Texas Medicaid covers roughly 5 million Texans in 2026, but because Texas has not expanded Medicaid under the Affordable Care Act, the income limits vary dramatically by which eligibility category you fall into. A pregnant woman earning $4,600 a month can qualify. A childless adult earning $400 a month cannot. Knowing which category applies to your household is the critical first step.
This guide covers the four main Texas Medicaid categories, their exact 2026 income thresholds by household size, and how to apply at YourTexasBenefits.com. Check your eligibility now at CoveredUSA, it takes 2 minutes.
Quick answer: Texas Medicaid income limits in 2026 range from 17% of the Federal Poverty Level for parents and caretakers (about $387/month for a family of 3) up to 203% FPL for pregnant women (about $4,622/month for a family of 3). Texas has not expanded Medicaid, so most childless adults do not qualify regardless of income.
Texas Medicaid in 2026: What You Need to Know First
Texas is one of ten states that has not adopted the ACA Medicaid expansion. That means Texas Medicaid does not offer a standard "adults up to 138% FPL" pathway. Instead, eligibility depends on which category you belong to, and the income rules differ sharply between them.
The four main Texas Medicaid coverage pathways are:
- Children and CHIP: coverage for minors from birth through age 18
- Pregnant Women: prenatal, delivery, and 12-month postpartum coverage
- Parents and Caretaker Relatives: extremely limited, among the lowest income caps in the country
- Elderly and Disabled (STAR+PLUS): for people 65+ or qualifying disabilities, including long-term care
If you are a childless adult under 65 with no disability and you are not pregnant, Texas Medicaid almost certainly does not cover you, regardless of how low your income is. The Texas Health and Human Services Commission and Medicaid.gov's Texas state profile both confirm this restriction.
Category 1: Texas Medicaid for Children (2026)
Texas children qualify for Medicaid at three different income thresholds based on age. Infants receive the most generous coverage. Children 6 to 18 have the lowest threshold. All income limits are measured against the 2026 Federal Poverty Level (FPL), published by HHS ASPE.
- Infants under age 1: Up to 203% FPL
- Children ages 1 to 5: Up to 149% FPL
- Children ages 6 to 18: Up to 138% FPL
The table below uses the 138% FPL threshold (children ages 6 to 18), the most widely applicable limit for school-age children in Texas.
Texas Medicaid Income Limits for Children Ages 6-18, 2026 (138% FPL)
| Household Size | Monthly Income Limit (138% FPL) | Annual Income Limit |
|---|
| 1 | $1,835 | $22,025 |
| 2 | $2,488 | $29,857 |
| 3 | $3,142 | $37,700 |
| 4 | $3,795 | $45,540 |
| 5 | $4,448 | $53,373 |
| 6 | $5,101 | $61,210 |
| 7 | $5,755 | $69,060 |
| 8 | $6,407 | $76,884 |
| Each additional person | +$653 | +$7,838 |
Texas Medicaid Income Limits for Children Ages 6-18, 2026. Source: 2026 HHS Federal Poverty Guidelines at 138% FPL.
Texas Medicaid Income Limits for Infants Under Age 1, 2026 (203% FPL)
| Household Size | Monthly Income Limit (203% FPL) | Annual Income Limit |
|---|
| 1 | $2,700 | $32,401 |
| 2 | $3,660 | $43,921 |
| 3 | $4,622 | $55,468 |
| 4 | $5,583 | $66,991 |
| 5 | $6,543 | $78,514 |
| 6 | $7,505 | $90,060 |
| 7 | $8,465 | $101,580 |
| 8 | $9,425 | $113,103 |
| Each additional person | +$960 | +$11,522 |
Texas Medicaid Income Limits for Infants Under Age 1, 2026. Source: 2026 HHS Federal Poverty Guidelines at 203% FPL.
Children who exceed Medicaid income limits may still qualify for CHIP (Children's Health Insurance Program). See Category 1B below.
Category 1B: Texas CHIP Income Limits (2026)
Texas CHIP covers children from birth through age 18 whose household income is too high for Medicaid but too low to comfortably afford private insurance. The CHIP income ceiling in Texas is 201% FPL.
Texas CHIP Income Limits, 2026 (201% FPL)
| Household Size | Monthly Income Limit (201% FPL) | Annual Income Limit |
|---|
| 1 | $2,673 | $32,080 |
| 2 | $3,624 | $43,490 |
| 3 | $4,577 | $54,917 |
| 4 | $5,528 | $66,330 |
| 5 | $6,478 | $77,737 |
| 6 | $7,431 | $89,168 |
| 7 | $8,382 | $100,581 |
| 8 | $9,332 | $111,988 |
| Each additional person | +$951 | +$11,407 |
Texas CHIP Income Limits, 2026. Source: 2026 HHS Federal Poverty Guidelines at 201% FPL. Apply at YourTexasBenefits.com.
CHIP requires a small monthly premium for most families, but the coverage is comprehensive: doctor visits, dental, vision, prescriptions, and hospital care.
Category 2: Texas Medicaid for Pregnant Women (2026)
Texas Medicaid covers pregnant women up to 203% of the Federal Poverty Level. Coverage begins the month the pregnancy is confirmed and extends through delivery plus 12 months of postpartum care. As of 2022, Texas extended postpartum Medicaid to 12 months (previously it was 60 days).
Texas Medicaid Income Limits for Pregnant Women, 2026 (203% FPL)
| Household Size | Monthly Income Limit (203% FPL) | Annual Income Limit |
|---|
| 1 | $2,700 | $32,401 |
| 2 | $3,660 | $43,921 |
| 3 | $4,622 | $55,468 |
| 4 | $5,583 | $66,991 |
| 5 | $6,543 | $78,514 |
| 6 | $7,505 | $90,060 |
| 7 | $8,465 | $101,580 |
| 8 | $9,425 | $113,103 |
| Each additional person | +$960 | +$11,522 |
Texas Medicaid Income Limits for Pregnant Women, 2026. Source: 2026 HHS Federal Poverty Guidelines at 203% FPL. Confirmed by hhs.texas.gov Medicaid program guidelines.
When counting household size for a pregnant woman, the unborn child counts as a household member. A woman living alone who is pregnant is counted as a household of 2.
Category 3: Texas Medicaid for Parents and Caretaker Relatives (2026)
This is where Texas Medicaid is most restrictive. Parents and caretaker relatives of dependent children qualify only at approximately 17% of the Federal Poverty Level, one of the lowest parent income caps in the entire country. According to KFF's analysis of Medicaid eligibility, most states set parent income limits at 100% FPL or higher. Texas's limit is roughly $387 per month for a family of three.
Texas Medicaid Income Limits for Parents and Caretaker Relatives, 2026 (approx. 17% FPL)
| Household Size | Monthly Income Limit | Annual Income Limit |
|---|
| 1 | $226 | $2,715 |
| 2 | $307 | $3,679 |
| 3 | $387 | $4,644 |
| 4 | $468 | $5,611 |
| 5 | $548 | $6,578 |
| 6 | $629 | $7,546 |
| 7 | $709 | $8,511 |
| 8 | $789 | $9,473 |
| Each additional person | +$80 | +$964 |
Texas Medicaid Income Limits for Parents and Caretaker Relatives, 2026. Approximately 17% FPL. Source: hhs.texas.gov Texas Works Handbook.
If you are a parent who earns more than these limits, you will not qualify for Texas Medicaid. You may qualify for an ACA Marketplace plan with subsidies. Use the screener at coveredusa.org/screener to check both options in one step.
Category 4: Texas Medicaid for Elderly and Disabled (STAR+PLUS) (2026)
Texans age 65 and older, or adults with qualifying disabilities, may access Medicaid through the STAR+PLUS managed care program. STAR+PLUS covers both acute care (doctor visits, hospital) and long-term services (home care, assisted living, nursing facility).
The income limit for STAR+PLUS and nursing facility care is $2,982 per month for an individual in 2026 (roughly 300% of the SSI Federal Benefit Rate). Unlike the family-based programs above, this limit applies per individual applicant rather than scaling by household size in the traditional sense.
Texas STAR+PLUS and Nursing Facility Income Limits, 2026
| Household Size | Monthly Income Limit Per Applicant | Annual Equivalent |
|---|
| 1 | $2,982 | $35,784 |
| 2 | $2,982 per person | $35,784 each |
| 3 | $2,982 per applicant | $35,784 each |
| 4 | $2,982 per applicant | $35,784 each |
| 5 | $2,982 per applicant | $35,784 each |
| 6 | $2,982 per applicant | $35,784 each |
| 7 | $2,982 per applicant | $35,784 each |
| 8 | $2,982 per applicant | $35,784 each |
| Each additional person | $2,982 per applicant | $35,784 each |
Texas STAR+PLUS and Nursing Facility Income Limits, 2026. The $2,982/month limit applies to each individual applicant. Source: hhs.texas.gov STAR+PLUS Handbook and Medicaid.gov Texas profile.
STAR+PLUS also has an asset limit of $2,000 for a single person. A spouse living at home (community spouse) may retain significantly more, up to $162,660 in countable assets in 2026. These rules are complex and eligibility is evaluated on a case-by-case basis by hhs.texas.gov.
Texas Medicaid Coverage Gap
Because Texas has not expanded Medicaid, there is a significant gap. Adults between about $0 and 100% FPL who are not pregnant, not a parent of dependent children, not elderly, and not disabled have no pathway to Texas Medicaid or ACA subsidies. Approximately 1 million Texans fall into this coverage gap.
If you are in this gap, options include:
- Federally Qualified Health Centers (FQHCs): Sliding-scale fee clinics funded by the federal government. Find one at findahealthcenter.hrsa.gov.
- ACA Special Enrollment Period: If you experience a qualifying life event, you may access Marketplace plans with subsidized premiums.
- Charity care: Most Texas hospitals must offer charity care programs. Ask the billing department directly.
Check your eligibility now at CoveredUSA, it takes 2 minutes: coveredusa.org/screener.
How to Apply for Texas Medicaid in 2026
Texas Medicaid enrollment is open year-round. There is no annual open enrollment window. You can apply whenever you qualify.
Step-by-Step Application Process
- Gather documents. You will need proof of identity, Texas residency, income, and household composition. See the checklist below.
- Go to YourTexasBenefits.com. This is the official Texas online portal for Medicaid, CHIP, SNAP, and TANF. One application covers all programs.
- Create an account or log in. Click "Apply for benefits" and select Medicaid and/or CHIP.
- Complete the application. Answer questions about your household, income, and health status. The online application takes approximately 20 to 45 minutes.
- Submit and save your confirmation number. Keep this number for tracking your application status.
- Respond to any requests for additional documents. HHSC may contact you to verify income or identity. Respond promptly to avoid delays.
- Wait for a determination. Most applications are processed within 15 to 45 days. Pregnant women and children may receive faster decisions.
You can also apply by phone at 1-800-252-8263 (Monday through Friday, 8 a.m. to 6 p.m. CT), in person at a local Texas HHSC benefits office, or by mailing a paper application.
Documents Needed for Texas Medicaid Application
- Proof of identity (driver's license, state ID, passport, or birth certificate)
- Proof of Texas residency (utility bill, lease agreement, or mail with your current address)
- Social Security numbers for all household members applying
- Proof of income (recent pay stubs, employer letter, or tax returns for self-employed)
- Proof of pregnancy (if applying under the pregnant women category)
- Immigration documentation, if applicable
- Bank statements or asset documentation (for STAR+PLUS applicants)
Common Reasons Texas Medicaid Applications Get Denied
- Income too high: The household income exceeds the limit for the applicable category. Double-check which category applies before submitting.
- Wrong category: Adults without dependent children are almost never eligible in Texas. Applying as a childless adult is a frequent error.
- Missing or incomplete documents: Failure to submit proof of income, identity, or residency by the follow-up deadline is the most common administrative denial reason.
- Texas residency not established: Medicaid requires proof of current Texas residency. Applicants who recently moved without documentation are frequently denied.
- Citizenship or immigration status: Texas Medicaid requires U.S. citizenship or qualifying immigration status for most categories. Emergency Medicaid is available for qualifying emergencies regardless of immigration status.
Frequently Asked Questions
Does Texas have Medicaid expansion in 2026?
No. As of 2026, Texas has not expanded Medicaid under the Affordable Care Act. Texas remains one of approximately ten states without expansion. Adults without dependent children who are not pregnant, not elderly, and not disabled generally do not qualify for Texas Medicaid regardless of income level.
What is the income limit for Texas Medicaid for a family of 4 in 2026?
It depends on which category applies. For children ages 6 to 18, a family of 4 can earn up to $3,795 per month (138% FPL). For a pregnant woman in a household of 4, the limit is $5,583 per month (203% FPL). For parents and caretaker relatives, the limit for a household of 4 is only about $468 per month (17% FPL).
How do I apply for Texas Medicaid online?
Apply at YourTexasBenefits.com. The online application covers Medicaid, CHIP, SNAP, and TANF in one submission. You will need proof of identity, residency, income, and household composition.
What is the difference between Texas Medicaid and CHIP?
Texas Medicaid is free for qualifying children and families. CHIP (Children's Health Insurance Program) covers children whose household income is too high for Medicaid but who cannot afford private insurance. CHIP has a small monthly premium but provides comprehensive coverage for children birth through age 18, up to 201% FPL in Texas.
What does STAR+PLUS cover in Texas?
STAR+PLUS is Texas Medicaid's managed care program for people 65 and older and adults with qualifying disabilities. It covers acute medical care (doctor visits, hospital, prescriptions) and long-term services (home health aide, adult day care, assisted living, nursing facility). The 2026 income limit is $2,982 per month per individual. More details are available at hhs.texas.gov.
Can undocumented immigrants get Texas Medicaid in 2026?
Standard Texas Medicaid requires U.S. citizenship or qualifying immigration status. However, Emergency Medicaid covers emergency medical conditions for income-eligible individuals regardless of immigration status. Pregnant women may access Texas Emergency Medicaid for labor and delivery. Routine and preventive care is not covered under Emergency Medicaid.
What if I earn too much for Texas Medicaid but cannot afford private insurance?
If your income is above the Texas Medicaid limit, you may qualify for subsidized health coverage through the ACA Marketplace. Texans between 100% and 400% FPL can receive premium tax credits to reduce monthly costs. Use the free screener at coveredusa.org/screener to see which options match your income and household size.
How long does Texas Medicaid approval take?
Most Texas Medicaid applications are processed within 15 to 45 days. Applications for children and pregnant women are often processed faster. You can check application status online at YourTexasBenefits.com or by calling 1-800-252-8263.
