Published: November 5, 2025 | Last Updated: November 5, 2025
Applying for Texas Medicaid in 2025 is simple when you know the steps. You can apply online through Your Texas Benefits, call 2-1-1, or visit a local office. The state reviews applications within 45 days.
Quick Facts About Texas Medicaid 2025
- Free application: Apply online at YourTexasBenefits.com or call 2-1-1 toll-free
- Children qualify with household income below 133% of the federal poverty level
- Pregnant women qualify up to 203% of poverty level
- Decision made within 45 days of applying
- Children’s Medicaid is completely free with no costs
- Texas has not expanded Medicaid coverage to all low-income adults
Ready to check if you qualify? Visit Your Texas Benefits to start your application now.
Who Can Get Texas Medicaid in 2025?
Medicaid provides health coverage for low-income children, families, seniors and people with disabilities. Texas has strict rules about who qualifies.
Children and Families
Children must be 18 years old or younger to qualify. In some cases, youth with disabilities up to age 20 can get coverage.
For a family of four in 2025, children qualify if monthly income is below $5,439 for infants, $3,991 for ages 1-5, or $3,697 for ages 6-18.
Pregnant Women
Pregnant individuals qualify with income up to 203% of federal poverty level, approximately $5,438 monthly for a family of four. Texas provides coverage through at least 12 months after pregnancy ends.
Parents and Caretakers
Parents and caretakers have the strictest income limits at only 17% of poverty level, around $455 monthly for a family of four. This makes it very hard for working parents to qualify.
Seniors and People with Disabilities
Single nursing home applicants in 2025 must have income under $2,901 monthly, assets under $2,000, and require nursing home level care.
Important Note About Adults
Texas did not expand Medicaid, so most adults without children do not qualify unless they are over 65, have a disability, or are pregnant.
Texas Medicaid Income Limits 2025
Income limits change based on your household size and who needs coverage. The table shows monthly income limits.
Children’s Medicaid Income Limits
| Family Size | Infants (0-1 yr) | Ages 1-5 | Ages 6-18 |
|---|---|---|---|
| 1 person | $2,717 | $1,995 | $1,845 |
| 2 people | $3,671 | $2,695 | $2,493 |
| 3 people | $4,625 | $3,395 | $3,141 |
| 4 people | $5,439 | $3,991 | $3,697 |
Based on 2025 federal poverty guidelines
Pregnant Women Income Limits
Pregnant women in a household of four qualify with income up to $5,439 per month. Count the unborn baby in your household size.
What Income Counts?
Income includes combined earnings from jobs and other sources for all household members, except child support, Supplemental Security Income, and children’s non-taxable income like disability payments.
How to Apply for Texas Medicaid Online
Applying online is the fastest way to get Medicaid. Here are the simple steps.
Step 1: Visit Your Texas Benefits Website
Go to YourTexasBenefits.com and choose “Apply for new benefits”. You can complete the form at your own pace.
Step 2: Create Your Account
Set up a free account if you don’t have one. You need basic information like your name, date of birth, and address.
Step 3: Answer Application Questions
The application asks about your household, income, and expenses. The process takes about 30 minutes to complete.
Step 4: Upload Documents
You need proof of income, Social Security numbers, and citizenship or immigration status. Send paycheck stubs and receipts for childcare or child support.
Step 5: Submit and Wait
After submission, Texas Health and Human Services reviews your application and contacts you within 45 days.
Other Ways to Apply
Apply by Phone
Call 2-1-1 toll-free Monday through Friday from 8:00 a.m. to 6:00 p.m. Central Time. A representative will help start your application.
Apply with Paper Forms
Print a paper application form and submit it by mail. Form H1200 is used for Medicaid for elderly people and those with disabilities.
Visit an Office
Go to a Texas Health and Human Services benefits office near you. Find locations by calling 2-1-1 or visiting the official website.
Documents You Need to Apply
Gather these before you start your application:
- Identification: Social Security numbers for everyone applying
- Proof of income: Recent paycheck stubs or income statements
- Residency proof: Texas address verification
- Citizenship status: Birth certificate, passport, or immigration documents
- Expense receipts: Childcare, child support, or adult care costs
Having everything ready makes the application faster and easier.
What Happens After You Apply?
Review Process
Texas Health and Human Services Commission tells you if you qualify within 45 days. They may ask for more information during this time.
If You’re Approved
You receive an enrollment packet in the mail after approval. You must choose a health plan or one will be chosen for you.
Choosing Your Health Plan
Texas Medicaid works through managed care plans. Pick a plan that includes your doctors and hospitals.
Renewal Requirements
All Medicaid members must submit a renewal application every 12 months to continue receiving benefits. The easiest way to renew is online at YourTexasBenefits.com.
Texas CHIP Program
If your income is too high for Medicaid, your children might qualify for CHIP.
CHIP covers children in families that earn too much for Medicaid but cannot afford health insurance. Children are eligible for CHIP with household incomes up to 201% of federal poverty level.
CHIP fees vary based on your income and are lower than private insurance.
Common Questions About Texas Medicaid
Can Adults Without Children Get Medicaid?
Usually not, unless you’re over 65, have a disability, or are pregnant. Texas did not expand Medicaid to cover all adults.
Is There Emergency Medicaid?
Yes, Texas offers Emergency Medicaid for individuals who meet income requirements and have a life-threatening medical emergency.
How Long Does Approval Take?
The state should contact you within 45 days of submitting your application. Call 2-1-1 for updates on your application status.
What Does Medicaid Cover?
Medicaid covers services through health plans including doctor visits, hospital care, prescriptions, and preventive care. Children with disabilities can get long-term services and supports including home care and personal care assistance.
Can I Apply if I Have Other Insurance?
Yes, you can apply for Medicaid even with other insurance. Medicaid may help pay costs your other insurance doesn’t cover.
Get Help With Your Application
Need assistance applying? Free help is available:
- Call 2-1-1: Toll-free support Monday through Friday, 8:00 a.m. to 6:00 p.m. Central Time
- Community partners: Local organizations can help you apply in person
- Health plan support: Contact managed care organizations for guidance
- Your Texas Benefits help: Email YourTexasBenefits-App@hhsc.state.tx.us with questions
Take Action Today
Applying for Texas Medicaid is free and confidential. Start your application today at YourTexasBenefits.com.
For more information, visit the official Texas Health and Human Services Medicaid page.
Don’t wait to get health coverage for you and your family. The sooner you apply, the sooner you can access the care you need.
Disclaimer: This article provides general information about Texas Medicaid. Eligibility rules and income limits may change. Always verify current requirements with Texas Health and Human Services or Your Texas Benefits for the most accurate information.
