Medicaid Women’s Health Program in Texas

The Medicaid Women’s Health Program provides low-income women with family exams, related health screening and birth control through Texas Medicaid. [En Espańol]

Covered Services

The Medicaid Women’s Health Program provides low-income women with:

  • One family planning exam each year, which might include:
    • Pap smear.
    • Screening for breast and cervical cancers, diabetes, sexually transmitted diseases, and high blood pressure.
  • Family planning counseling and education. This can include natural family planning and abstinence.
  • Birth control:
    • Birth control pill.
    • Vaginal ring.
    • Hormone patch.
    • Diaphragm.
    • Male and female condoms.
    • Spermicide.
    • Intrauterine device (IUD).
    • Cervical cap.
    • Depo-Provera.
    • Methods to prevent pregnancy (tubal ligations or Essure).

    (Doesn’t include emergency birth control)

  • Follow-up family planning visits related to your method of birth control.

This program only pays for the services listed above. If a health problem such as a sexually transmitted disease, diabetes or cancer is found, you will be referred to a doctor or clinic that can treat you. You might have to pay for those extra services.

Who Can Apply?

The Women’s Health Program is for women who are:

  • Ages 18 to 44. Women can apply the month they turn age 18 through the month they turn age 45.
  • U.S. citizens and legal immigrants.
  • Living in Texas.
  • Not currently getting full Medicaid benefits, CHIP, or Medicare Part A or B.
  • Not pregnant.
  • Not sterile, infertile, or unable to get pregnant due to medical reasons.
  • Not getting private health insurance that covers family planning services, unless filing a claim on the health insurance would cause physical, emotional or other harm from a spouse, parent, or other person.
  • Meet monthly family income limits at or below these levels:
Family Size
Monthly Countable Income
1
$1,670
2
$2,247
3
$2,823
4
$3,400
5
$3,976
6
$4,553
7
$5,130
8
$5,706
For each additional person, add:
$577

How to Apply

1. Complete a Women’s Health Program application form.

You can fill out the one-page form at a clinic that gives these services. You might get services the same day. Or you can get a form by:

  • Downloading the form [English] [Español] (see mailing instructions below).
  • Calling the Women’s Health Program at 1-866-993-9972 (toll-free). We can take your calls 8 a.m. to 7:30 p.m. Central Time.
  • Picking up a copy at a clinic that gives these services. You can get one from some community organizations. Call 2-1-1 to locate an office.
  • Picking up a copy from an HHSC benefits office.
  • Picking up a copy at a clinic that gives these services. You also can get one from some community organizations. Call 2-1-1 to locate an office.
  • Picking up a copy at a Women, Infants and Children Nutrition Program (WIC) office. Call 1-800-942-3678 (toll-free) to find an office.

If you need help filling out a form, a community organization can help. To find a community organization near you, call 2-1-1.

2. Send or bring paperwork that shows your income, expenses, and citizenship.

If you go to a HHSC benefits office or clinic to apply, please bring the following items with you. It will help process your form faster:

Proof of income, such as:

  • Paycheck stub you got in the last 60 days.
  • Proof someone in your family is in a benefits program. You can give us documents such as:
    • Current Children’s Medicaid ID (Form 3087).
    • WIC verification of certification. (This shows you are in the WIC program.)
    • WIC voucher.
    • WIC / Lone Star Card shopping list.
  • A letter from an employer.
  • Proof of self-employment income, unemployment benefits, child support, supplemental security income (SSI), or other income.

Proof of expenses, if you want to claim exemptions, such as:

  • Childcare Expenses: Receipts or income tax returns showing paid childcare.
  • Child Support Expenses: Cancelled checks or wage withholding statements, Attorney General collection and distribution records, or county clerk records, or statement from custodial parent for child support paid.

Proof of your citizenship and identity, such as:

      • A U.S. passport.
      • A certificate of naturalization.
      • A certificate of U.S. citizenship.

These 3 items prove both citizenship and identity. If you do not have one of these documents, you will need to give 2 documents, 1 from each list:

To Verify Citizenship To Verify Identity
U.S. birth certificate. Current driver’s license with photo.
U.S. citizen ID card. DPS ID card with photo (For example: Texas ID card).
Hospital record of birth. Work or school ID card with photo.
Northern Mariana ID card.
American Indian card with classification code KIC.
Religious record of birth with date and place of birth, such as baptism record.
Affidavit from two adults establishing the date and place of birth in the United States.

You only have to prove citizenship and identity one time. You do not have to resubmit this information if you reapply.

3. Return the completed form.

After you fill out and sign the form, you can send it by one of these ways:

HHSC – WHP
MC 821-1
PO Box 16017
Houston, TX  77222-6017
If you pick up a form from a doctor’s office, clinic, community organization, or benefit office, a pre-paid envelope might come with it.

Frequently Asked Questions

  • How will I know if I’m covered by the Women’s Health Program?

    If you are approved, you will get a Women’s Health Program Medicaid ID form in the mail. You must take this form with you when you get Medicaid services. This form helps doctors offices know which services you can get and how to bill Medicaid.

    You will get a new Medicaid ID each month while you are able to get services.
    Call 1-866-993-9972 (toll-free) if you:

    • Didn’t get a Medicaid ID and want to see if you are in the program.
    • If you lost your Medicaid ID.
  • How long will I get services?

    If you are approved, you will get Medicaid Women’s Health Program services for 1 year.  We will send you a renewal form so you can reapply before your coverage ends.

  • How much will I have to pay?

    These services are free.  If you need treatment or other medical services not covered by this program, you might have to pay for those extra services.

  • Where will I need to go to get my birth control?

    You can get your birth control at a clinic or doctor’s office, or your doctor might give you a prescription. A drug store can fill your prescription for free if you show your Medicaid ID.

  • What if my doctor finds a health problem that isn’t covered?

    If your women’s health doctor finds a problem such as a sexually transmitted disease, diabetes, or cancer, you will be referred to a doctor who can treat you. You might have to pay for those extra services. The Women’s Health Program only pays for the services listed under Covered Services.

  • What if my doctor tells me I might have breast or cervical cancer?

    The Women’s Health Program doesn’t cover follow-up screenings and treatment for breast or cervical cancer. You will need to visit a breast and cervical cancer services clinic. You might be able to get free or low-cost screenings and treatment. To find a this type of clinic, you can:

    To learn more, go to www.hhsc.state.tx.us/help/index.html. Click on “Women.” Then scroll down to “Medicaid for Breast and Cervical Cancer.”

Brochures

Find a Doctor or Clinic

To find a doctor or clinic that works with the Women’s Health Program, you can:

Steps Options
1 Health Plan: Pick “Traditional Medicaid.”
2 Provider Type: Pick “Specialist.”
3 Location: Enter your ZIP code.
4 Provider Specialty: Pick any one of the following:

    • Family planning agency (public health)
    • Gynecology (DO)
    • OB/GYN (DO)
    • OB/GYN (MD)
5 Click the “Search” button.
6 Pick a doctor from the list and call that office: Ask if they are taking new Medicaid Women’s Health Program patients.

Contact Us

To learn more, call 1-866-993-9972 (toll-free), 8 a.m. to 7:30 p.m. Central Time.

Information for Providers

Visit www.hhsc.state.tx.us/WomensHealth.htm