Medicaid is free or low-cost health coverage for Texans with limited income. Whether you qualify depends mostly on your household size, your income, and your situation — like being a child, a parent, pregnant, a senior, or living with a disability. This guide explains it all in plain language.
Texas Health Help is a community nonprofit. We do not approve benefits, but we share clear, trustworthy information and help families across rural and underserved Texas understand their options and connect to the right resources — for free.
What is Texas Medicaid?
Medicaid is a program run by the State of Texas (HHSC) and the federal government that pays for medical care for people with low income. It covers doctor visits, hospital care, prescriptions, and more — so cost doesn't keep you or your family from getting care.
Texas Medicaid is made up of several programs. Children, pregnant women, and people with disabilities have higher income limits than other adults, so many working families still qualify for at least one program.
2026 Texas Medicaid Income Limits (by Program)
Texas Medicaid income limits are based on your household sizeand the program you apply for, measured as a percentage of the Federal Poverty Level (FPL). Pregnancy and children's programs use the most generous limits, while coverage for adults is far more limited.
| Program / who it covers | Income limit |
|---|---|
| Babies under age 1 | Up to ~198% FPL |
| Children ages 1–5 | Up to ~144% FPL |
| Children ages 6–18 | Up to ~133% FPL |
| CHIP (children) | Up to ~201% FPL |
| Pregnant women | Up to ~198% FPL |
| CHIP Perinatal (during pregnancy) | Up to ~201% FPL |
| Parents & caretaker relatives | About ~15% FPL (very low) |
| Adults 65+ / with a disability | Tied to SSI (~$967/mo individual) |
| Adults without children or a disability | Not covered — Texas hasn't expanded Medicaid |
What that looks like in monthly income
Example: the monthly income limit for a pregnant woman or a baby under age 1 (about 198% FPL). Remember a pregnant woman's unborn baby counts toward household size.
| Household size | Approx. monthly limit (≈198% FPL) |
|---|---|
| 2 | ~$3,490 / month |
| 3 | ~$4,397 / month |
| 4 | ~$5,305 / month |
| 5 | ~$6,212 / month |
- Children often qualify even when parents earn a moderate income.
- Pregnant women have higher limits — and the unborn baby counts toward household size.
- Parents and caretakers have much lower limits than children.
- Seniors (65+) and people with disabilities qualify under different, SSI-related rules.
These figures are approximate and update each year, so the most reliable way to know is to apply — there's no cost to check, and the state runs the math across every program at once.
What Does Medicaid Cover?
Texas Medicaid generally covers:
- Doctor and clinic visits
- Hospital and emergency care
- Prescriptions
- Lab tests and X-rays
- Pregnancy and newborn care
- Checkups and shots for children
- Mental health and counseling
- Rides to covered medical appointments
Who May Qualify?
You may qualify for some form of Texas Medicaid if you are:
- A child under 19 in a low- or moderate-income household
- Pregnant and living in Texas
- A parent or caretaker of a child with limited income
- Age 65 or older
- Living with a disability
- A U.S. citizen or qualified non-citizen
Not sure? Apply anyway. The state will check your eligibility for free, across every program at once.
How to Apply (Step by Step)
- 1
Gather your documents
Use the checklist below so you have everything ready in one sitting.
- 2
Choose how you want to apply
Online at YourTexasBenefits.com, by phone at 2-1-1 (press option 2), by mail, or in person at a local HHSC benefits office.
- 3
Fill out one application
One Texas application can check you for Medicaid, CHIP, CHIP Perinatal, SNAP, and more at the same time.
- 4
Submit and watch for requests
The state may ask for more documents. Send them in right away to avoid delays — most applications are decided within about 45 days.
- 5
Get help if you're stuck
If anything is confusing, our community navigators can walk through it with you — free and confidential.
What Documents May Be Needed
Most applications ask for some version of the following:
- Photo ID (driver's license, state ID, or passport)
- Proof of income (recent pay stubs, benefits letter, or tax return)
- Proof of address (utility bill, lease, or piece of mail)
- Household info (names, birthdays, and Social Security numbers)
- Proof of citizenship or qualified immigration status
- Proof of pregnancy, if applicable (a note from your clinic)
Helpful Texas Resources
YourTexasBenefits.com
Apply online for Medicaid, CHIP, SNAP, and more — one application for many programs.
Texas HHSC
Official state information on Medicaid programs, benefits, and local offices.
2-1-1 Texas
Free, statewide helpline. Dial 2-1-1 to connect with health and community services.
Pregnant? See our Pregnancy Medicaid guide and CHIP Perinatal guide.
Need help applying for Texas Medicaid?
You don't have to figure this out alone. Our community navigators help Texas families understand eligibility, gather documents, and apply — at no cost and in plain language.
Related guides & resources
CHIP Texas 2026
Low-cost coverage for children when you earn a little too much for Medicaid.
Pregnancy Medicaid
Coverage for prenatal care, delivery, and postpartum in Texas.
How to Apply for SNAP
Texas food-stamp income limits and a step-by-step application guide.
Senior Support
Medicare, long-term care, and benefits help for older Texans.
Free & Low-Cost Clinics
Find sliding-scale and no-cost clinics near you across Texas.
Free Rides to the Doctor
NEMT transportation benefits for Medicaid members in Texas.
Frequently Asked Questions
What are the income limits for Medicaid in Texas?+
Texas Medicaid income limits depend on your household size and program. Children's and pregnancy coverage use the highest limits — babies under 1 and pregnant women qualify up to about 198% of the federal poverty level (roughly $4,397/month for a household of 3), and CHIP reaches about 201%. Parents and caretakers have a much lower limit (around 15% FPL), and most adults without children or a disability aren't covered because Texas hasn't expanded Medicaid. Numbers change yearly, so the most reliable step is to apply — the state checks your eligibility for free.
Who qualifies for Medicaid in Texas?+
You may qualify if you are a Texas resident with low or moderate income and you are a child, a pregnant woman, a parent or caretaker of a child, age 65 or older, or living with a disability. U.S. citizens and many qualified non-citizens are eligible. Even if you're unsure, it's worth applying.
Can adults without children get Medicaid in Texas?+
Texas has not expanded Medicaid to most low-income adults without children or a disability, so many adults won't qualify on income alone. If that's you, you may still qualify for low-cost coverage through the Health Insurance Marketplace, and our navigators can help you explore that for free.
Does household size include everyone living with me?+
Medicaid counts your tax household — generally you, your spouse, and the people you claim as dependents. If you're pregnant, your unborn baby (or babies) count toward your household size, which raises your income limit.
How long does it take to get approved?+
Most Medicaid applications are processed within about 45 days. Pregnancy-related applications are treated as time-sensitive and can move faster. Sending in any requested documents right away helps avoid delays.
What if I make too much for Medicaid?+
You may still qualify for CHIP (children's coverage), CHIP Perinatal (care during pregnancy), or low-cost plans through the Marketplace. One Texas application can check you for several programs at once.
Is applying free?+
Yes. Applying for Texas Medicaid is always free, and checking your eligibility costs nothing. Be cautious of any website or person that charges a fee to apply.
Does Texas Health Help decide if I qualify?+
No. We are a community nonprofit. We help you understand the program and gather what you need. Only the State of Texas (HHSC) can approve benefits.
Disclaimer: Texas Health Help (Community Health Access Hub Texas) is a community nonprofit, not a government agency. We do not determine eligibility or approve benefits. Only the State of Texas Health and Human Services Commission (HHSC) and program administrators can make those decisions. This page is general educational information and is not legal, medical, or financial advice.