Why Applications Get Denied
Most denials aren't about being truly ineligible. The most common reasons are:
- A missing or late document
- Income or household information that didn't match what HHSC had on file
- A form that went to the wrong address, or mail that bounced
- A deadline that passed while paperwork was still being gathered
If any of that sounds familiar, an appeal — not a brand-new application — is usually the faster path back to coverage.
Your Right to a Fair Hearing
If HHSC denies, reduces, or ends your Medicaid or SNAP benefits, your notice must tell you why and how to appeal. This is called a fair hearing, and it's your chance to present your case to someone who wasn't involved in the original decision.
The deadline matters. You generally have 90 days from the date on your denial or termination notice to request a fair hearing. Don't wait until the last week — the sooner you request it, the sooner it gets scheduled.
If You're Already Receiving Benefits
If HHSC is trying to reduce or stop benefits you already have, ask for a fair hearing before the effective date of that change (check your notice for the exact deadline) and your benefits can often continue unchanged while the appeal is pending. This window is shorter than the general 90-day deadline, so read your notice carefully and act fast.
How to Request a Fair Hearing
- By phone — call 2-1-1 or the number listed on your denial notice
- Online — through your YourTexasBenefits.com account
- In writing — mail a letter to the address on your notice, including your name, case number, and the decision you're appealing
- In person — at your local HHSC benefits office
Keep a copy of whatever you send, and note the date you sent it.
What Happens After You Request a Hearing
- You'll get a hearing date. HHSC will mail you a notice with the date, time, and how the hearing will happen — usually by phone.
- You can review your case file. You have the right to see what HHSC used to make its decision before the hearing.
- You can bring evidence and ask questions. This isn't a courtroom — you don't need a lawyer, though you're allowed to bring one or a trusted advocate.
- You'll get a written decision. The hearing officer's decision is final unless you appeal further through the state court system.
Documents to Gather Before Your Hearing
Bring (or have ready to reference by phone):
- A copy of your original application and denial notice
- Pay stubs, an employer letter, or other proof of income for the period in question
- Proof of household size (birth certificates, a lease)
- Any document HHSC said was missing — even if you believe you already sent it
- Notes on dates you submitted paperwork, if there's a dispute about timing
A Denial Isn't Always the End of the Road
- Did the notice name a specific missing document? Sometimes simply resubmitting that one item resolves the whole case without a hearing.
- Could a different program apply? If you were denied Medicaid for income reasons, CHIP might still cover your children, and Marketplace plans with subsidies are worth checking too.
- Is your case genuinely pending, not denied? "Pending" and "denied" sometimes look similar at a glance. See our Medicaid eligibility guide if you're unsure.
We Can Help With Your Appeal
You don't have to navigate this alone. Texas Health Help's navigators help people gather the right documents, understand their denial notice, and request a fair hearing correctly the first time — all for free.
Related guides & resources
Texas Health Help is a community nonprofit, not a government agency. We help you understand the appeals process and prepare your case — only HHSC or a hearing officer can approve benefits or overturn a denial. Appeal deadlines and procedures can change; confirm current details on your specific notice or by calling 2-1-1.