How to Qualify for Medicaid in Texas: 2025 Eligibility, Income Limits & Application Guide
6.5 min read
Navigating the Texas Medicaid system can feel overwhelming, but if you’re a low-income individual or part of a vulnerable population, Medicaid can be a vital lifeline. In 2025, eligibility rules remain strict in Texas, which has not adopted Medicaid expansion under the Affordable Care Act. That said, many Texans still qualify — including children, pregnant women, people with disabilities, and seniors.
This guide breaks down exactly how to qualify for Medicaid in Texas in 2025, including income limits, application steps, and answers to common questions.
Who is eligible for Medicaid in Texas in 2025?
In Texas, eligibility for Medicaid depends on several criteria: your income, household size, age, medical condition, and family circumstances. Unlike many other states, Texas has not expanded Medicaid to cover all low-income adults. That means most adults without dependent children won't qualify — unless they meet specific requirements.
The main groups who can qualify include:
Children under 19
Pregnant individuals
Parents or caretaker relatives of dependent children
Adults age 65 and older
People with disabilities
Certain individuals with high medical bills (Medically Needy Program)
For each of these groups, there are specific income thresholds and, in some cases, asset limits. Let’s break those down next.
Income limits for Medicaid in Texas (2025)
Income eligibility is measured against the Federal Poverty Level (FPL), which adjusts annually based on inflation. Here’s what that looks like in 2025 for common applicant categories:
Children (0–18 years):
To qualify, household income must be below 133% of the FPL. For a family of four, this is about $3,563/month.
Pregnant Individuals:
Pregnancy Medicaid allows income up to 203% of the FPL — approximately $5,438/month for a family of four.
Parents or Caretaker Relatives:
This group has the strictest limits — only up to 17% of FPL, which equals around $455/month for a family of four.
Seniors and People with Disabilities:
Eligibility is based on both income and assets. Generally, income must be below $943/month for individuals and $1,415/month for couples (SSI standard), and assets are limited to $2,000 per person.
Note: Income guidelines change annually. Always verify the current thresholds with Your Texas Benefits.
How to apply for Medicaid in Texas
Applying for Medicaid in Texas can be done through several convenient channels. The fastest and most straightforward way is online through the official Texas Health and Human Services portal.
Application options:
Online at YourTexasBenefits.com
Mobile app: "Your Texas Benefits" on iOS/Android
By phone: Call 2-1-1 or 1-877-541-7905
In person at a local HHSC office
When applying, make sure to gather the following documents:
Proof of income (recent pay stubs or tax return)
Social Security numbers for all household members
Proof of Texas residency (utility bill, lease agreement)
Medical records or disability-related documentation (if applicable)
Processing can take several weeks. If you need healthcare in the meantime, you may qualify for retroactive coverage.
Medicaid renewal: keeping your coverage active
Medicaid eligibility isn’t permanent. All recipients must renew their benefits annually. In Texas, you’ll typically receive a renewal notice in the mail — or via your online account — 30–60 days before your coverage expires.
To avoid losing coverage:
Respond to renewal notices immediately
Update your information (address, income, household size)
Submit required documents before the deadline
If you miss the renewal deadline, your benefits may be suspended or terminated. Fortunately, you can reapply at any time if you still meet the eligibility criteria.
Understand your rights and uncover your path
Understanding how to qualify for Medicaid in Texas in 2025 starts with knowing where you stand. While the state's eligibility rules are strict, there are still multiple pathways to coverage for those in need. Whether you're applying for yourself, a child, or a loved one, being prepared with the right documents and accurate information will streamline the process.
Don’t hesitate to reach out to local assistance programs, community health centers, or a Medicaid planner if you need help navigating the system.
Frequently asked questions
Can adults without children get Medicaid in Texas?
Usually not. Unless you're over 65, have a disability, or are pregnant, most adults without children do not qualify.
Is there emergency Medicaid in Texas?
Yes. Texas offers Emergency Medicaid for undocumented individuals who meet income requirements and have a life-threatening medical emergency.
Can green card holders qualify?
Legal permanent residents may qualify after a five-year waiting period, although some exceptions apply (e.g., for refugees or children).
What if I was denied Medicaid?
You can appeal the decision. Submit a written request to the HHSC within 90 days of the denial notice.