Are You Eligible for Medicaid in Texas?
Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include your age, whether you are pregnant, disabled, blind, or aged; your income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether you are a U.S. citizen or a lawfully admitted immigrant. The rules for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home.
Your child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if you are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child’s status, not the parent’s. Also, if someone else’s child lives with you, the child may be eligible even if you are not because your income and resources will not count for the child.
In general, you should apply for Medicaid if you have limited income and resources. You must match one of the descriptions below. (Even if you are not sure whether you qualify, if you or someone in your family needs health care, you should apply for Medicaid and have a qualified caseworker in your state evaluate your situation.)
Pregnant Women
Apply for Medicaid if you think you are pregnant. You may be eligible if you are married or single. If you are on Medicaid when your child is born, both you and your child will be covered.
Children and Teenagers
Apply for Medicaid if you are the parent or guardian of a child who is 18 years old or younger and your family’s income is limited, or if your child is sick enough to need nursing home care, but could stay home with good quality care at home. If you are a teenager living on your own, the state may allow you to apply for Medicaid on your own behalf or any adult may apply for you. Many states also cover children up to age 21.
Person who is Aged, Blind, and/or Disabled
Apply if you are aged (65 years old or older), blind, or disabled and have limited income and resources. Apply if you are terminally ill and want to get hospice services. Apply if you are aged, blind, or disabled; live in a nursing home; and have limited income and resources. Apply if you are aged, blind, or disabled and need nursing home care, but can stay at home with special community care services. Apply if you are eligible for Medicare and have limited income and resources.
Other Situations
Apply if you are leaving welfare and need health coverage. Apply if you are a family with children under age 18 and have limited income and resources. (You do not need to be receiving a welfare check.) Apply if you have very high medical bills, which you cannot pay (and you are pregnant, under age 18 or over age 65, blind, or disabled).
Screening Tools
To help you see if you may be eligible for a variety of governmental programs, you may access the GovBenefits and BenefitsCheckUp websites (see Related Links Inside CMS listed below).
Call 2-1-1 in Texas
Calling 2-1-1 is a free, easy way to find out about services you can get. You can find services in your area or through state programs.
When you call 2-1-1, you pick a language and then pick from 3 options:
| Press 1 | to learn about services in your area, such as: |
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- Food
- Housing
- Child care
- After-school programs
- Senior services
- Help after a disaster
- Tax help
Staff can talk with you anytime you call – 24 hours a day, 7 days a week.
| Press 2 | to learn about state benefits, such as: |
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- SNAP food benefits (used to be called food stamps)
- Medicaid
- Children’s Health Insurance Program (CHIP)
- Cash help for families (TANF)
Staff can talk with you Monday to Friday, 8 a.m. to 8 p.m.
| Press 3 | to report waste, fraud and abuse in state health and human services programs. |
Staff can talk with you Monday to Friday from 8 a.m. to 5 p.m.
| If you can’t connect to 2-1-1, call us toll-free at 1-877-541-7905. You also can visit the 2-1-1 Texas website to find the phone number to your local 2-1-1 Area Information Center. You might not be able to connect to 2-1-1 if:
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Fill out an application form
The first page of the form tells you how to mail or fax your completed application form.
Texas Medicaid Application Download
Visit an HHSC benefits office
Call 2-1-1 or search our office locations to find the HHSC benefits office near you.
People who apply for services usually need to meet with us in an HHSC benefits office. However, we can talk with you over the phone or we can come to your home if:
- You live more than 30 miles away from the closest HHSC benefits office.
- You can’t come to the HHSC benefits office because of bad weather.
- You are sick.
- You can’t get a ride to the HHSC benefits office.
- Your work or training hours do not allow you to come to the HHSC benefits office.
- You can’t travel because you are 60 years old or older, or you have a disability.
- You are a victim of family violence.
- You are taking care of someone who lives in your home.
If you need an interpreter when visiting a benefits office, we can get one for you at no cost. Let us know if you need an interpreter on your application. Or let us know when you set up an office visit. You also can bring your own interpreter.
Medicaid for Families
A family with a parent or relative caring for a child under age 19 may receive health care coverage through Medicaid if certain income and resource requirements are met. HHSC looks at a family’s income and compares it with the amount the family pays for basic needs such as rent, utilities, child care and work-related expenses. Resources such as cash on hand, money in the bank and value of vehicles are also considered.
Those who receive Medicaid for Families can also get Temporary Assistance for Needy Families (TANF). Families can choose if they want to receive one or both types of benefits.
A family can receive Medicaid benefits as long as income and resource requirements are met. Before the end of each six month period of coverage, a renewal application is sent to the family.
