Texas Medicaid Eligibility


 

Texas Medicaid Income Guidelines

Below, we have indicated the current requirements for Medicaid in Texas by the percentage of household income in relation to the Federal Poverty Level (see below). If you are a low-income adult under age 65 with no children in Texas, you are unfortunately ineligible for Medicaid, regardless of your lack of means or employment status. Medicaid is a program designed to assist low-income families, children, families-to-be (pregnant women), and other uninsured individuals in need of medical coverage. Medicaid offers health insurance coverage to the following individuals who meet the income criteria dictated by the state of Texas.

Group                                       Income (percent of FPL)

Infant                                                    185%

Child age 1-5                                        133%

Child age 6-19                                      100%

Parent (unemployed)                            12%

Parent (employed)                                 26%

Pregnant Women                                  185%

Single Aged/Blind/Disabled                   75%

Aged/Blind/Disabled Couple                  83%

 

Other Eligible Groups

  • Families who receive Temporary Assistance for Needy Families (TANF) benefits
  • Supplemental Security Income (SSI) beneficiaries
  • Disabled individuals who no longer qualify for SSI benefits
  • Low-income Medicare recipients
  • Qualified Medicare Beneficiary (QMB) program: Medicaid pays your Medicare monthly premium, deductibles, and coinsurance if your income is below the poverty level.
  • Specified Low-Income Medicare Beneficiary (SLMB) program: Medicaid pays your monthly premiums only if your income is below 120% FPL.
  • Medically Needy program: Medicaid for those who have high medical expenses that when subtracted from your income deem you eligible for Medicaid.

 

Federal Poverty Level 2012

 

Resources

Texas Health & Human Services Commission: Medicaid

Texas Medicaid Client Hotline: 800-252-8263

Apply for CHIP/Children’s Medicaid: 800-647-6558

HHSC Office of the Ombudsman: 877-787-8999 or 888-425-6889 for deaf or hearing impaired