Get Ready to Renew Your Medicaid or CHIP Coverage

Make sure Texas Medicaid has your current mailing address, phone number, email, or other contact information. This way, they will be able to contact you about your Medicaid or CHIP coverage. You can review and update all of your personal information with Texas Medicaid by calling 2-1-1 or logging into YourTexasBenefits.com account. 

Texas Medicaid will be mailing you a letter about your Medicaid or CHIP coverage. These “renewal notices” will be mailed in a yellow envelope that says “Action Required” in red or will be sent electronically to those beneficiaries who signed up for electronic notices. You will need to complete and return the renewal packet or request for information on time. You must be given a minimum of 30 days to respond to renewal packets or requests for information. 

If you believe Texas Medicaid’s decision that you no longer qualify for Medicaid or CHIP is wrong, you can request a Medicaid Fair Hearing to contest this decision. You should get a written notice explaining why Texas Medicaid claims you no longer qualify. While you have 90 days from the date of the denial notice to request a Fair Hearing, if you request the Fair Hearing within 10 days of the date of the denial notice, your Medicaid or CHIP coverage will continue until a hearing is held and the hearings officer issues the decision. This continuation of benefits pending the hearing decision is an important protection against the immediate loss of Medicaid eligibility. 

If Texas Medicaid correctly determines that you no longer qualify for Medicaid or CHIP or you lose your fair hearing, there are options you can consider. 

You may be able to buy a health plan through the Health Insurance Marketplace. Losing Medicaid or CHIP coverage is a Qualifying Life Event (QLE), which allows you to enroll in a Marketplace plan outside of the Open Enrollment Period. Visit HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596 (TTY: 1-855-889-4325) to get details about Marketplace coverage. Four out of five former Medicaid beneficiaries can find plans that cost less than $10 per month. To apply, you will need current information about your household, income, and Texas Medicaid’s decision about your Medicaid or CHIP coverage. 

You may be able to sign up for Medicare without paying a late enrollment fee. If you now qualify for Medicare, but did not sign up for it when you first became eligible, you have a limited time (the “Special Enrollment Period”) to sign up without paying the usual penalty. Your Special Enrollment Period starts the day Texas Medicaid notifies you that your Medicaid coverage is ending and continues for 6 months after your Medicaid coverage ends. To sign up for Medicare during this Special Enrollment Period, fill out a CMS-10797 Form and mail or fax it to your local Social Security Office. You can also call Social Security at 1-800-772-1213. TTY users can call 1-800-325-0778. 

You may be able to obtain health care coverage through the CHIP program or the Medicaid Buy-In for Children (MBIC) program. 

To apply for CHIP, visit YourTexasBenefits.com to access the application, or you can apply by phone by calling 2-1-1, picking a language, and then pressing 2. A Texas Health and Human Services Commission (HHSC) representative will then help you with your application over the phone and mail it to you to sign. 

For more information about the Medicaid Buy-In for Children program, and to apply, visit the Medicaid Buy-In for Children webpage. 

For more information on the Medicaid and CHIP renewal process, visit Get Ready to Renew Your Medicaid or CHIP Coverage. 

If you need assistance with the Medicaid renewal process, you can:  

• Visit Get Ready to Renew Your Medicaid or CHIP Coverage for local resources, 

• Use Ask a Question,  

• Use the Legal Help Directory, or 

• Contact the State Bar of Texas Lawyer Referral Service.