The Fineprint
Applying for Medicaid
Medicaid is a federal and state program that aids vulnerable populations, such as low income families, pregnant women, the elderly, children, and people with disabilities, in covering healthcare expenses. Medicaid covers over approximately 70 million low-income Americans and about 1 in 6 elderly adults. The government has a set of rules and guidelines for states to follow, but how the program conducts itself varies from state to state. Medicaid can be crucial in contending with exorbitant healthcare costs that otherwise are difficult to meet.
Table of Contents:
Step 1: Confirm that you are eligible
These are the general requirements to be eligible for Medicaid (varies by state to state):
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Low-income Adults (earning up to 133% of the Federal Poverty Line)
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Pregnant women (incomes similarly earning up to 133% of the Federal Poverty Line) (also receive postpartum coverage, typically 60 days after birth)
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Elderly Individuals (Ages 65+) (eligibility involves income and asset limits) (If qualifies for Supplemental Security Income (SSI) then automatically qualifies for Medicaid)
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People with disabilities (eligibility involves income and asset limits) (If qualifies for Supplemental Security Income (SSI) then automatically qualifies for Medicaid)
Step 2: (Applying for Texas Medicaid) Gather Important Documents and Information
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Names, dates of birth, social security numbers
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Most recent federal tax information
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Income information, most recent pay stubs
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If any, current health insurance information
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Other income such as unemployment benefits, SSI benefits, etc.
Step 3: Ways to Apply
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Go to yourtexasbenefits.com and click “Apply for new benefits” or request a paper form and submit by mail
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Go to a Texas Health and Human Services Commission (HHSC) office near you (can be found by calling 2-1-1 or visiting the “Find an Office” page on yourtexasbenefits.com)
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Call 2-1-1, Monday-Friday 8am to 6pm
Ways to Find a Navigators or Certified Application Counselor (CAC)
Finding enrollment assisters can be immensely helpful in deciphering documents and applying for Medicaid. Navigators and Certified Application Counselors (CAC) are professionals that are trained to help individuals apply to coverage, such as Medicaid or CHIP, free of charge. They can help gather needed documents, break down eligibility requirements, and provide general information about enrolling in these coverage programs.
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Ways to find enrollment assisters:
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Use official look up tools (Ex. using HealthCare.gov and using the “Find Local Help” tool)
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In Texas, there is a Community Partner Program in which local organizations partner with Texas HHS to help individuals apply for benefits (calling 2-1-1 and asking for “community partner” can connect you to nearby help)