Texas Medicaid includes the CHIP health coverage program for those under 19.
Residents of Texas may qualify for Medicaid or the related Children's Health Insurance Program (CHIP), both of which are designed to provide affordable health benefits to those in need. As of June 2010, more than 3.3 million Texans were enrolled in Medicaid, more than 2.4 million of whom were children under age 19. The state's Health and Human Services Commission (HHC) implements rules regarding eligibility and coverage for both Medicaid and CHIP.
Eligibility
In Texas, eligibility for Medicaid is determined primarily by income, age and health. Anyone earning less than 25 percent of the federal poverty level is eligible to apply, as are low-income families with children whose family income is less than 100 percent of this figure Others who may be eligible include low-income pregnant women who earn 185 percent or less of the federal poverty level, elderly persons over age 65 without social security income, and people with certain disabilities such as blindness or paralysis. Medicaid recipients who qualify due to a disability may have to pay a monthly insurance premium.
CHIP
The Children's Health Insurance Program (CHIP) is an extension of Medicaid available to those under age 19 whose parents earn too much to qualify for Medicaid but too little to purchase private health insurance. Unlike regular Medicaid, CHIP requires monthly premiums proportionate to the parent's income. Co-payments, also determined based on financial capabilities, usually cost between $3 and $10 per doctor visit or prescription.
Coverage
Medicaid coverage varies depending on the patient's age. Children receive comprehensive care that includes preventive care, routine vaccinations, hospital inpatient and outpatient care, prescriptions and diagnostics. Children also receive dental benefits under Medicaid and CHIP that cover routine exams, cleanings and preventive measures such as sealants and fluoride treatments. Adults receive many of the same medical benefits as children, but are not compensated for dental bills other than those for treatments of existing problems.
Application Procedure
To apply for Medicaid or CHIP in Texas, candidates must supply proof of Texas residency as well as U.S. citizenship. The state's Health and Human Services Commission will also require proof of income, a statement of assets and each applicant's health history. Applicants can fill out and submit applications online at yourtexasbenefits.com or print out the application and send it by mail or fax.
