Medicaid is a federal medical care program created in 1965 and administered by each state. The Texas Health and Human Services Commission reports that, over the years, "Congress has transformed Medicaid from a narrowly defined program available only to persons eligible for cash assistance into a large insurance program with complex eligibility rules." In Texas, nearly 3 million low-income people receive Medicaid assistance, including children, pregnant women and disabled residents.
Poverty Guidelines
Medicaid eligibility guidelines are determined largely on a formula that compares household income with federal poverty guidelines. For 2010, an annual income of $10,830 for a one-person household is considered 100 percent of poverty level. For a two-person family the amount is $14,570, and it increases by $3,740 for each additional family member. The U.S. Department of Health and Human Services provides federal poverty guideline charts through the Centers for Medicare and Medicaid Services.
Children and Medicaid
A child is eligible for Medicaid from birth to age 1 if his family's income does not exceed 185 percent of the federal poverty level. For a family of three in 2010, this would be $33,873.50. From ages 1 to 5, the federal poverty level limit is 133 percent, dropping to 100 percent for children ages 6 to 19. Uninsured children who are Texas residents and U.S. citizens, or permanent legal aliens age 18 or younger can qualify for CHIP or Children's Medicaid.
Pregnant Women
Pregnant women can qualify for medical care through Medicaid if their household annual income is less than 185 percent of the federal poverty level.
Nonworking Parent
The smallest Medicaid income eligibility limit is for parents who qualify for Temporary Assistance for Needy Families (TANF). For 2010, the income cap for a parent with two children (a family of three) is $198.35 per month, or 13 percent of the federal poverty level.
Working Parent
A working parent in Texas is eligible for Medicaid if her income does not exceed 27 percent of the federal poverty level, according to healthinsuranceinfo.net.
SSI, Aged and Disabled
Poor elderly Texans and those receiving Supplemental Security Income (SSI) are eligible for Medicaid. According to the Kaiser Family Foundation, Medicaid eligibility income levels for the aged, blind and disabled in 2009 were 75 percent of the federal poverty level for a single person and 83 percent for a couple. For individuals qualifying for nursing home services, the income limit was 300 percent of SSI. Qualifications for nursing home services vary, based on a number of factors besides income levels.
Former Foster Care Children
A Texan who ages out of foster care can be covered by Medicaid through the month he turns 21. There are several eligibility requirements, including an income of less than 400 percent of the federal poverty level for a single person.
Non-U.S. Citizens
Undocumented immigrants of any income level can qualify for Medicaid in the event of a medical emergency, such as childbirth and labor, "or other conditions that may threaten an individual's life," according to a report by the Texas comptroller of public accounts. Otherwise, undocumented immigrants must meed the Medicaid income eligibility requirements, according to the report.
