Texas Medicaid and CHIP eligibility

Do I qualify for coverage in Texas?

Medicaid and CHIP programs help qualified Texas residents get access to affordable health care benefits. Review the requirements to find out if you may be eligible for one of these plans.

STAR

STAR benefits are available to you if:

You’re pregnant.

You’re ages 20 or younger.

You get Temporary Assistance for Needy Families (TANF).

You’re in the Adoption Assistance or Permanency Care Assistance (AAPCA) programs.

STAR Kids

STAR Kids benefits are available to young people ages 20 and below who have disabilities or complex health needs, are covered by Medicaid, and meet at least one of the following:

Get Supplemental Security Income (SSI)

Get SSI and Medicare

Get services through the Medically Dependent Children Program (MDCP) waiver

Get services through the Youth Empowerment Services (YES) waiver

Get services through any of the following Health and Human Services Commission (HHSC) Intellectual and Developmental Disability (IDD) waiver programs:

o Community Living Assistance and Support Services (CLASS)

o Deaf Blind with Multiple Disabilities (DBMD)

o Home and Community-based Services (HCS)

o Texas Home Living (TxHmL)

Live in a community-based Intermediate Care Facility for Individuals with an Intellectual Disability or Related Condition (ICF/IID) or nursing facility

Get services through a Medicaid Buy-In (MBI) program

STAR+PLUS

STAR+PLUS benefits are available to you if you are approved for Medicaid, and meet at least one of the following:

Age 21 or older and get Supplemental Security Income (SSI) benefits

Don’t get SSI, but are able to get STAR+PLUS Home and Community-Based Waiver Services

Age 21 or older and get Medicaid through Social Security Exclusion programs

Age 21 or older and live in a nursing home

Get services through the Medicaid Breast and Cervical Cancer (MBCC) program

CHIP

CHIP benefits are available to children that are:

Age 18 or younger and a U.S. citizen or legal permanent resident.

Ineligible for Medicaid because family income is too high.

Without other private health insurance.

CHIP Perinatal

CHIP Perinatal benefits are available if you live in our service area and are:

A pregnant woman.

Ineligible for Medicaid.

Without other private health insurance.

You can also check your eligibility for these programs by visiting the Your Texas Benefits website and using the Prescreening Tool. Or, you can call 2-1-1 (TTY 711) toll-free Monday through Friday from 8 a.m. to 6 p.m. Central time for more information.

Check your service area

How do I apply for Texas Medicaid or CHIP?

If you meet the eligibility requirements, you can apply at any time. Simply follow these steps:

1. Gather important information

When you’re ready to apply, make sure you have the following information at hand:

Names, birth dates, and Social Security numbers

Most recent federal tax information (if available)

Pay stubs or other job and income information for the last month

Current health insurance information, if any

Other income like unemployment benefits, SSI benefits, pensions or retirement, alimony, etc.

2. Apply for benefits

Apply for Texas Medicaid or CHIP benefits in one of five ways:

Visit Your Texas Benefits website and choose Apply for new benefits.

Call 2-1-1 (TTY 711) toll-free Monday through Friday from 8 a.m. to 6 p.m. Central time.

Print or request a paper form and submit it by mail.

Go to a Texas Health and Human Services Commission (HHSC) benefits office near you. Find one by calling 2-1-1 or visit the Find an Office page.

Visit a community partner near you. Find a community partner.

3. Check your mail and choose Wellpoint as your health plan

After you’re approved, you’ll get an enrollment packet in the mail. You need to choose a health plan, or the enrollment broker will choose one for you. For STAR and CHIP, call 800-964-2777 (TTY 711) to join Wellpoint. For STAR Kids and STAR+PLUS, call 877-782-6440 to join Wellpoint.