Where to start your Texas Medicaid application
You apply for Medicaid in Texas through the Health and Human Services Commission (HHSC), which runs the program for the state. The fastest way is to apply online at YourTexasBenefits.com, which is the official portal for all Texas benefit programs. You can also apply by mail, phone, or in person at a local HHSC office, but online is usually faster — you get a decision within 30 days instead of 45 to 60 days by mail.
Before you start, gather documents that prove your identity, income, and household size. You will need a Social Security number for everyone in your household, recent pay stubs or tax returns to show income, and proof of Texas residency like a utility bill or lease. If you are applying for a child, bring their birth certificate. If you are over 65 or applying based on disability, you may need medical records or a disability information letter.
The application itself takes 15 to 30 minutes online. You enter your household information, income, and the reason you are applying (age, disability, pregnancy, or low income). The system will tell you right away if you appear to meet the income limits, though HHSC will verify everything before making a final decision.
Key Takeaways
- Apply online at YourTexasBenefits.com, by phone at 211, by mail, or in person at your local HHSC office.
- You need proof of identity, income, household size, and Texas residency — gather these before you start.
- Online applications usually get a decision within 30 days; mail applications take 45 to 60 days.
- Texas Medicaid covers children and pregnant people at higher income levels than adults without children, so your household composition matters.
- If you are denied, you can request a hearing within 90 days and provide additional information HHSC may have missed.
Income limits and who can apply in Texas
Texas Medicaid income limits depend on your household size and who is in it. For a single adult with no children, the limit is around 17% of the federal poverty level — roughly $240 per month. For a pregnant person or child, the limit is much higher: around 200% of poverty, or about $2,800 per month for a family of three. For people over 65 or those with disabilities, the limit is around 75% of poverty.
These numbers change every year in January when the federal poverty guidelines update. The exact amount for your situation depends on your household size and composition. When you apply online, the system will show you the current limit for your household before you submit.
Texas does not cover childless adults under 65 without a disability, even at very low incomes. This is a state policy choice — other states cover this group, but Texas does not. If you fall into this category, you may still have other options through the federal marketplace at Healthcare.gov, where you might find plans with subsidies based on your income.
What happens after you submit your application
After you submit, HHSC sends you a confirmation number and tells you when to expect a decision. You can check the status of your application anytime by logging back into YourTexasBenefits.com with your username and password. HHSC will also send you a letter in the mail with the decision.
During the review period, HHSC may contact you to verify information — usually by mail, sometimes by phone. If they ask for documents, respond within the deadline they give you, usually 10 days. Missing the deadline can result in a denial even if you would have been approved. If you cannot find a document, call HHSC and ask if something else will work instead.
If you are approved, your coverage usually starts on the first day of the month after HHSC approves you. For example, if you are approved on March 15, coverage begins April 1. In some cases — like pregnancy or emergency situations — coverage can start retroactively to cover medical bills from the past three months.
Documents you need to have ready
Gather these documents before you apply. You do not have to upload them all at once — the application will tell you which ones HHSC needs for your specific situation.
| Document type | What it proves | Examples |
|---|---|---|
| Identity | Who you are | Driver's license, passport, state ID, birth certificate |
| Social Security number | Your SSN and household members' SSNs | Social Security card, tax return, W-2 |
| Income | How much you earn | Recent pay stubs, tax return, letter from employer, bank statements showing deposits |
| Residency | You live in Texas | Utility bill, lease, mortgage statement, mail from a government agency |
| Household composition | Who lives with you | Birth certificates for children, marriage certificate, divorce decree |
If you are self-employed, bring your last two years of tax returns and a profit-and-loss statement for the current year. If you receive child support, alimony, or Social Security, bring the most recent statement or award letter. If you are applying based on disability, HHSC will request medical records directly from your doctor — you do not have to gather these yourself.
What to do if you are denied
If HHSC denies your application, the denial letter will explain why and tell you how to request a hearing. You have 90 days from the date of the letter to ask for one. A hearing is a chance to present additional information or correct mistakes HHSC made when reviewing your case.
Common reasons for denial are income slightly above the limit, missing documents that HHSC could not verify, or household size counted differently than you reported. If your income changed since you applied, or if you can find the documents HHSC requested, a hearing is worth doing. You can represent yourself or bring someone to help you — you do not need a lawyer, though you can hire one if you want.
To request a hearing, follow the instructions on the denial letter. You can usually do this by mail, phone, or online through YourTexasBenefits.com. Tell HHSC what information you want to add or what you think was wrong. The hearing usually happens within 30 to 60 days.
Keeping your coverage active after approval
Once you are approved, your coverage lasts for a set period — usually 12 months for adults, sometimes longer for children. Before your coverage ends, HHSC will send you a renewal notice asking you to confirm your information is still correct. You must respond by the deadline or your coverage will stop.
If anything changes during your coverage period — your income goes up, you move, someone leaves your household, or you get a job with health insurance — report it to HHSC within 30 days. You can report changes online at YourTexasBenefits.com, by phone, or by mail. Reporting changes keeps your coverage accurate and prevents overpayments that you might have to repay later.
If your income increases above the limit, your coverage will end, but you may be able to switch to a plan through Healthcare.gov. If your income drops again, you can reapply to Medicaid anytime — there is no waiting period between applications.
Other ways to apply if online is not an option
If you cannot apply online, call 211 (Texas 211 helpline) and ask for help applying to Medicaid. They can take your information over the phone and submit the application for you. This usually takes longer than applying yourself online, but it works if you do not have internet access or are not comfortable using a computer.
You can also go in person to your local HHSC office. Find the nearest one by entering your zip code at hhs.texas.gov/locations. Bring all your documents and be prepared to wait — offices are often busy. Call ahead to ask if you need an appointment or if you can walk in.
If you apply by mail, download the application form from YourTexasBenefits.com or ask HHSC to mail you one. Mail it to the address on the form with copies of your documents. Keep a copy for your records. Mail applications take longer to process, so apply as soon as you can if you need coverage quickly.
Frequently Asked Questions
Can I apply for Medicaid if I am not a U.S. citizen?
It depends on your immigration status. Lawful permanent residents (green card holders) and some other legal immigrants can apply. Undocumented immigrants cannot apply for regular Medicaid, but Texas does cover emergency medical services for anyone regardless of status. Contact HHSC or 211 to learn what you may be able to access.
How long does it take to get approved?
Online applications usually get a decision within 30 days. Mail applications take 45 to 60 days. If HHSC needs more information from you, the clock pauses while you respond — this can add weeks. In emergencies like pregnancy, approval can happen faster.
What if my income is slightly above the limit?
You will be denied for regular Medicaid, but you may be able to buy a plan through Healthcare.gov with a subsidy that makes it affordable. Go to Healthcare.gov, enter your income, and see what plans are available. You can also reapply to Medicaid if your income drops later.
Do I have to pay anything for Medicaid in Texas?
No. Texas Medicaid is free for people who meet the income and other requirements. You do not pay premiums, and most services have no copay. Some services like non-emergency transportation may have small copays, but these are rare and only for certain groups.
Can I apply while I am still working?
Yes. Medicaid is based on income, not employment status. If your job pays low wages and your household income is below the limit, you can apply. Having a job does not disqualify you, and you can keep Medicaid even if you get a raise, as long as your new income stays below the limit.