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Texas Medicaid Eligibility

Not Expanded

Program: Texas Medicaid / CHIP

$914/mo/mo
Individual income limit
$1,850/mo/mo
Family of 4 income limit
100% FPL
FPL threshold

Key Facts for Texas

  • ✓Texas has not expanded Medicaid and has some of the most restrictive eligibility rules
  • ✓Non-disabled adults without children generally do not qualify
  • ✓Texas has the highest uninsured rate in the country
  • ✓Children qualify through CHIP up to 201% FPL
  • ✓Pregnant women qualify up to 198% FPL
  • ✓Apply through YourTexasBenefits.com

What Texas Medicaid / CHIP Covers

✓ Doctor visits
✓ Hospital care
✓ Prescription drugs
✓ Mental health
✓ Dental (limited)
✓ Vision (limited)

Who Qualifies in Texas?

Children
Most children under 19 qualify regardless of immigration status through CHIP or Medicaid.
Pregnant women
Pregnant women typically qualify at higher income limits than standard Medicaid in Texas.
Low-income adults
Texas has not expanded Medicaid. Non-disabled adults without children may not qualify.
Seniors & disabled
Adults 65+ and people with disabilities may qualify through SSI-related Medicaid programs.

About Texas Medicaid / CHIP

Texas Medicaid is one of the most restrictive programs in the country. Texas has not expanded Medicaid under the Affordable Care Act, meaning most low-income adults without dependent children do not qualify — even if they earn very little. Texas has the highest uninsured rate of any state, with roughly 5 million residents lacking coverage. Despite these limitations, specific groups — children, pregnant women, people with disabilities, and seniors — can access comprehensive coverage through Texas Medicaid and the Children's Health Insurance Program (CHIP). If you don't qualify for Medicaid in Texas, you may still be eligible for subsidized marketplace coverage through the ACA.

How to Apply for Texas Medicaid / CHIP: Step by Step

1
Check your eligibility
Texas Medicaid has strict eligibility rules. Children, pregnant women, people with disabilities, and seniors with limited income are the most likely to qualify. Adults without children rarely qualify in Texas. Take our free quiz for an instant estimate.
2
Create a YourTexasBenefits account
Go to YourTexasBenefits.com and create an account. This is the Texas Health and Human Services online portal where you apply for Medicaid, CHIP, SNAP, and other benefits.
3
Gather your documents
Collect proof of identity, Texas residency, income for all household members, Social Security numbers, and citizenship or immigration documents. Having these ready before you start significantly speeds up processing.
4
Submit your application
Apply online at YourTexasBenefits.com, by phone at 2-1-1 (Texas's health and human services hotline), by mail, or in person at your local Texas Health and Human Services office.
5
Await your decision
Most Medicaid applications in Texas are processed within 45 days. CHIP applications may be processed faster. You'll receive a letter with the decision. If denied, you have the right to appeal within 90 days.

Documents You Need to Apply

  • ☐Social Security number for each person applying
  • ☐Photo ID (driver's license, state ID, or passport)
  • ☐Proof of Texas residency (utility bill, lease, or bank statement)
  • ☐Proof of income (pay stubs, employer letter, or tax return)
  • ☐Proof of citizenship or immigration status
  • ☐Birth certificates for any children applying
  • ☐Medicare card if applicable

How Long Does Approval Take?

Standard Texas Medicaid applications are processed within 45 days. For disability-related applications, processing can take up to 90 days due to the medical determination required. Pregnant women may receive expedited processing. If you have a medical emergency, ask about emergency Medicaid, which can provide immediate limited coverage while your full application is reviewed.

Texas Medicaid FAQs

Who qualifies for Medicaid in Texas?

Texas Medicaid covers children through CHIP, pregnant women up to 198% FPL, people with disabilities, seniors with limited income, and some low-income parents. Non-disabled adults without dependent children generally do not qualify in Texas because the state has not expanded Medicaid.

Does Texas have Medicaid expansion?

No. Texas is one of approximately 10 states that have not expanded Medicaid under the Affordable Care Act. This means adults earning between 100% and 138% of the Federal Poverty Level who would qualify in expansion states are left without Medicaid coverage in Texas. They may qualify for subsidized marketplace plans instead.

How do I apply for Medicaid in Texas?

Apply online at YourTexasBenefits.com, by calling 2-1-1, by mail, or in person at your local Texas Health and Human Services office. The online portal is available 24/7 and is the fastest option.

Does CHIP cover children in Texas?

Yes. CHIP (Children's Health Insurance Program) covers children in families that earn too much for Medicaid but cannot afford private insurance. In Texas, children qualify through CHIP up to 201% of the Federal Poverty Level — about $5,221/month for a family of four.

What does Texas Medicaid cover?

Texas Medicaid covers doctor visits, hospital care, prescription drugs, mental health services, and emergency care. Dental and vision coverage for adults is limited compared to expansion states. Children receive more comprehensive dental and vision benefits through CHIP.

What if I don't qualify for Medicaid in Texas?

If you don't qualify for Medicaid, you may be eligible for subsidized health coverage through the ACA marketplace at HealthCare.gov. Texans earning between 100% and 400% of the Federal Poverty Level can qualify for premium tax credits that significantly reduce monthly plan costs.

Check your eligibility

Find out if you qualify for Texas Medicaid / CHIP in 60 seconds. Free, no obligation.

Check eligibility →

Apply directly in Texas

You can also apply directly through the state portal — though our enrollment specialists can help you navigate the process for free.

Apply at state portal →
⚠ Not an Expansion State

Texas has not expanded Medicaid. Eligibility is more restricted for adults.