Medicaid is a federal- and state-funded, state-operated health insurance program for certain low-income individuals, including the elderly, disabled, pregnant women and children. Texas also provides Medicaid to low-income women with breast or cervical cancer. You may apply at your local Medicaid office or complete an application for assistance (See Resources) and submit it via postal mail, fax or online.
Types
The Texas Medicaid program consists of numerous types of Medicaid. Children may be covered under Children's Medicaid, CHIP or the Youth Transitioning Out of Foster Care programs. Women may be covered under Medicaid for Pregnant Women, CHIP Perinatal Coverage, Women's Health Program or Medicaid for Women with Breast or Cervical Cancer. The elderly and disabled may be covered under Medicaid for People 65 or Older and People with Disabilities, Medicare Savings Programs and Medicaid Buy-In Program.
Assets
You must meet income and resource requirements to qualify for Medicaid. Income limits range from $867 to as much as $4,320 month, depending on the type of income and the specific Medicaid program. Resource limits range from $2,000 to $5,000, depending on the specific Medicaid program.
Disability
If you are applying for Medicaid due to being disabled, your application will be reviewed by a medical review team. When you submit your application, request releases of information so that you can authorize Medicaid to obtain these records on your behalf. You can also obtain these records by contacting each of your health care providers.
Supplemental Security Income
If you receive SSI, you are automatically eligible for Texas Medicaid. SSI is a program offered by the Social Security Administration (SSA) that provides monthly payments to elderly and disabled individuals who have an insufficient work history to qualify for disability payments.
Spend-Down
If you earn more than $690 in unearned income per month and do not receive SSI, you will be required to pay a spend-down each month before you are eligible for Medicaid. You will be required to pay the difference between your income and $690 each month out-of-pocket before Medicaid pays for any of your medical bills. For example, if you earn $900 per month in Social Security disability, you will be required to pay the first $210 of your medical expenses before you will be eligible for Medicaid.
Employment
If you are employed, you may still be eligible for Medicaid through the Medicaid buy-in program. If you earn more than $1,354 per month, you will be required to pay a premium to be eligible for Medicaid.
