Who can get Medicaid in Texas

Texas Medicaid covers people in specific groups: children under 19, pregnant people, parents or caretakers of children, people over 65, and people who are blind or disabled. You must also be a U.S. citizen or may have access to immigrant, live in Texas, and meet income limits. The income threshold depends on which group you fall into — a single adult with no children has a different limit than a parent caring for children.

Texas did not expand Medicaid under the Affordable Care Act, which means working-age adults without children, pregnant people, or disabilities generally do not meet the income requirements, even if they earn very little. This is a key difference from many other states. If you are an adult without dependents, your income must be extremely low — typically under $500 per month — to may have access to under the traditional rules.

Key Takeaways

  • Texas Medicaid covers children, pregnant people, parents or caretakers, seniors, and people who are blind or disabled, but income limits are strict and vary by group.
  • Working-age adults without children or disabilities face very low income thresholds because Texas has not expanded Medicaid may be able to access.
  • You must prove U.S. citizenship or may have access to immigrant status, Texas residency, and income through documents like tax returns, pay stubs, or bank statements.
  • You can start the process online through the Texas Health and Human Services portal, by phone, or in person at a local office.
  • Processing typically takes 30 days, though it can be faster if you provide all required documents upfront.

Income limits by household type

Income limits in Texas are set as a percentage of the federal poverty level. For children, the limit is typically around 200% of the federal poverty level, which means a family of three with a child can earn roughly $3,500 per month and still may have access to. For pregnant people, the limit is similar. For parents or caretakers, the limit is lower — around 19% of the federal poverty level in most cases, which works out to roughly $400 per month for a family of three.

These numbers change yearly and depend on family size. The Texas Health and Human Services website has a current income calculator where you can enter your household size and monthly income to see whether you fall within the range. Income includes wages, self-employment earnings, Social Security, unemployment benefits, and child support. Some income is not counted — for example, the first $90 of monthly earnings and certain types of assistance.

If your income is above the limit for one group, you may still may have access to under another. For example, if you are pregnant and your income is too high for the pregnancy program, you might may have access to under a different category. The application process will walk you through this.

Documents you will need to provide

Texas requires proof of identity, residency, citizenship or immigration status, and income. For identity, bring a driver's license, passport, or state ID. For residency, a utility bill, lease, or mortgage statement dated within the last two months works. For citizenship, a birth certificate, passport, or naturalization papers are standard. If you are a may have access to immigrant, you will need your immigration documents.

For income, bring recent pay stubs (usually the last 30 days), a tax return from the past year, or a letter from your employer stating your wages. If you are self-employed, bring tax returns and bank statements. If you receive Social Security, unemployment, or other benefits, bring the award letter or benefit statement. If your income varies, bring documents covering the past three months so the caseworker can calculate an average.

You do not need to gather everything before you start. You can submit an incomplete application and send missing documents later, though having everything ready speeds up the process. The caseworker will tell you exactly what is missing and give you a deadline to provide it.

How to start the process in Texas

You can apply online through the Texas Health and Human Services portal at yourtexasbenefits.com. This is the fastest route if you have your documents ready and are comfortable with online forms. You create an account, answer questions about your household, upload documents, and submit. You will get a confirmation number and can check your status online.

You can also call the Texas Health and Human Services hotline at 211 (dial 2-1-1) or 1-877-541-7905 to speak with someone who can walk you through the questions and take your information over the phone. This takes longer than online but can be helpful if you have questions or need language support. Spanish-language assistance is available.

A third option is to visit a local Health and Human Services office in person. You can find the nearest office on the Texas HHS website. Bring your documents and be prepared to wait. In-person visits are useful if you need help filling out forms or have complex circumstances, but they typically take longer than online or phone.

What happens after you submit your application

After you submit, a caseworker is assigned to your case. They will review your documents and may contact you if something is missing or unclear. You will receive a letter in the mail with a decision — approved, denied, or pending. This usually takes 30 days, though it can be faster if everything is in order.

If you are approved, your coverage begins on the first day of the month you applied or the first day of the following month, depending on when your application was received. You will receive a Medicaid card in the mail. You can use it at any doctor, hospital, or pharmacy that accepts Medicaid in Texas.

If you are denied, the letter will explain why. Common reasons include income above the limit, not meeting residency requirements, or missing citizenship documentation. You have the right to request a hearing to appeal the decision. The letter will include instructions on how to do this.

Special situations: pregnancy, disability, and age

If you are pregnant, you may may have access to for Medicaid even if your income is higher than the standard limit for your household type. Texas covers pregnant people up to around 200% of the federal poverty level. Pregnancy coverage continues for 60 days after delivery. You do not need to be a U.S. citizen to may have access to for pregnancy coverage — may have access to immigrants are covered.

If you are disabled or blind, you may may have access to regardless of your work history. You will need medical documentation of your condition. This can come from a doctor, hospital, or disability information made by Social Security. The process for disability cases is more detailed and may take longer than 30 days.

If you are over 65, you are likely already on Medicare through Social Security. However, you may also may have access to for Medicaid to help pay Medicare premiums and cover costs Medicare does not. This is called Medicare Savings Programs. Income limits for seniors are slightly higher than for working-age adults.

Renewing your coverage each year

Medicaid coverage in Texas lasts 12 months. Before your coverage ends, you will receive a renewal notice in the mail. You must submit updated information about your income and household to keep your coverage active. You can renew online, by phone, or in person using the same methods as the initial application.

If your income or household size changes during the year — for example, you get a job, lose a job, or have a baby — you should report the change right away. Some changes may end your coverage, while others may not affect it. Reporting changes promptly prevents overpayments or unexpected loss of coverage.

Frequently Asked Questions

Can I get Medicaid if I work part-time?

Yes, if your total monthly income is below the limit for your household type. Part-time wages count as income. Some earnings are excluded — typically the first $90 per month — which can help you stay under the limit. Use the income calculator on the Texas HHS website to check your specific situation.

What if I do not have a birth certificate or citizenship documents?

You can still apply. Texas HHS can help you obtain copies of vital records or work with you to verify citizenship through other means. Bring whatever identity documents you have and explain what you are missing. The caseworker will guide you through the next steps.

How long does it take to get a Medicaid card after approval?

Your coverage begins on the first day of the month you applied or the following month, depending on timing. The physical card usually arrives within two weeks, but you can use your coverage immediately even before the card arrives. Doctors and pharmacies can look up your coverage by your Social Security number or case number.

Can I have both Medicaid and private insurance?

Yes. If you have employer insurance or insurance through the marketplace, you can have both. Medicaid will coordinate with your private insurance and may cover costs your private plan does not. Tell your Medicaid caseworker about any other coverage you have.

What if my income is too high but I have large medical bills?

High medical bills do not lower your income for Medicaid purposes in Texas. However, you may be able to deduct certain medical expenses — like ongoing treatment costs — from your income when calculating whether you may have access to. Ask the caseworker about medical expense deductions during your application.