Texas Medicaid & CHIP
Last updated August 2026
Texas Medicaid and CHIP cover children, pregnant women, seniors, and people with disabilities. The single most useful fact: the kids' income limits are far higher than most working parents assume. A family of four can earn $3,564 a month for free Children's Medicaid, or $5,386 a month for CHIP. One application at YourTexasBenefits.com checks both automatically.
CHIP is nearly free: the enrollment fee is $50 or less per family per year, and copays run $3 to $35. Lower-income families pay no fee at all. Both programs cover checkups, dentist visits, medicine, vaccines, hospital care, vision, hearing, mental health, and pre-existing conditions.
Be honest about the adult picture: Texas did not expand Medicaid. A non-disabled adult without dependent children generally cannot get Medicaid here at any income. Parents qualify only at extremely low income, around $285 a month for a two-parent family of four. So apply for the kids even when the adults have no path.
Pregnancy changes everything. Medicaid for Pregnant Women covers a family of two up to $3,571 a month, through the pregnancy plus 12 months postpartum. Earn too much for that? CHIP Perinatal picks up pregnancy care with slightly higher limits. Decisions for pregnant applicants must come within 15 working days; kids' cases within 45 days.
Once a child is in, coverage holds for 12 months straight, even if your income rises mid-year. If a child is denied Medicaid for income, HHSC screens them for CHIP automatically; no second application. And any denial can be appealed to a fair hearing within 90 days, where the agency, not you, carries the burden of proof.
Updated August 2026 Program details can change — confirm with the program directly.
Who qualifies
- Children 18 and younger qualify for CHIP with family income up to about $5,386/month for a family of 4
- Texas Medicaid mainly covers children, pregnant women, seniors, and people with disabilities; income limits for non-disabled adults are very restrictive
You may qualify. The program makes the final decision.
How to apply
- 1
Apply at YourTexasBenefits.com, or call 2-1-1 and pick option 2. One application checks Medicaid and CHIP for everyone.
- 2
Pregnant? Say so first. Your decision must come within 15 working days, and coverage runs 12 months past the birth.
- 3
Upload proof through your YourTexasBenefits account, or mail/fax it (HHSC, P.O. Box 149027, Austin, TX 78714-9027; fax 877-447-2839).
- 4
Watch for the decision: within 45 days for children's coverage.
- 5
If income is too high for Children's Medicaid, do nothing; HHSC automatically checks the child for CHIP.
- 6
Pay the CHIP enrollment fee if billed ($50 or less per family per year) so coverage starts.
- 7
Denied? Request a fair hearing within 90 days via 2-1-1 or in writing.
What the application looks like
Common questions
What is the income limit for CHIP in Texas?
About $2,622 a month for a family of one, $4,464 for three, $5,386 for four, before taxes. Children's Medicaid, which is completely free, reaches $3,564 a month for a family of four.
How much does CHIP cost?
At most $50 per family per year, plus copays of $3 to $5 for lower incomes and $20 to $35 for higher. Families at the lower end pay no enrollment fee. Children's Medicaid has no fees or copays at all.
Can adults get Medicaid in Texas?
Rarely. Texas did not expand Medicaid, so non-disabled adults without dependent children are excluded, and parents qualify only at extremely low income. Pregnant women, seniors, and people with disabilities have real paths; apply for those.
I'm pregnant and uninsured. What do I do?
Apply at YourTexasBenefits.com today. Medicaid for Pregnant Women covers up to $3,571 a month for a household of two, decisions come within 15 working days, and coverage lasts 12 months after birth. CHIP Perinatal catches those slightly over the limit.
Will a raise cost my child their coverage mid-year?
No. Both Children's Medicaid and CHIP give 12 months of continuous coverage once enrolled, regardless of mid-year income changes.
What if my child is denied?
If it was an income denial for Medicaid, HHSC auto-screens for CHIP. If you disagree with any decision, request a fair hearing within 90 days; the agency has to prove its case, and decisions come in writing.
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