What to Know About Low Income Health Insurance in Texas
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Children's Medicaid and the Children's Health Insurance Program (CHIP) offer health insurance options for low income youth in Texas.
Adults have limited options for low income health insurance in Texas. It's difficult to qualify for Medicaid in Texas as an adult. Community health centers and low-cost health insurance plans might be options if you don't meet the Medicaid requirements. If you make at least $13,590 per year, you might get free or low-cost health insurance from the federal marketplace.
Texas low income health insurance income limits
Texas has several low income health insurance programs. To qualify, you can only make up to the income limit, which varies based on the number of people in your household.
Low income health insurance program | Monthly income limit for a family of three |
|---|---|
| Medicaid for qualifying adults | $331 |
| Children's Medicaid | $2,756 |
| Medicaid for pregnant women | $4,102 |
| Medicaid for breast and cervical cancer | $4,143 |
| Children's Health Insurance Program (CHIP) | $4,165 |
| CHIP for pregnant women | $4,185 |
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Medicaid for low income adults in Texas
Most adults without children are not eligible for Medicaid in Texas.
Parents, seniors and people with disabilities are eligible, but qualifying for Medicaid as an adult in Texas is difficult. The requirements are based on monthly income and vary based on the number of people in your household. A family of three, for example, can make no more than about $331 per month and must meet other requirements.
Pregnant women in Texas have two different program options for low income health insurance, and it's easier to qualify than it is for other adults.
Adults who have been diagnosed with breast or cervical cancer may have an easier time qualifying for Medicaid in Texas. To qualify, single individuals can make up to $29,160 per year, which is 200% of the federal poverty level. For a family of three, the cap is $49,720 per year. You also have to meet other requirements.
- Are between 18 and 64
- Are a U.S. citizen or eligible immigrant
- Live in Texas
- Have no other health insurance
- Need breast or cervical cancer treatment
Medicaid expansion in Texas
Texas has not expanded Medicaid. In states with expanded Medicaid, you can qualify based on just your income. A senior in Texas usually has to make less than $10,789 per year to qualify for Medicaid. That's 26% below the federal poverty level. Seniors also have to meet other requirements, like being enrolled in Medicare Part A. In the 40 states with expanded Medicaid, a single person can make up to $20,120 and still qualify without meeting other requirements.
An estimated 772,000 people in Texas make too much to qualify for Medicaid but make too little to get premium subsidies on the federal health insurance marketplace. This is called the "coverage gap." Texas has the largest coverage gap in the country. If Texas expanded its Medicaid system, it would be easier for low income adults to get health insurance coverage.
Texas Children's Medicaid
Children's Medicaid can provide low-cost or free health insurance in Texas.
Children's Medicaid is the best low income health insurance for children in Texas. Medicaid covers about 38% of the children in Texas. The program provides coverage for most common health care services.
- Checkups at the doctor
- Dental visits
- Medicine and vaccines
- Hospital care and services
- X-rays and lab tests
- Vision and hearing care
- Access to medical specialists
- Access to mental health care
- Special health needs
- Preexisting conditions
Children's Medicaid in Texas also covers some forms of long-term care for children with disabilities, which sets it apart from the other low income health insurance programs in Texas.
- Home care and personal care
- Transportation to medical appointments
- Nursing home care
- Mental illnesses hospitalization
- Care for children with intellectual disabilities
To qualify, a child must be under 18, although some 19-year-olds and 20-year-olds with disabilities qualify. A child must also be a Texas resident and either a U.S. citizen or a qualified noncitizen.
There are also monthly income caps for Children's Medicaid.
Texas Children's Medicaid income limits
People in household | Monthly income limit |
|---|---|
| 1* | $1,616 |
| 2 | $2,186 |
| 3 | $2,756 |
| 4 | $3,325 |
| 5 | $3,895 |
*A single household member is a child who doesn't live with a parent or relative.
If your household has more than eight people in it, add $570 to the income limit for each additional person.
Keep in mind that it is possible for your child to qualify for Medicaid even if you don't. For example, a household with three people can make up to $2,756 per month and still get Medicaid for their child. But for adults to qualify, a family of three can make no more than about $331 per month.
If you make too much for your child to qualify for Children's Medicaid, your child may qualify for the Texas Children's Health Insurance Program (CHIP).
Medicaid disenrollment in Texas
The Kaiser Family Foundation estimates that up to 476,700 adults and 760,900 children could lose Medicaid coverage in Texas by March 2024. Continuous enrollment, which meant that people who were covered by Medicaid did not have to reenroll to keep their coverage, ended on March 31, 2023. Contact the Texas Health & Human Services Commission to see if you are still eligible for Medicaid and to reenroll.
Children's Health Insurance Program (CHIP) in Texas
If your income is too high to qualify for Children's Medicaid, the Children's Health Insurance Program (CHIP) could be a good option.
Texas CHIP coverage is similar to Children's Medicaid but does not include any coverage for long-term disability support or services.
Children must be 18 or under, Texas citizens and either U.S. citizens or qualified noncitizens. The income limits for CHIP are higher than those for Children's Medicaid. This means you can make more money and still qualify for the Texas Children's Health Insurance Program.
CHIP income limits in Texas
People in household | Monthly income limit |
|---|---|
| 1* | $2,443 |
| 2 | $3,304 |
| 3 | $4,165 |
| 4 | $5,025 |
| 5 | $5,886 |
*A single household member is a child who doesn't live with a parent or relative.
Households with more than seven people should add $861 per person to the income limit.
Low income health insurance for pregnant women in Texas
Pregnant women in Texas have two options for low income health insurance: Medicaid for pregnant women and CHIP for pregnant women. The monthly income limit for CHIP is slightly higher, so it's easier to qualify.
Medicaid for pregnant women in Texas
Medicaid provides health insurance coverage for low income pregnant women in Texas.
Medicaid for pregnant women in Texas covers services like:
- Prenatal doctor visits
- Prenatal vitamins
- Labor and delivery
- Checkups for the baby after birth
To qualify, you must be a Texas resident and a U.S. citizen or qualified noncitizen.
You also have to meet income requirements, which Texas breaks down monthly. The requirements vary based on how many people are in your household.
Texas Medicaid income limits for pregnant women
People in household | Monthly income limit |
|---|---|
| 1 | $2,406 |
| 2 | $3,254 |
| 3 | $4,102 |
| 4 | $4,950 |
| 5 | $5,799 |
For each person over five in the household, add $849 per month to the income limit.
CHIP for pregnant women
Pregnant women might also qualify for the Children's Health Insurance Program in Texas. If you are pregnant but make too much to qualify for Medicaid, you could consider CHIP Perinatal.
CHIP Perinatal and Medicaid cover similar things, including prenatal doctor visits, labor and delivery, and baby checkups after birth.
The income limits for CHIP Perinatal are slightly higher, which means you can make more and still qualify.
CHIP income limits for pregnant women in Texas
People in household | Monthly income limit |
|---|---|
| 1 | $2,455 |
| 2 | $3,320 |
| 3 | $4,185 |
| 4 | $5,050 |
| 5 | $5,916 |
For households with more than five members, add an additional $866 per month per person.
Other low income health insurance options in Texas
If you don't qualify for Medicaid or CHIP, there are other options for low income health insurance in Texas.
Vaccines for Children program
If you or your child is 18 or under, the Texas Vaccines for Children program is a good way to get low-cost vaccinations. You or your child must be one of the following to qualify.
- Covered by Medicaid
- Covered by CHIP
- Uninsured
- Underinsured
- Of American Indian or Alaska Native heritage
Community centers
Community health care centers don't sell insurance. But they do offer low-cost health care. If you can't afford insurance, a community center can be a good way to get the health care you need.
If you go to a Federally Qualified Health Center (FQHC), you might get discounted health care. Fees are adjusted based on your income and family size. A Federally Qualified Health Center also cannot deny your care just because you can't afford to pay.
Alternative health plans
An alternative health plan is any plan that doesn't work like traditional health insurance.
Alternative health plans include things like short-term health insurance, limited benefit plans and health care sharing ministries.
These plans may limit the length of your coverage or only cover certain situations. Some alternative plans are not regulated by the state, so there's no guarantee that claims will be paid. While these plans can be a good option if you have no other choice, make sure you research the plan carefully and understand its limitations.
Premium subsidies
If you don't qualify for Medicaid, you could buy a traditional health insurance plan from the federal health insurance marketplace. Depending on your income, you might qualify for premium subsidies that can lower your monthly rate.
To qualify, you have to make at least the federal poverty level based on your household size.
Federal poverty level
People in household | Federal poverty level |
|---|---|
| 1 | $13,590 |
| 2 | $18,310 |
| 3 | $23,030 |
| 4 | $27,750 |
| 5 | $32,470 |
For families with over eight people, add $4,720 for each additional person.
If you make between 100% and 150% of the federal poverty level, you won't pay anything for a health insurance plan that you buy from the federal marketplace. That means an individual can make between $13,590 and $20,385 and get free health insurance. A family of three can make between $23,030 and $34,545 and get a free plan.
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Frequently asked questions
What is the best low income health insurance in Texas?
Medicaid is the best low income health insurance in Texas for children, but it's very difficult for adults to qualify. If you do qualify, Medicaid is a good option. If you make too much to qualify for Medicaid, you could buy an alternative health plan, get health care at a community center or look for cheap traditional health insurance.
What company has the cheapest health insurance in Texas?
Aetna and Cigna have cheap health insurance in Texas. If you don't qualify for Medicaid, you could consider buying a traditional health insurance policy. If you buy the policy on the federal marketplace, you might qualify for premium subsidies that can make your health insurance cheaper.
What is Texas STAR Medicaid?
If you have STAR Medicaid, also called managed care, that means your Medicaid benefits come from a health insurance company. In most parts of Texas, you'll have at least two companies you can choose from. You'll then get your health care from doctors and hospitals within your company's network.
Sources
Information for this article was sourced from HealthCare.gov, the Kaiser Family Foundation, the Texas Department of State Health Services, the Texas Health & Human Services Commission and Texas.gov.