Texas Medicaid is run by the state, not the federal government, and may be able to access depends on your income, age, and family status

Texas Medicaid covers people in specific categories: children under 19, pregnant people, parents of dependent children, seniors over 65, and people with disabilities. The income limits are lower in Texas than in most other states because Texas did not expand Medicaid under the Affordable Care Act. This means many working adults without children do not meet the income threshold, even if they earn very little.

To find out whether you meet Texas income and category requirements, you apply through the Health and Human Services Commission (HHSC), which administers Medicaid in Texas. You can apply online through YourTexasBenefits.com, by mail, in person at a local HHSC office, or by phone. The process takes about 30 days from the date HHSC receives a complete application.

Key Takeaways

  • Texas Medicaid covers children, pregnant people, parents of dependent children, seniors, and people with disabilities — but income limits are strict because Texas has not expanded Medicaid.
  • You apply through YourTexasBenefits.com, by mail, phone, or in person at your local HHSC office, and you will need proof of income, citizenship, and residency.
  • If your income is too high for Medicaid, you may be able to purchase coverage through the federal marketplace at Healthcare.gov, which may offer subsidies based on your income.
  • Once approved, coverage usually begins on the first day of the month after HHSC approves your case, though some categories have different start dates.
  • If HHSC denies your case, you have the right to request a hearing within 90 days of the denial notice.

Who qualifies for Texas Medicaid by category

Texas Medicaid covers children under 19 whose household income is at or below 200 percent of the federal poverty level. For a family of three in 2024, that is roughly $3,200 per month gross income. Children in this income range are covered through the Medicaid for Children program.

Pregnant people and new parents can receive Medicaid during pregnancy and for 60 days after delivery, regardless of immigration status. Income limits for this group are higher than for other adults — up to about 196 percent of the federal poverty level. After the 60-day postpartum period ends, coverage stops unless you meet another category (such as being a parent of a dependent child).

Parents of dependent children can receive Medicaid if their household income is at or below about 19 percent of the federal poverty level — roughly $300 per month for a family of three. This is the strictest income limit in Texas Medicaid and reflects the state's decision not to expand the program.

People age 65 and older and people with disabilities may receive Medicaid if they meet income and asset limits. For seniors and disabled adults, the income limit is roughly $900 per month for a single person, and you can have up to $2,000 in countable assets. These groups often may have access to for both Medicaid and Medicare (called "dual may be able to access").

Documents you will need to apply

HHSC requires proof of several things before it can process your case. Bring or upload a photo ID (driver's license, passport, or state ID), proof of Texas residency (utility bill, lease, or mail from a government agency), and proof of citizenship (birth certificate, passport, or naturalization papers). If you do not have a birth certificate, you can apply for one through the Texas Vital Statistics office.

You will also need to report your household income. Bring recent pay stubs (usually the last 30 days), tax returns, or a letter from your employer stating your income. If you are self-employed, bring tax returns from the last two years. If you receive unemployment, Social Security, or other benefits, bring the award letter or benefit statement. If your income changes or you have no income, you can still apply — HHSC will ask you to explain your situation.

If you are applying as a parent or caregiver, you will need to list all household members and their ages. If you are applying for a child, bring the child's birth certificate and Social Security number. If you are applying for disability benefits, HHSC may ask for medical records or a letter from your doctor describing your condition.

How to apply through YourTexasBenefits.com

The online portal YourTexasBenefits.com is the fastest way to apply. Create an account with your email address and a password, then select "Apply for Benefits." Choose Medicaid from the list of programs. You will answer questions about your household size, income, citizenship, and residency. Upload photos of your documents (ID, proof of income, proof of residency, and proof of citizenship) directly into the portal.

After you submit your application, HHSC sends you a confirmation email with a case number. Check your email regularly — HHSC may ask you to provide additional information or clarify something on your application. If you do not respond within 10 days, HHSC may close your case. You can also log back into YourTexasBenefits.com to check the status of your application and respond to any requests.

If you do not have internet access or prefer not to apply online, you can call the HHSC Customer Service line at 1-877-541-7905 (Monday through Friday, 8 a.m. to 5 p.m. Central Time) to request an application by mail. You can also visit your local HHSC office in person — find the office nearest you on the HHSC website by entering your county.

What happens after you apply

HHSC has 30 days from the date it receives your complete application to make a decision. If your application is incomplete, HHSC sends you a notice asking for more information. You have 10 days to respond. If you do not respond, HHSC closes your case, but you can reapply at any time.

If HHSC approves your case, you receive an approval notice by mail showing your coverage start date, your case number, and your Medicaid ID number. Coverage usually begins on the first day of the month after approval. Once you have your Medicaid ID, you can use it at any doctor, hospital, or pharmacy that accepts Medicaid in Texas. You do not receive a physical card — your ID number is all you need.

If HHSC denies your case, the denial notice explains the reason. Common reasons include income above the limit, not meeting a category requirement, or not providing proof of citizenship or residency. You have 90 days from the date of the denial notice to request a hearing. To request a hearing, call 1-877-541-7905 or submit a written request to your local HHSC office.

What to do if your income is too high for Medicaid

If HHSC denies you because your income exceeds the Medicaid limit, you may be able to purchase health insurance through the federal marketplace at Healthcare.gov. The marketplace is open year-round in Texas, though you can enroll without penalty during the annual open enrollment period (usually November through January) or if you have a may have access to life event (such as losing employer coverage or having a baby).

If your income is between 100 and 400 percent of the federal poverty level, you may receive a tax credit that lowers your monthly premium. You can apply for marketplace coverage at Healthcare.gov, and the application will tell you whether you may have access to for a credit. Some people who are denied Medicaid in Texas find that marketplace coverage with a subsidy is more affordable than paying out of pocket.

Renewing your Medicaid coverage

Texas Medicaid coverage lasts 12 months from your approval date. Before your coverage ends, HHSC sends you a renewal notice asking you to confirm that your household information and income have not changed. You can renew online through YourTexasBenefits.com, by mail, or by phone. If you do not renew before your coverage ends, you lose Medicaid and must reapply.

If your income or household changes during the year (such as a job loss, a new job, or a new household member), report the change to HHSC within 10 days. You can report changes online, by phone, or in person. Changes may affect your coverage or your may be able to access, so it is important to report them promptly.

Frequently Asked Questions

Can I get Medicaid if I am not a U.S. citizen?

Pregnant people and children can receive Medicaid regardless of immigration status. Other adults must be U.S. citizens or may have access to immigrants (such as lawful permanent residents or refugees). Undocumented immigrants can receive emergency Medicaid only — coverage for emergency medical conditions that require immediate treatment.

What if I am working but still have a low income?

If you are a parent of a dependent child, you may meet the income limit for Medicaid, though Texas limits are very strict. If you do not meet the Medicaid limit, check Healthcare.gov for marketplace coverage with a subsidy. Some employers also offer coverage, so ask your employer whether health insurance is available.

How long does it take to get Medicaid after I apply?

HHSC has 30 days to decide your case from the date it receives a complete application. If your application is incomplete, the clock restarts after you provide the missing information. Coverage usually begins on the first day of the month after approval, so the total time from application to coverage can be 30 to 60 days.

What if HHSC asks for more information after I apply?

HHSC sends you a notice asking for specific documents or clarification. You have 10 days to respond by uploading documents to YourTexasBenefits.com, mailing them to your local HHSC office, or calling 1-877-541-7905. If you do not respond within 10 days, HHSC closes your case, but you can reapply.

Can I use Medicaid from Texas if I move to another state?

No. Medicaid is a state program, and coverage ends when you move. You must apply for Medicaid in your new state. Some states have higher income limits or different categories, so you may become may be able to access in your new state even if you were denied in Texas.