Texas Medicaid Income Limits in 2026

Last Update: 28 April 2026

Texas Medicaid income limits in 2026 depend on your age, family size, and program type. Children, pregnant women, and elderly or disabled adults have different income rules.

Most non-disabled adults without children do not qualify — because Texas has not expanded Medicaid.

Quick Summary:

• 📋 Texas Medicaid is run by the Texas Health and Human Services Commission (HHSC)
• 👶 Children under age 1 qualify up to 203% of the Federal Poverty Level (FPL)
• 🤰 Pregnant women qualify up to 203% FPL with 12 months of postpartum coverage
• 👴 Elderly and disabled adults follow different income rules based on SSI
• ❌ Texas has not expanded Medicaid — most childless adults do not qualify
• ✅ Apply online at YourTexasBenefits.com

What Are the Texas Medicaid Income Limits for 2026?

Texas Medicaid uses the Federal Poverty Level (FPL) to set income limits for most programs. The 2026 FPL figures below are the foundation for all MAGI-based Medicaid programs in Texas.

These numbers come directly from the U.S. Department of Health and Human Services (HHS), effective January 2026.

2026 Federal Poverty Level (FPL) — Monthly and Annual

Source: U.S. HHS, 2026 Poverty Guidelines

To compare income limits across all states, see the full Medicaid income limits by state 2026 guide.

Texas Children’s Medicaid Income Limits 2026

Texas uses Modified Adjusted Gross Income (MAGI) rules for children. There is no asset test for children’s Medicaid. Limits are based on the child’s age group.

Children may stay enrolled up to age 19 — and sometimes up to age 20.

Children Under Age 1 — 203% FPL

Children Ages 1–5 — 149% FPL

Children Ages 6–18 — 138% FPL

✅ No asset test applies to children’s Medicaid in Texas.

Texas Medicaid Income Limits for Pregnant Women 2026

Pregnant women qualify for Medicaid up to 203% of FPL in Texas. This matches the income limit for infants under age 1.

The unborn child counts as a household member, which can increase your limit. Coverage continues for 12 full months after delivery — even if income rises during that time.

Pregnant Women — Monthly Income Limits (203% FPL)

Source: Texas HHS — Medicaid & CHIP

CHIP Income Limits in Texas 2026

CHIP (Children’s Health Insurance Program) covers children who earn too much for Medicaid but can’t afford private insurance.

CHIP covers children from birth through age 18. The income limit is 206% of FPL in Texas. Annual family costs are very low — most pay $35 or less per year.

CHIP Monthly Income Limits — 206% FPL

CHIP Cost-Sharing:

• Maximum annual cost: $50 per family
• Most families pay: $35 or less per year
• Small co-pays apply for some services

Texas also offers CHIP Perinatal for unborn children of pregnant women who don’t qualify for Medicaid. This program covers up to 202% FPL.

Texas Medicaid Income Limits for Parents 2026

Texas has some of the lowest income limits for parents in the entire country. These limits are not based on FPL percentages — they equal roughly 12–17% of FPL, which is extremely restrictive.

A family of four with one parent must earn less than approximately $300–$410/month to qualify.

One-Parent Households

Two-Parent Households

⚠️ These limits are among the lowest parental Medicaid thresholds in the United States.

Non-Disabled Adults Without Children — No Coverage in Texas

Texas has not expanded Medicaid under the Affordable Care Act (ACA). This means most adults ages 19–64 who don’t have dependent children are not eligible for Texas Medicaid — no matter how low their income is.

An estimated 1.1 million uninsured Texas adults would qualify if the state expanded Medicaid. Texas currently has the highest uninsured rate in the nation at 17.4% (as of 2023).

As of April 2026, no confirmed ballot date exists for a Medicaid expansion vote in Texas.

Texas Long-Term Care Medicaid Income Limits 2026

Long-term care Medicaid covers nursing home care and home-based care for elderly and disabled Texans. These programs use SSI-based income rules, not FPL. The 2026 Federal Benefit Rate (FBR) is $994/month.

These figures are effective January 1, 2026.

2026 Long-Term Care Income & Asset Limits

Key 2026 Long-Term Care Figures at a Glance

• 🏥 Nursing Home income cap (single): $2,982/month (up from $2,901 in 2025)
• 👫 Married couple (both applying): $5,964/month
• 💰 Asset limit (single): $2,000 in countable assets
• 🏠 Community Spouse Resource Allowance: Up to $162,660
• 📅 Monthly Maintenance Needs Allowance (community spouse): $4,066.50/month
• 🏡 Home equity interest limit: $752,000 (no limit if spouse lives in the home)
• 💵 Personal Needs Allowance (nursing home residents): $75/month
• ⏳ Gift Penalty Divisor: $262.37/day

Medicaid for the Elderly and People with Disabilities (MEPD) 2026

MEPD is regular Medicaid for seniors and disabled Texans — not long-term care. To qualify, you must receive SSI or be deemed SSI-eligible.

2026 MEPD Income Limits:

• Single: $994/month
• Married couple: $1,491/month
• Asset limit (single): $2,000

A functional need with daily living activities (ADLs) is required. A full nursing facility level of care is not required for this program.

Want to check if you qualify? Use the Medicaid eligibility calculator 2026 to estimate your eligibility in minutes.

What Is a Miller Trust (QIT) in Texas?

If your income is over $2,982/month and you need nursing home or HCBS Medicaid, you may still qualify using a Qualified Income Trust (QIT) — also called a Miller Trust.

Here is how it works:

1. Excess income is deposited into a special trust account each month
2. That income is excluded from the Medicaid eligibility calculation
3. You then qualify based on the remaining countable income

Texas uses the “name on the check” rule to determine whose income counts. An elder law attorney can help set up a Miller Trust correctly.

Texas Medicaid Look-Back Period 2026

Texas enforces a 60-month (5-year) look-back period for Nursing Home Medicaid and HCBS Waivers.

• Any assets transferred below fair market value within 5 years can trigger a penalty
• The penalty creates a waiting period before Medicaid begins
• The IRS gift tax annual exclusion ($19,000 in 2026) does NOT override Medicaid look-back rules

Plan ahead — improper transfers can delay critical care coverage significantly.

2026 Federal Policy Changes Affecting Texas Medicaid

One Big Beautiful Bill Act (OBBBA) — Signed July 4, 2025

Congress passed the OBBBA in 2025. Here’s what it means for Texas Medicaid in 2026 and beyond:

Texas HHSC is currently assessing the impact of the OBBBA. Specific implementation timelines have not been confirmed as of April 2026.

To understand how your coverage costs are calculated, see the Medicaid fee schedule 2026 for current procedure rates and reimbursement details.

How to Apply for Texas Medicaid in 2026

Applying is free and takes about 15–30 minutes online.

3 Ways to Apply:

1. 🌐 Online: YourTexasBenefits.com
2. 📞 Phone: Call 1-877-541-7905 or dial 2-1-1
3. 📬 Mail: Submit paper Form H1200 (for MEPD / Medicare Savings Program)

What you’ll need:

• Proof of identity (ID or passport)
• Social Security numbers for all applicants
• Proof of income (pay stubs, tax returns)
• Proof of Texas residency
• Immigration documents (if applicable)

Most Texas Medicaid recipients get care through Managed Care Organizations (MCOs). The elderly and disabled managed care program is called STAR+PLUS.

Texas Medicaid 2026 — Full Eligibility Summary

Frequently Asked Questions

Last Updated: April 28, 2026

Sources: Texas HHS — Medicaid & CHIP | YourTexasBenefits.com | U.S. Department of Health and Human Services 2026 FPL Guidelines

⚠️ Disclaimer: Income limits are verified as of April 2026. Always confirm current figures directly with Texas HHSC or at YourTexasBenefits.com before making any coverage decisions.