The Medicaid Income Limit is the most important criteria for deciding whether you qualify for Medicaid in your state. In this post, we are going to explain in detail the Texas Medicaid Income Limits for 2021.
Based on this information, you will be able to determine whether your income qualifies you for Texas Medicaid or not.
However, before we get into details about the income limit, we will first explain the Medicaid program in Texas and how it works.
Next, we will discuss who is eligible for Medicaid, including how eligibility works for various categories, including Children, Pregnant Women, and Adults.
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
How Many People are on Medicaid?
According to the Centers for Medicare & Medicaid Services, as of November 2020, here are the number of people enrolled in Medicaid and Chip in the entire United States:
- 78,521,263 individuals were enrolled in Medicaid and CHIP
- 72,204,587 individuals were enrolled in Medicaid
- 6,695,834 individuals were enrolled in CHIP
Texas Medicaid
The Texas Medicaid program provides medical coverage to low-income individuals and families.
As of 2020, the program, along with the Children’s Health Insurance Program (CHIP) covered 4.7 million people.
This includes 3.7 million children as shown by the image below.
Medicaid services in Texas are run by the Texas Health and Human Services Commission (HHS).
Who Can Get Medicaid in Texas?
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
Texas Medicaid Income Limit
The Texas Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line.
To qualify, you must meet the Texas Medicaid Income limits listed below.
Here is the Federal Poverty Level (FPL) for 2021.
| 2021 Federal Poverty Levels for the 48 Contiguous States & D.C. | |||
| Household Size | Poverty Guideline for 48 states & DC | Alaska | Hawaii |
| 1 | $12,880 | $16,090 | $14,820 |
| 2 | $17,420 | $21,770 | $20,040 |
| 3 | $21,960 | $27,450 | $25,260 |
| 4 | $26,500 | $33,130 | $30,480 |
| 5 | $31,040 | $38,810 | $35,700 |
| 6 | $35,580 | $44,490 | $40,920 |
| 7 | $40,120 | $50,170 | $46,140 |
| 8 | $44,660 | $55,850 | $51,360 |
| Over 8 people | add $4,540 for each additional person | $5,680 | $5,220 |
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 198 percent of FPL
- Any child age 1-5 with a family income up to 144 percent of FPL
- Children ages 6- 18 with family income up to 133 percent of FPL
- CHIP for children with family income up to 201 percent of FPL
- Pregnant women with family income up to 198 percent of FPL
- Parents of minor children with family income up to 14 percent of FPL
- Individuals who are elderly, blind, and disabled with family income up to 74% of the FPL
Texas Medicaid Income Limit Charts
The Texas Medicaid eligibility income limit charts are divided by groups.
For example, the first chart is focused on income limits for children who qualify for Medicaid.
Similarly, the second chart below focuses on the Medicaid income limits for adults in Texas who qualify for Medicaid.
Texas Medicaid Income Limit for Children
Below is the income limit for children by age category. Find the age category your child falls into and you will see the income limit by household size.
| Texas Medicaid Income Limit – Children | ||||||
| Children Medicaid Ages 0-1 | Children Medicaid Ages 1-5 | Children Medicaid Ages 6-18 | Children Separate CHIP | |||
| % FPL | 100% | 198% | 144% | 133% | 201% | |
|
Household Size
|
1 | $12,880 | $25,502 | $18,547 | $17,130 | $25,889 |
| 2 | $17,420 | $34,492 | $25,085 | $23,169 | $35,014 | |
| 3 | $21,960 | $43,481 | $31,622 | $29,207 | $44,140 | |
| 4 | $26,500 | $52,470 | $38,160 | $35,245 | $53,265 | |
| 5 | $31,040 | $61,459 | $44,698 | $41,283 | $62,390 | |
| 6 | $35,580 | $70,448 | $51,235 | $47,321 | $71,516 | |
| 7 | $40,120 | $79,438 | $57,773 | $53,360 | $80,641 | |
| 8 | $44,660 | $88,427 | $64,310 | $59,398 | $89,767 | |
Next is the income limit for adults by category. Find the category you fall into and you will see the income limit by household size.
Texas has not expanded Medicaid to include adults without dependents.
Therefore, adults without dependents do not qualify for Medicaid in Texas.
For an update on the Medicaid expansion debate and timeline in Texas, see our Texas Medicaid Expansion update below.
Texas Medicaid Income Limit for Adults
| Texas Medicaid Income Limit – Adults | ||||||
| Pregnant Women Medicaid | Adults (Medicaid) Parent/ Caretaker | Seniors & People w/ Disabilities (Medicaid) | Adults (Medicaid) Expansion to Adults | |||
| % FPL | 100% | 198% | 14% | 74% | NO | |
|
Household Size
|
1 | $12,880 | $25,502 | $1,803 | $9,531 | N/A |
| 2 | $17,420 | $34,492 | $2,439 | $12,891 | N/A | |
| 3 | $21,960 | $43,481 | $3,074 | $16,250 | N/A | |
| 4 | $26,500 | $52,470 | $3,710 | $19,610 | N/A | |
| 5 | $31,040 | $61,459 | $4,346 | $22,970 | N/A | |
| 6 | $35,580 | $70,448 | $4,981 | $26,329 | N/A | |
| 7 | $40,120 | $79,438 | $5,617 | $29,689 | N/A | |
| 8 | $44,660 | $88,427 | $6,252 | $33,048 | N/A | |
How to Read the Texas Medicaid Income Limits Charts Above
You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.
Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.
For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 198% of the Federal Poverty Level – which for a family of two is $34,492 as shown in the chart above.
How to Apply for Texas Medicaid
There are 2 ways you can apply for Medicaid in Texas.
Option 1 – Apply online
You can apply online through the Your Texas Benefits Portal – as shown in the image below.
If you have an account, you can log in or create your Your Texas Benefits Account. Click here to be taken to the website.
Option 2 – Apply at HHS Office Near You
You can apply in person at the Texas Health and Human Services Commission (HHS) office near you. Click here to locate an HHS office.
Texas Medicaid Phone Number
Here’s how to contact the Texas Medicaid Agency:
Texas Medicaid Phone Number: Call toll-free at 800-252-8263.
You can find out if you have Medicaid by phone:
Call toll-free at 800-252-8263, 2-1-1 or 877-541-7905.
Choose English or Spanish.
Choose option 2. The person you speak with can help you find out if you have Medicaid or not.
Texas Medicaid Expansion Update
Texas has not expanded Medicaid under the Affordable Care Act (ACA).
As a result, Texas has the biggest coverage gap in the country, with an estimated 761,000 residents ineligible for Medicaid and also ineligible for premium subsidies to offset the cost of private coverage in the exchange.
Also, it is estimated that about 1.7 million additional people would be covered if the state accepted Medicaid expansion under the ACA.
Additionally, Non-disabled, non-pregnant adults are only eligible for Medicaid if they have a minor child and earn less than 14% of the poverty level.
Furthermore, the Texas Medicaid enrollment has only grown by 3% since 2013.
Texas Medicaid Income Limits Summary
We hope this post on Texas Medicaid Income Limits was helpful to you.
If you have any questions about Medicaid in the state of Texas, you can ask us in the comments section below.
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Be sure to check out our other articles about Medicaid.
Income limits for Florida Medicaid
Tennessee TennCare Income Limits Charts
Utah CHIP Program Income Limits
Vermont Dr Dynasaur CHIP Income Limits