Here, you will learn about health insurance options for children in low-income families in Texas. You will also learn about health insurance options for children with disabilities. This article explains Children’s Medicaid, Medicaid Buy-In for Children (MBIC), and the Children’s Health Insurance Program (CHIP) programs in Texas.
The information in this article is reproduced from the Texas Health and Human Services website. Revised on September 9, 2022.
What health insurance programs are available in Texas for children in low-income families?
Children in Texas without health insurance may be able to get free or low-cost health coverage from Children’s Medicaid or the Children’s Health Insurance Program (CHIP).
Children's Medicaid is a health care program for children in low-income families.
Children’s Health Insurance Program (CHIP) is a health care program for children whose families earn too much to get Medicaid but cannot afford health insurance.
Other than income, what are the requirements to qualify for Children’s Medicaid or CHIP?
To qualify for Children’s Medicaid or CHIP, children must be:
Age 18 or younger (Children up to age 20 may be able to get Medicaid in some cases).
A Texas resident.
A U.S. citizen or legal permanent resident
A pregnant woman of any age can apply for CHIP perinatal services or Medicaid for her unborn child.
Who can apply?
The following people can apply for Children’s Medicaid or CHIP:
Any adult who lives more than half the time with an uninsured child may apply. This includes parents, stepparents, grandparents, other relatives, legal guardians, or adult brothers or sisters.
Anyone age 18 or younger who lives on their own can apply.
A pregnant woman of any age.
What if I am not a U.S. citizen?
An adult applying on behalf of a child does not need to be a U.S. citizen. The child must be a U.S. citizen or legal permanent resident in Texas to be considered for Children’s Medicaid or CHIP.
How do I know whether to apply for Children’s Medicaid or CHIP?
What services are covered by Children’s Medicaid and CHIP?
The following services are covered by both Children’s Medicaid and CHIP:
Regular checkups at the doctor and dentist
Medicine and vaccines
Hospital care and services
X-rays and lab tests
Vision and hearing care
Access to medical specialists and mental health care
Treatment of special health needs and pre-existing conditions
How much does Children’s Medicaid cost?
Children's Medicaid is free. There is no cost to receive services.
How much does CHIP cost?
CHIP fees vary based on your income.
CHIP enrollment fee and co-pays are based on your family's income. Enrollment fees are $50 or less per family, per year.
Co-pays for doctor visits and medicine range from $3 to $5 for lower-income families and $20 to $35 for higher-income families.
Does Medicaid cover services for children with disabilities?
Children with disabilities can get long-term services and supports through Medicaid. These services can include:
Home care and personal care, like having someone help monitor your child's health and help them with daily activities.
Having someone help take your child to their medical appointments.
Nursing home care.
A hospital for mental illnesses.
A place of care for people with intellectual disabilities.
Read this page to learn about services for children with disabilities.
Does CHIP cover services for children with disabilities?
CHIP does not cover long-term services and supports for children with disabilities.
What if I have a child with a disability and I make too much money to get Medicaid?
If you have a child with a disability and you make too much money to get Medicaid, you might be able to get coverage through the Medicaid Buy-In for Children program (MBIC). MBIC allows families of children with disabilities to make a monthly payment to get Medicaid coverage.
How do I apply for the Medicaid Buy-In for Children program?
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