Texas Medicaid covers different groups depending on your age, income, and family situation

Texas Medicaid is not one program — it is several, each with its own income limits and rules about who can join. The state runs programs for children, pregnant women, parents, seniors, and people with disabilities. Your path into Medicaid depends on which group you fall into and whether your income and assets stay below the state's thresholds.

Texas has not expanded Medicaid beyond the federal minimum, which means the income cutoffs are lower here than in many other states. A single adult with no children typically cannot get Medicaid in Texas based on income alone, even if they earn very little. But if you are pregnant, a parent, a child, elderly, or disabled, you may have a route in.

Key Takeaways

  • Texas Medicaid covers children up to age 19 at income levels much higher than for adults, and covers pregnant women up to 12 months after delivery.
  • Parents can get Medicaid only if they earn below roughly $300 per month, because Texas has not expanded the program to cover low-income adults without children.
  • People age 65 and older, and people with disabilities, have separate income and asset rules that are often more generous than for working-age adults.
  • Your household size, not just your personal income, determines whether you fall below the limit, and limits change each year.
  • You can check your situation through the Texas Health and Human Services portal or by calling 211 for a referral to a local office.

Children and teenagers in Texas

Texas covers children through Medicaid and through a separate program called CHIP (Children's Health Insurance Program). A child under 19 can get Medicaid if your household income is below 138% of the federal poverty level. For a family of three in 2024, that is roughly $3,600 per month before taxes.

CHIP covers children in families that earn too much for Medicaid but not enough to buy private insurance. The income limit for CHIP is higher — around 200% of poverty — and the program charges a small monthly premium, usually $15 to $50 per child depending on family income.

Both programs cover doctor visits, hospital care, prescriptions, dental, and vision. You do not need to be a U.S. citizen to enroll a child, though you will need proof of Texas residency and the child's age.

Pregnant women and new mothers

Pregnant women can get Medicaid if household income is below 196% of the federal poverty level — much higher than the limit for other adults. This covers prenatal care, delivery, and hospital stays related to pregnancy.

Coverage continues for 12 months after the baby is born, even if your income rises during that year. This is called postpartum coverage. After 12 months, you lose Medicaid unless you fall into another category (such as being a parent of a child under 19).

You can enroll in Medicaid while pregnant at any time. You do not have to wait for an open enrollment period. Bring proof of pregnancy — a letter from your doctor or a positive pregnancy test — when you apply.

Parents and caretakers

A parent or caretaker of a child under 19 can get Medicaid in Texas, but only if household income is below roughly 19% of the federal poverty level. For a family of three, that is around $400 per month before taxes. This is one of the lowest thresholds in the country.

Because the income limit is so low, most working parents do not may have access to. If you earn minimum wage, you will likely earn too much. The program exists mainly for parents who are not working or who work very few hours.

If you do not have children under 19 living with you, you cannot get Medicaid based on income alone in Texas, no matter how low your earnings are.

People age 65 and older

Seniors age 65 and older can get Medicaid if they meet income and asset tests. The income limit is higher than for working-age adults — around $1,150 per month for a single person in 2024 — but you also cannot own more than $2,000 in countable assets (not including your home or car).

Many seniors use Medicaid to pay for nursing home care or in-home services after Medicare stops covering them. Medicaid covers long-term care, which Medicare does not. If you are on Medicare and have low income, you may also be able to get help paying your Medicare premiums and out-of-pocket costs through a program called Medicare Savings Programs.

Medicaid for seniors is often called "Medicaid for the Elderly" or SSI-related Medicaid. You can apply through the Texas Health and Human Services office or through Social Security if you are already receiving benefits.

People with disabilities

People who receive Supplemental Security Income (SSI) from Social Security automatically get Medicaid in Texas. SSI is a federal program for people with disabilities, blind individuals, and seniors with very low income. If Social Security approves you for SSI, you do not have to apply for Medicaid separately — it starts automatically.

People who receive Social Security Disability Insurance (SSDI) do not automatically get Medicaid, but they may be able to get it if they also have low income and few assets. There is also a work incentive program called Medicaid Buy-In that lets working people with disabilities keep Medicaid even if they earn more than the usual limit.

If you have a disability but do not receive SSI or SSDI, you can still apply for Medicaid directly. You will need medical documentation of your disability and proof that your income and assets are below the state limits.

Income and asset limits that change each year

Texas updates its income limits every January. The limits depend on your household size and which program you are in. A household includes you, your spouse if you are married, and any children under 19 who live with you.

Some programs count only earned income (wages from a job), while others count all income including unemployment, child support, and Social Security. Some programs have asset limits — meaning you cannot own more than a certain amount of money or property — while others do not.

Because limits change and the rules are different for each program, the best way to know whether you may have access to is to apply or call 211 and ask a local specialist. They can tell you the current limits for your situation and whether you should apply now or wait.

How to learn about you may have access to

You can check your situation through the Texas Health and Human Services portal at yourtexasbenefits.com. Create an account, enter your income and household information, and the system will tell you which programs you may be able to join. This is an informational tool and does not enroll you in anything.

You can also call 211 from anywhere in Texas and ask for a referral to your local Health and Human Services office. A specialist there can walk you through the rules for your situation and tell you what documents you will need to bring if you decide to apply.

If you are already receiving Social Security (retirement, disability, or survivor benefits), you can also apply for Medicaid through your local Social Security office. Bring proof of your income, residency, and citizenship or immigration status.

Frequently Asked Questions

Do I have to be a U.S. citizen to get Medicaid in Texas?

No. Lawful permanent residents, refugees, asylees, and some other immigration statuses are allowed to get Medicaid. You will need to show proof of your immigration status. Undocumented immigrants cannot get regular Medicaid, but Texas does cover emergency medical care for anyone regardless of status.

What if my income is above the limit but I have high medical bills?

Some Medicaid programs allow you to "spend down" — meaning you subtract your medical bills from your income to see if you fall below the limit. This is most common for seniors and people with disabilities. Ask your local office whether spend-down applies to your situation.

Can I get Medicaid if I have a job but earn very little?

It depends on your household. If you are a parent of a child under 19, you can get Medicaid if your household income is below the state limit, even if you work. If you are a single adult with no children, you cannot get Medicaid based on income alone in Texas.

How long does it take to learn about I may have access to?

The Texas Health and Human Services office has 45 days to make a decision after you apply. In practice, many decisions come faster — sometimes within two weeks. If you are pregnant or applying for emergency Medicaid, the office must decide within 24 hours.

What happens if my income changes after I get Medicaid?

You must report income changes to your local office. If your income rises above the limit, your Medicaid will end. If it falls below the limit, you stay covered. Some programs give you a grace period before coverage ends, so report the change right away rather than waiting.