Texas Medicaid

Texas Medicaid serves primarily children from low-income families, pregnant women, people age 65+ and people with disabilities who could not otherwise afford private insurance coverage.

Most people who receive Medicaid in Texas are enrolled in one of the following managed care programs:

STAR
The largest program, serving low-income families, children, and pregnant women.
STAR Kids
Specifically for children and youth (age 20 and younger) with disabilities.
STAR Health
Coordinated healthcare for children in foster care.
STAR+PLUS
For adults 65 and older or adults with disabilities, covering health care and long-term services, including nursing home care or home care.

Beyond the primary managed care plans, Texas offers several targeted programs:

Children’s Health Insurance Program (CHIP)
Coverage for children under 18 in families who earn too much for Medicaid.
Medicaid for Pregnant Women
Covers pregnant women, often up to 12 months postpartum.
Healthy Texas Women (HTW)
Offers family planning and preventive services to low-income women (ages 15–44) who do not qualify for full Medicaid.

Because Texas has not expanded Medicaid under the Affordable Care Act, coverage is largely limited to specific, vulnerable populations rather than all low-income adults.

FAQ

What is the monthly limit for Medicaid in Texas?

Eligibility for non-disabled adults is limited to parents with incomes below 15% of the poverty level whose child is enrolled in Medicaid. Children under age 19 are covered up to 144% of the poverty level.

texas MedicaidHousehold Size	144% Child 0—18	203% Pregnant Women	15% Adults 19—64
1	$1,915	$2,700	$200
2	$2,597	$3,661	$271
3	$3,278	$4,622	$342
4	$3,960	$5,583	$413
5	$4,642	$6,543	$484
6	$5,323	$7,504	$555
7	$6,005	$8,465	$626
8	$6,686	$9,426	$697

A 5% disregard based on the federal poverty level (FPL) for the household size may be applied and is reflected in the amounts shown above. Source: Kaiser Family Foundation (KFF).

How much can I make in Texas and still get Medicaid?

For a single mother with two kids, the parent is only eligible for Medicaid if the kids are on Medicaid and her total household income doesn’t exceed $4,098 per year or $342 per month.

This creates a large “coverage gap” where they don’t qualify for Medicaid but struggle to afford private insurance, while their children often do qualify.

Is there Medicaid for adults in Texas?

No, adults without dependents are ineligible for Medicaid regardless of how low their income is, unless they’re disabled, in which they have the option to “buy-in” to Medicaid coverage by making monthly payments.

How do I apply for Medicaid in Texas?

Go to a Texas Health and Human Services (HHS) benefits office near you or apply online through Your Texas Benefits and choose “Apply for new benefits.”

Texas Health and Human Services Commission
Medicaid & CHIP Services
(800) 335 8957