Emergency Medicaid in Texas: Coverage for Emergency Services 2025

Last Updated: 17 November 2025

Need Emergency Care Right Now? Read This First

EMERGENCY? GO TO THE HOSPITAL NOW. Read this later.

Quick Answer: Emergency Medicaid in Texas pays for life-saving medical care – even if you have NO insurance, NO money, and NO legal status.

If you’re having a heart attack, serious accident, stroke, or baby delivery, Texas will cover your hospital bills. You apply AFTER getting treatment.

Who Gets This:

• ✓ Undocumented immigrants
• ✓ People with no insurance
• ✓ Low-income Texas residents
• ✓ Anyone with a life-threatening emergency

What’s Covered:

• ✓ Emergency room visits
• ✓ Emergency surgery
• ✓ Labor and delivery (having a baby)
• ✓ Life-threatening injuries
• ✗ Regular checkups (NOT covered)
• ✗ Follow-up care (NOT covered)

How to Get It:

1. Get emergency treatment FIRST at any hospital
2. Apply LATER (up to 3 months after)
3. Go to YourTexasBenefits.com or call 2-1-1
4. No cost if approved

Bottom Line: In Texas, emergency rooms MUST treat you regardless of ability to pay, citizenship, or insurance. Your life comes first. Paperwork comes second.

What is Emergency Medicaid?

Emergency Medicaid is Texas’s way to pay for urgent medical care. It helps people who cannot get regular Medicaid. This includes people who:

• Are undocumented
• Make a little too much money for regular Medicaid
• Don’t have health insurance

This is NOT full health insurance. It only pays for sudden, serious problems like:

• Heart attacks
• Strokes
• Bad car accidents
• Having a baby
• Broken bones that need surgery

Texas pays hospitals about $1 billion every year for emergency care. In 2025, some delays happened, but hospitals must treat you first. For more details about regular coverage, see standard Texas Medicaid programs.

Who Can Get Emergency-Only Coverage?

You can get Emergency Medicaid if you:

1. Live in Texas
You must live here. Even if you just moved, you may qualify.

2. Meet Income Rules
Your monthly income must be low enough:

• Pregnant women: Up to 198% FPL (about $2,583 for one person)
• Other adults: Lower amounts

3. Have an Emergency
You must be very sick or badly hurt. Your problem could cause:

• Death
• Serious harm to your body
• Loss of body parts or functions

Important Facts:

• No citizenship needed. Undocumented people can get this.
• No asset test. They don’t check your savings or car.
• Hospitals check after they help you, not before.

You can apply up to 3 months after getting care. For regular Medicaid rules, see the full Medicaid eligibility requirements.

What Medical Problems Are Covered?

Emergency Medicaid only covers life-threatening problems:

YES – These Are Covered:

• Heart attacks and chest pain
• Strokes
• Serious bleeding
• Bad infections
• Organ failure
• Bad accidents
• Broken bones needing surgery
• Severe pain that could be dangerous
• Labor and having a baby

NO – These Are NOT Covered:

• Regular checkups
• Routine doctor visits
• Refilling medicines
• Follow-up care after you are stable
• Preventive care like flu shots

2025 keeps covering “sudden onset” emergencies. Hospitals bill Texas after treating you. If approved, you pay nothing.

For more on emergency services, check emergency services under regular Medicaid.

Emergency Labor and Delivery

Yes, childbirth is fully covered. Labor counts as an emergency. Full coverage includes:

• Normal delivery
• C-section surgery
• Pain medicine (epidurals)
• Baby care right after birth
• Any delivery problems

No approval needed first. Hospitals treat you and bill later.

For Undocumented Moms:

• Birth is covered (emergency)
• Prenatal care before birth is NOT covered
• Postpartum care after birth is NOT covered
• BUT your baby born here is a U.S. citizen
• Your baby gets full Medicaid right away

2025 saw more moms using this because of Medicaid changes. For pregnancy details, see emergency pregnancy coverage.

Coverage for Undocumented Immigrants

Yes, undocumented people get Emergency Medicaid. But only for real emergencies, not regular care.

What You Get:

• Emergency room care
• Emergency surgery
• Hospital stays for emergencies
• Labor and delivery

What You DON’T Get:

• Doctor checkups
• Regular medicines
• Follow-up visits
• Preventive care

About Immigration Questions: Hospitals may ask your status (started November 2024). But:

• You can refuse to answer
• They still must treat you
• Federal law requires emergency care for everyone

Your Baby: If your baby is born in Texas, they are automatically a U.S. citizen with full Medicaid.

How to Apply After Emergency Treatment

You can apply AFTER getting care. Up to 3 months back.

How to Apply:

1. Online: YourTexasBenefits.com (fastest)
2. Phone: Call 2-1-1
3. In Person: Visit local HHS office
4. At Hospital: Ask hospital staff to help

What You Need:

• ID (any ID, even from another country)
• Proof you live in Texas (bill, mail)
• Income papers (pay stubs)
• Hospital bills

How Long: Up to 45 days. But if approved, it covers your emergency even before you applied.

2025 has some delays. But keep trying. If you qualify for regular Medicaid, learn how to apply for full coverage.

Hospital Presumptive Eligibility

Hospitals can approve you RIGHT AWAY during your emergency. This is called “presumptive eligibility.”

How It Works:

• Hospital staff check if you might qualify
• They give you temporary coverage (up to 60 days)
• Covers your emergency while you apply for full approval
• Very little paperwork needed at first

Who Gets This:

• Pregnant women in labor
• Undocumented people with emergencies
• Anyone in a medical crisis

2025 keeps this system. It helps during backlogs.

Limitations of Emergency Coverage

Emergency Medicaid is limited. Here’s what it does NOT cover:

NO Follow-Up Care:

• Once you are stable, coverage stops
• No doctor visits after leaving hospital
• No physical therapy
• No continuing treatment

NO Medicines:

• Pills you take home are not covered
• Ongoing prescriptions not included

NO Preventive Care:

• No checkups
• No screenings
• No vaccines

NO Chronic Disease Help:

• No diabetes care
• No blood pressure checks
• No asthma treatment

When Coverage Ends: Once you are “stable” (not in danger), coverage stops. This could leave bills for ongoing care.

2025 has stricter checks. If reviewers say it wasn’t a “true emergency,” they might deny coverage.

Transitioning to Full Medicaid

After an emergency, you might qualify for full Medicaid:

Pregnant Women:

• Apply for full pregnancy Medicaid
• Get 12 months of postpartum coverage
• Automatic extensions for new moms

Newborns:

• Babies born in Texas automatically qualify
• Full Medicaid from birth
• Report birth quickly to HHS

Low-Income People:

• If you meet income and citizenship rules
• Get ongoing health coverage
• Apply through YourTexasBenefits.com

2025 has slower processing. But pregnant women and babies get priority.

Emergency vs. Urgent Care

Know the difference to avoid surprise bills:

Emergency Care (COVERED):

• Life-threatening problems
• Chest pain (heart attack)
• Trouble breathing
• Bad bleeding
• Stroke signs
• Serious accidents
• Go to: Hospital Emergency Room

Urgent Care (NOT COVERED):

• Problems that need quick care but won’t kill you
• Sore throat
• Small sprains
• Mild fever
• Minor cuts
• Go to: Urgent care clinic, community health center

Gray Areas: Some problems are in between. You might think it’s an emergency, but reviewers might disagree later.

When in Doubt: If you think you’re dying or seriously hurt, GO TO THE ER. Your health comes first. Worry about bills later.

Conclusion: Your Life Matters More Than Paperwork

Emergency Medicaid in Texas exists for one simple reason: No one should die or suffer permanent harm because they can’t afford emergency care. This program has saved thousands of lives and paid over $1 billion in emergency medical bills for Texans who had nowhere else to turn.

Remember These Critical Facts:

You WILL Get Emergency Care: Federal law (EMTALA) requires every hospital emergency room to examine and stabilize you – regardless of your ability to pay, insurance status, or immigration status. They cannot turn you away. They cannot demand payment up front. Your emergency treatment happens FIRST, always.

You CAN Get It Covered: Emergency Medicaid pays for that care retroactively. Even if you’re undocumented, uninsured, or low-income, you can apply up to 3 months after your emergency and get those hospital bills covered. Many people who think they don’t qualify actually do.

The Limits Are Real: This is NOT health insurance. It only covers the emergency itself – not follow-up care, not medications you take home, not physical therapy, not ongoing treatment. Once you’re stable, coverage stops. If you need continuing care, you’ll need to find other options or apply for full Medicaid if you qualify.

Take Action Now:

If You’re Having an Emergency RIGHT NOW:

• Stop reading
• Call 911 or go to the nearest emergency room immediately
• Don’t worry about money, papers, or insurance
• Your life is the priority

If You Recently Had an Emergency:

• Apply for Emergency Medicaid within 3 months
• Go to YourTexasBenefits.com (fastest)
• Call 2-1-1 for help
• Ask hospital billing department for assistance
• Gather your ID, proof of Texas residence, and income papers

If You Need Ongoing Healthcare: Emergency Medicaid won’t cover your regular health needs. Check if you qualify for:

• Standard Texas Medicaid programs for full coverage
• Community health centers with sliding-scale fees
• County hospital district programs
• Federally Qualified Health Centers (FQHCs)

Special Note for Pregnant Women: If you’re pregnant and had emergency labor covered, you may qualify for 12 months of full Medicaid postpartum coverage. Your baby automatically gets full Medicaid as a U.S. citizen. Apply immediately at YourTexasBenefits.com or through your hospital.

Special Note for Undocumented Residents: You have the same right to emergency medical care as anyone else in Texas. Don’t let fear prevent you from seeking life-saving treatment. While hospitals may ask about immigration status, you can decline to answer, and they still must treat your emergency. Your baby born in Texas is automatically a U.S. citizen with full Medicaid eligibility.

The Bottom Line: Emergency Medicaid isn’t perfect. It won’t solve all your healthcare needs. But it exists to ensure that when you face a medical crisis – when your life or health hangs in the balance – money and paperwork don’t stand between you and survival.

Your health matters. Your life matters. Get the emergency care you need. We’ll figure out the rest afterward.

For questions, call Texas Health and Human Services at 2-1-1 (available 24/7 in over 150 languages). For full Medicaid benefits, explore standard Texas Medicaid programs to see all your coverage options.

Frequently Asked Questions