Texas Medicaid Income Limits (2026)

Texas Medicaid is the largest non-expansion Medicaid program in the United States. Because Texas did not expand Medicaid under the Affordable Care Act, adult eligibility income limits are tied to pre-ACA TANF-related thresholds rather than the 138% FPL standard used in expansion states. The result is the well-known Texas Medicaid coverage gap: adults earning too much for legacy Medicaid (above ~17% FPL for parents) but too little for ACA marketplace subsidies (below 100% FPL) often have no affordable coverage option. The 2026 Federal Poverty Level — $15,960 for a single person in the 48 contiguous states, $33,000 for a family of four — is the anchor for every threshold below.

Eligibility in Texas Medicaid splits into four main population groups: adult parents and caretakers (the strict 17% FPL group — see state Medicaid expansion status for how TX compares to expansion states), pregnant women (a much more generous 198% FPL group, with CHIP-Perinatal coverage extending up to 202% FPL for the unborn child even when the mother is undocumented), children under 19 (138% FPL Medicaid, then CHIP up to 201% FPL), and aged/blind/disabled adults — those who qualify for both Medicaid and Medicare can access dual-eligible plans (income and asset tests under SSI rules). Each group has its own application path — if you have a job and wonder whether you still qualify, Texas counts earned income differently for each group, but most go through the same intake portal at yourtexasbenefits.com or the statewide 2-1-1 call line.

The household-size table below shows the 2026 Texas Medicaid income limits across all three covered populations. If your household income is over the relevant Texas Medicaid limit but under 400% FPL, you almost certainly qualify for ACA marketplace subsidies through Healthcare.gov. If you have a child whose family income is over the children's Medicaid limit, check the Texas CHIP program (up to 201% FPL). If you are 65 or older with limited income and assets, check the Medicare Savings Programs section below.

Texas Medicaid income limits by household size (2026)

The 2026 Texas Medicaid income guidelines below are based on the 2026 Federal Poverty Level for the 48 contiguous states. Adult column = TANF-related parent/caretaker limit (~17% FPL). Children column = standard children's Medicaid (138% FPL — the 6-18 age bracket; infants 0-1 may qualify higher). Pregnancy column = 198% FPL Medicaid for Pregnant Women. Add roughly $5,680 of annual income per additional household member.

Texas Medicaid eligibility requirements (non-income)

Beyond income, Texas Medicaid applicants must meet the following non-income requirements. Each population group (adults, children, pregnant women, aged/blind/disabled) has its own version of these rules; the items below apply across the board.

• Texas residency: applicant must currently live in Texas with the intent to remain. There is no minimum length-of-residence requirement.
• U.S. citizenship or qualifying immigration status: U.S. citizens, lawful permanent residents (after the federal 5-year bar in most cases), refugees, and asylees qualify. Undocumented adults do not qualify for full Texas Medicaid but may receive emergency Medicaid for life-threatening conditions and CHIP-Perinatal during pregnancy.
• Social Security Number: required for the applicant unless requesting only emergency Medicaid or CHIP-Perinatal.
• Household composition: must be claimed under MAGI rules (parent + dependent children + spouse) for the parent/child/pregnancy categories. Aged/blind/disabled categories use SSI household rules.
• Asset test: NOT applied for MAGI Medicaid populations (adult parents, children, pregnant women). Asset test IS applied for aged/blind/disabled adults — generally $2,000 for an individual or $3,000 for a couple, with the home, one vehicle, and certain burial accounts excluded.
• Other coverage: applicants are not required to be uninsured, but Texas Medicaid coordinates as the payer of last resort if other coverage exists.

What income counts for Texas Medicaid

Texas Medicaid uses Modified Adjusted Gross Income (MAGI) rules for parents, children, and pregnant women, anchored to the household's projected annual income on the federal tax return. Aged/blind/disabled populations use SSI countable-income rules instead. The lists below cover the MAGI categories that handle the vast majority of Texas Medicaid applications.

Income sources included

• Wages, salaries, tips, and overtime pay (gross, before payroll taxes)
• Net self-employment / 1099 / gig-work earnings (after allowable business expenses)
• Social Security retirement and disability (SSDI) — but Supplemental Security Income (SSI) is excluded
• Unemployment compensation
• Pensions, annuities, and most retirement-account withdrawals
• Alimony received under divorce decrees finalized before 2019
• Rental and investment income (interest, dividends, capital gains)

Income sources excluded

• Supplemental Security Income (SSI) payments
• Child support received
• Federal tax refunds and refundable tax credits (EITC, Child Tax Credit)
• Veterans Affairs disability benefits and most VA pensions
• SNAP (food-stamps) benefits and TANF cash assistance
• Loans, gifts, and one-time inheritances under MAGI rules (note: counted as resources for SSI-related Medicaid)
• Federal Pell Grants and most need-based student aid used for tuition or required fees
• Workers' compensation payments

How to apply for Texas Medicaid in Texas

Texas Medicaid applications go through Your Texas Benefits, the statewide intake portal run by the Texas Health and Human Services Commission (HHSC). The same application captures Medicaid, CHIP, SNAP, TANF, and women's-health programs. You can apply online, by mail, by phone (2-1-1), or in person at any HHSC benefits office.

1. 1. Gather your documents: photo ID, Social Security cards (or numbers) for everyone in the household, proof of Texas residency, proof of citizenship or immigration status, and the most recent month of pay stubs or self-employment records.
2. 2. Create an account at yourtexasbenefits.com or call 2-1-1 to start an application by phone.
3. 3. Complete the application: list every household member, report all income sources, and attach (upload or mail) the supporting documents from step 1.
4. 4. Sign the application electronically (or by hand if mailed). HHSC sends a confirmation with your case number; save it.
5. 5. Respond to any HHSC requests for additional information within the 10-day window listed on the notice. Failing to respond is the most common reason Texas Medicaid applications get denied.
6. 6. Wait for the eligibility determination notice. Most cases are decided in 30-45 days; pregnancy applications are typically decided in 15 days under federal expedited-processing rules.

Official portal: yourtexasbenefits.com

Documents needed

• Photo ID for the head of household (Texas driver's license, state ID, or passport)
• Social Security Numbers for every household member applying for coverage
• Proof of Texas residency (utility bill, lease, mortgage statement)
• Proof of U.S. citizenship or qualifying immigration status (birth certificate, passport, permanent-resident card, asylee letter)
• Last 30 days of pay stubs (or 12 months for self-employment / 1099)
• Most recent federal tax return (or signed statement that none was filed)
• Proof of pregnancy from a clinic or hospital, if applying for pregnancy Medicaid
• For aged/blind/disabled adults: bank statements, vehicle titles, and proof of any disability determination

Processing timeline: Standard Texas Medicaid applications are decided in 30-45 days. Pregnancy applications are decided in 15 days under federal rules. Disability applications can take 60-90 days because they require a medical determination from the Texas Disability Determination Services unit.

Common reasons applications get denied

• Income above the population-specific threshold (the most common single reason — Texas adults without dependent children are denied at any income level above ~17% FPL).
• Failure to respond to a 10-day request for additional information (missing pay stubs, missing immigration documents, missing pregnancy verification).
• Adult applicant without a dependent child, not pregnant, not disabled, and not 65+ (Texas does not cover the ACA-expansion adult group).
• Federal 5-year bar for newly-arrived lawful permanent residents (some categories, including pregnant women and children under 21, are exempt under federal CHIPRA Title XXI rules).
• Asset test failure for aged/blind/disabled applicants (countable resources above $2,000 for an individual or $3,000 for a couple).
• Failure to verify Texas residency (no utility bill, lease, or other address documentation in the applicant's name).

If your child's family income is over the Texas Medicaid limit

Texas CHIP (the Children's Health Insurance Program) covers children under age 19 in households earning up to 201% of the Federal Poverty Level — about $51,210 per year for a family of three in 2026. CHIP families pay a small enrollment fee ($35 to $50 per year per family for most income tiers) plus low copays. CHIP-Perinatal extends pregnancy coverage to 202% FPL for the unborn child even when the mother is undocumented and ineligible for full Texas Medicaid. Apply through the same yourtexasbenefits.com portal — HHSC routes the application to the right program automatically based on income and household composition.

Compare CHIP and Medicaid income limits across all 50 states

If you are 65 or older with limited income — Medicare Savings Programs

Texas runs three Medicare Savings Programs (MSPs) for low-income Medicare beneficiaries: Qualified Medicare Beneficiary (QMB) up to 100% FPL ($1,330/mo for an individual in 2026) which pays Medicare Parts A + B premiums, deductibles, and coinsurance; Specified Low-Income Medicare Beneficiary (SLMB) up to 120% FPL ($1,596/mo) which pays Part B premiums only; and Qualifying Individual (QI) up to 135% FPL ($1,795/mo) which also pays Part B premiums but is funded through a fixed annual block-grant. All three have an asset test (about $9,660 for an individual / $14,470 for a couple in 2026). MSP enrollment automatically qualifies you for the federal Extra Help / Low-Income Subsidy for Medicare Part D drug costs.

Read the Medicare eligibility guide

Frequently Asked Questions