.
6. Applicants must provide all requested information and documentation or applications will be denied.
7. Applicants have the right to appeal adverse decisions.

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