Texas offers Medicaid health insurance to individuals and families who meet certain income and eligibility requirements. Pregnant women, children, the elderly, and people with disabilities can qualify for coverage. You may also be eligible if you receive Supplemental Security Income (SSI) or Temporary Assistance for Needy Families (TANF). To apply, residents can visit the Texas Health and Human Services website or contact their local Medicaid office. The application process includes providing personal information, income and asset details, and proof of residency. Once enrolled, individuals will receive a Medicaid ID card that allows them to access medical services covered by the program.
Who is Eligible for Medicaid in Texas?
To qualify for Medicaid in Texas, individuals must meet specific income and asset requirements. These limits vary depending on the type of Medicaid coverage and the individual’s circumstances.
Income Limits
The income limit for Medicaid in Texas is based on the Federal Poverty Level (FPL). The FPL is a measure of poverty used by the federal government to determine eligibility for various programs. In 2023, the FPL for a single person in Texas is $13,590 per year. For a family of four, the FPL is $27,750 per year.
- Individuals with incomes at or below 138% of the FPL are eligible for full Medicaid coverage.
- Individuals with incomes between 138% and 400% of the FPL may be eligible for limited Medicaid coverage.
- Individuals with incomes above 400% of the FPL are not eligible for Medicaid.
Asset Limits
In addition to income limits, Medicaid also has asset limits. Assets are any resources that an individual owns, such as cash, stocks, bonds, and real estate. The asset limit for Medicaid in Texas is $2,000 for individuals and $3,000 for couples.
There are some exceptions to the asset limit. For example, individuals can own a home, a car, and personal belongings without affecting their Medicaid eligibility.
Table of Income and Asset Limits
The following table summarizes the income and asset limits for Medicaid in Texas:
| Income Limit | Asset Limit | |
|---|---|---|
| Individuals | 138% of FPL | $2,000 |
| Couples | 138% of FPL | $3,000 |
| Children | 138% of FPL | No limit |
Note: The income and asset limits for Medicaid in Texas are subject to change. It is important to check with the Texas Health and Human Services Commission for the most up-to-date information.
Age and Disability Requirements
To qualify for Medicaid in Texas, individuals must meet specific age and disability requirements. Here’s a breakdown:
- Age Requirements:
- Children: Children under 19 years of age are eligible for Medicaid, regardless of their family’s income or assets.
- Pregnant Women: Pregnant women are eligible for Medicaid throughout their pregnancy and up to 60 days postpartum.
- Adults: Adults aged 19 to 64 may be eligible for Medicaid if they meet certain income and asset limits. However, Texas has strict income and asset limits, making it challenging for adults to qualify.
- Disability Requirements:
- SSI Recipients: Individuals who receive Supplemental Security Income (SSI) benefits are automatically eligible for Medicaid.
- Disabled Adults and Children: Adults and children with disabilities who meet the Social Security Administration’s (SSA) definition of disability may be eligible for Medicaid, regardless of their income or assets.
Table Summarizing Age and Disability Requirements:
| Age Group | Eligibility |
|---|---|
| Children under 19 | Eligible regardless of income or assets |
| Pregnant Women | Eligible throughout pregnancy and up to 60 days postpartum |
| Adults 19 to 64 | May be eligible if they meet income and asset limits |
| SSI Recipients | Automatically eligible |
| Disabled Adults and Children | May be eligible if they meet SSA’s definition of disability |
Requirements for Medicaid Eligibility in Texas
Medicaid is a government-funded health insurance program that provides coverage to low-income individuals and families. Eligibility varies across states, and Texas has specific criteria that must be met. Let’s explore the residency and citizenship requirements for Medicaid in Texas.
Residency Requirements
- U.S. Citizenship: U.S. citizens residing in Texas are eligible for Medicaid if they meet income and other program requirements.
- Legal Permanent Residents: Lawful permanent residents with legal residency status in Texas can apply for Medicaid subject to income and other criteria.
- Qualified Non-Citizens: Certain qualified non-citizens, such as refugees, asylees, Cuban/Haitian entrants, and victims of trafficking, may be eligible for Medicaid based on residency and other qualifications.
Citizenship Requirements
- U.S. Citizens: U.S. citizens residing in Texas can apply for Medicaid regardless of their immigration status.
- Legal Permanent Residents: Lawful permanent residents with qualifying residency status in Texas are eligible for Medicaid.
- Qualified Non-Citizens: Certain non-citizens meeting specific criteria, such as refugees, asylees, Cuban/Haitian entrants, and victims of trafficking, may be eligible for Medicaid.
- Undocumented Immigrants: Undocumented immigrants are not eligible for Medicaid in Texas, with limited exceptions for emergency medical services.
Additionally, applicants must meet income and asset limits set by the Texas Health and Human Services Commission to qualify for Medicaid. For more information, visit the Texas Medicaid website or contact the Texas Health and Human Services Commission.
| Household Size | Annual Income Limit |
|---|---|
| 1 | $18,754 |
| 2 | $25,092 |
| 3 | $31,430 |
| 4 | $37,768 |
| 5 | $44,106 |
| 6 | $50,444 |
| 7 | $56,782 |
| 8 | $63,120 |
Special Eligibility Categories
In addition to the general Medicaid eligibility criteria, there are a number of special eligibility categories that allow certain individuals to qualify for Medicaid in Texas, even if they do not meet the income and asset limits. These categories include:
- Pregnant Women: Pregnant women with incomes up to 200% of the federal poverty level (FPL) are eligible for Medicaid.
- Children: Children under the age of 19 with incomes up to 200% of the FPL are eligible for Medicaid.
- Parents and Caregivers of Children: Parents and caregivers of children under the age of 19 who meet certain income and asset limits are eligible for Medicaid.
- Individuals with Disabilities: Individuals with disabilities who meet certain income and asset limits are eligible for Medicaid.
- Residents of Nursing Homes: Residents of nursing homes who meet certain income and asset limits are eligible for Medicaid.
- Individuals Receiving Home and Community-Based Services (HCBS): Individuals receiving HCBS who meet certain income and asset limits are eligible for Medicaid.
The income and asset limits for these special eligibility categories vary depending on the category and the individual’s circumstances. For more information on Medicaid eligibility in Texas, please visit the Texas Health and Human Services website.
Below is a table that summarizes the special eligibility categories for Medicaid in Texas:
| Category | Income Limit | Asset Limit |
|---|---|---|
| Pregnant Women | 200% of FPL | N/A |
| Children | 200% of FPL | N/A |
| Parents and Caregivers of Children | Varies | Varies |
| Individuals with Disabilities | Varies | Varies |
| Residents of Nursing Homes | Varies | Varies |
| Individuals Receiving HCBS | Varies | Varies |
Hey there, folks! Thanks a million for taking the time to learn about who qualifies for Medicaid in the Lone Star State. I hope you found the information helpful and informative. If you have any more questions or if you’re curious about other healthcare programs in Texas, be sure to swing by our website again real soon. We’re always here to help you navigate the ins and outs of healthcare in Texas. In the meantime, stay healthy and keep smiling!