Texas Medicaid Eligibility and Enrollment

In this article...
  • Learning how to enroll in Medicaid and what services it covers is important. Find out everything there is to know about getting started with Texas Medicaid.

Medicaid provides financial help for individuals and families who are unable to pay for their own health care. Unlike regular insurance, Medicaid primarily covers those with incomes up to 400% of the federal poverty level. Medicaid programs cover costs such as primary and ambulatory care. Depending on the state, coverage might also include extras such as long-term care, dental care and physical therapy or rehabilitation.  

Below, we discuss everything older adults need to know about Medicaid in Texas, including how to enroll and what types of coverage are available.

What Is Texas Medicaid?

Texas Medicaid encompasses a variety of programs to provide financial health care coverage to eligible individuals throughout the state. Providing coverage for families, individuals and older adults, Texas Medicaid strives to preserve the well-being of Texans by providing quality health care services that can be accessed within beneficiaries' communities.

In Texas, there are five types of Medicaid coverage:

  • STAR
  • STAR Kids
  • STAR Health
  • Traditional Medicaid

Each of the STAR programs provides managed care for recipients. While STAR, STAR Kids and STAR Health offer services for families, kids and pregnant women, STAR+PLUS features managed care for those aged 65 and older and individuals who are living with disabilities. Traditional Medicaid covers individuals who aren't eligible for managed care.

What Does Texas Medicaid Cover? 

Traditional Medicaid in Texas covers a variety of services for its beneficiaries. That includes:

  • Primary care
  • Ambulatory care
  • Inpatient hospital care
  • Laboratory and X-ray services
  • Services provided in a skilled nursing facility
  • Medical transportation
  • Prescription drugs

Older adults who are enrolled in the STAR+PLUS managed care program receive all the benefits of traditional Medicaid, as well as:

  • Physical therapy
  • Optometry services
  • Hearing aids and audiologist care
  • Podiatry services
  • Mental health services
  • Dental Care

  • Services provided in an assisted living facility
  • Hospice care

Because the STAR+PLUS program is a managed care program, those who are enrolled in it must seek care from providers that are in their coverage network. 

Who Is Eligible for Medicaid in Texas?

Senior citizens who wish to enroll in Texas Medicaid must meet the state's eligibility requirements. They must be at least 65 years of age or living with a diagnosed disability to be eligible for STAR+PLUS or traditional Medicaid coverage. Additionally, applicants must be residents of Texas, as well as a U.S. national, citizen, permanent resident or legal alien. Financially, older adults wishing to enroll in Medicaid may not exceed $733 in monthly income. 

How Do I Enroll in Medicaid in Texas?

To enroll in Texas Medicaid, Texans can call 2-1-1 from anywhere in Texas or visit Your Texas Benefits to apply online.

Contact Information for Texas Medicaid

More information can be obtained by calling the Texas Medicaid hotline at (800) 252-8263 or by sending an email to medicaid@hhsc.state.tx.us.