Some individuals qualify for health insurance assistance in Texas.
The state of Texas offers several medical assistance programs for children, women and older individuals. Acceptance into these programs is based on factors such as the income, resources, age, family dynamic and special circumstances of an individual. All applications and questions for health-care assistance are provided by the Texas Health and Human Services Commission (HHSC).
Children
Children under the age of 19 whose families meet certain low income and resource requirements and do not have other health coverage are eligible for Medicaid. Medicaid covers a child for six months (12 months for newborns whose mothers were covered by Medicaid at the time of birth); at the end of the six-month coverage period, a renewal application will be sent to the child's residence.
Children under the age of 19 whose families exceed the income requirement for Medicaid, but who meet certain income requirements and do not have other health coverage are eligible for the Children's Health Insurance Program (CHIP). CHIP covers children for a low enrollment cost based on income and low-cost prescriptions. The coverage period is 12 months; renewal applications will be sent at the end of this period. A child who was in foster care on his 18th birthday may be eligible for Medicaid through his 20th birthday if he meets certain income and resource requirements and has no other health coverage.
Women
For pregnant women who meet certain income requirements and have no other health coverage, CHIP will cover prenatal visits and delivery, as well as health care for the child for one year. Women between the ages of 18 to 44 and who have low income and no other health coverage may qualify for the Women's Health Program. The program provides coverage for gynecological visits, screenings, and birth control counseling and methods. If a woman is diagnosed with breast or cervical cancer, she may qualify for coverage if she meets income requirements and has no other health coverage that covers the cancer treatment. She will need to be evaluated by a Breast and Cervical Cancer Services clinic.
Individuals Over Age 65
If an individual over the age of 65 needs continuous care for more than 30 days, he may be eligible for Medicaid for Long-Term Care based on certain income and resource requirements. Resources include bank accounts, certificates of deposit, property that is not the primary residence, stocks, bonds and the cash value of some life insurance policies. Coverage is for one year; a renewal application will be sent to the residence or guardian on file. If an individual receives Supplemental Security Income (SSI), she will automatically qualify for Medicaid. HHSC will send information to those who qualify for SSI; an individual may also be eligible for coverage of care received in the three months prior to the acceptance of SSI. Medicaid may help pay for the cost of Medicare for individuals meeting certain income and resource requirements. This coverage will help pay for premiums, deductibles and co-pays and coverage is for one year. A renewal application will be sent to the address on file. Individuals who have higher incomes but who still need assistance may be eligible for the Medicaid Buy-in program. Income and resource limits are higher but the individual will have to pay a monthly premium for her coverage. A person must work, not live in an institution, pay income tax, receive disability or be eligible for SSI before income requirements, and in the past three months have earned more than $1,000.
Families
A parent or relative caring for a child under 19 years of age may be eligible for Medicaid coverage if certain income and resource limits are met.
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