Haris Ashley
In Texas, children aged 2 and over may be eligible for low-cost or free health coverage through the Children's Medicaid program or the Children's Health Insurance Program (CHIP). Eligibility for these programs is based on family income, with Children's Medicaid serving children from low-income families, and CHIP catering to children whose families earn too much to qualify for Medicaid but cannot afford private health insurance. Children can also stay on their parents' insurance plan until the age of 26, after which a working parent can petition to keep their child on their plan if the child has a disability.
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What You'll Learn
Children's Medicaid and CHIP
Children in Texas may be eligible for low-cost or free health coverage under Children's Medicaid or the Children's Health Insurance Program (CHIP). To qualify for either program, the child must be 18 years old or younger. In some cases, children with disabilities who are 19 or 20 years old can get Medicaid.
Children's Medicaid
Children's Medicaid is a free health care program for children from low-income families. If your child is eligible, there is no cost to receive services. However, if your family income is too high to qualify for Medicaid but you cannot afford health insurance, your child may still be eligible for CHIP.
CHIP
CHIP is a health care program for children who do not have health insurance. CHIP coverage incurs copays for some health services, with enrollment fees and copays based on family income. Families with CHIP coverage pay $50 or less per year for enrollment, with additional copays for specific services.
Applying for Children's Medicaid or CHIP
To apply for either program, you will need to provide information about your family's income to determine your child's eligibility and which program they qualify for. You can use the same application for both programs by visiting the Texas Health and Human Services website or calling 877-KIDS-NOW (543-7669).
Transitioning to Adult Medical Care
It is important to note that Children's Medicaid and CHIP coverage typically ends when a child turns 18, at which point they may transition to adult medical services and insurance. In Texas, the age of majority is 18, and healthcare professionals may not share information with parents unless the youth provides consent. Additionally, some pediatricians stop seeing children at age 18, making it necessary to transition to adult medical care.
Alternative Options
If your child is approaching the age limit for Children's Medicaid or CHIP, there are alternative options to consider. Your child can stay on your family health insurance plan until the age of 26, or even longer if they have a disability and meet certain conditions. Additionally, your child may be eligible for Medicare or other programs based on their income and needs.
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Income requirements
In Texas, children might be able to get low-cost or free health coverage through Children's Medicaid or the Children's Health Insurance Program (CHIP). Both programs cover doctor visits, prescription drugs, dental care, eye exams, glasses, and more.
Children's Medicaid is a health care program for children from low-income families. There is no cost to receive services through Children's Medicaid. To be eligible, a child must be 18 years old or younger. In some cases, children with disabilities who are 19 or 20 years old can get Medicaid. When applying, the family's income will be assessed to determine eligibility and the specific program the child can get into. If your family income is higher than the limits for Children's Medicaid, you might be eligible for CHIP.
CHIP is a health care program for children whose families earn too much to qualify for Medicaid but cannot afford health insurance. CHIP fees vary based on your income. If your child is eligible for CHIP, your enrollment fee and co-pays will be based on your family's income. Enrollment fees are $50 or less per family, per year.
If you have a child with a disability and make too much money to get Children's Medicaid, you might be able to get coverage through the Medicaid Buy-In for Children (MBIC) program. MBIC allows families of children with disabilities to make a monthly payment to get Medicaid coverage.
When your child turns 18 years old, most programs will only look at your child's income, property, and savings to decide if they can continue to get services or benefits. Many federal and state programs set a limit of $2,000 in savings for the child. If your child has more than that, they cannot get the service.
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Coverage and costs
Children in Texas may be able to get free or low-cost health coverage through Children's Medicaid or the Children's Health Insurance Program (CHIP). To be eligible for either program, the child must be 18 years old or younger. In some cases, children with disabilities who are 19 or 20 years old can get Medicaid.
Children's Medicaid is free, with no cost to receive services if the child is eligible. CHIP fees vary based on income. If a child is eligible for CHIP, the family's enrollment fee and co-pays will be based on their income. Enrollment fees are typically $50 or less per family per year.
Both programs cover doctor visits, prescription drugs, dental care, eye exams, glasses, and more. Families with CHIP coverage pay less than $50 a year, and there may be copays for some health services. A copay is a fee paid each time a service is used, such as visiting the doctor or filling a prescription.
If a family's income is too high to qualify for Children's Medicaid but they cannot afford health insurance, they may be able to get coverage through the Medicaid Buy-In for Children (MBIC) program. This program allows families of children with disabilities to make monthly payments to receive Medicaid coverage.
When a child turns 18, most programs start considering the child's income, property, and savings to determine eligibility for services or benefits. Many programs have a savings limit of $2,000, and the child may no longer be eligible if their savings exceed this amount.
At age 18, children can also begin receiving SSI, Medicare, or other services based on their disability and income. To receive Medicare, the child must have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months. Additionally, children can stay on their parent's health insurance plan until the age of 26. After this age, if the child has a disability, a working parent can petition their workplace to keep the child on the plan.
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Applying for insurance
In Texas, children might be able to get low-cost or free health coverage from Children's Medicaid or the Children's Health Insurance Program (CHIP). To apply for either of these programs, visit the Texas Health and Human Services website or call 877-KIDS-NOW (543-7669). You can use the same application for both programs.
When applying for insurance for your child, you will need to provide information about your family's income to see which programs your child can get. You will also need to provide information about your child's income, property, and savings. Many federal and state programs set a limit of $2,000 in savings for a child to be eligible for benefits.
If your child has a disability, they may be able to get coverage through the Medicaid Buy-In for Children (MBIC) program, which allows families of children with disabilities to make a monthly payment to get Medicaid coverage. If your child is over 18, they may be able to get Medicare if they have been receiving Social Security Disability Insurance (SSDI) benefits for at least 24 months.
It is important to note that Children's Medicaid and CHIP have different eligibility requirements. Children's Medicaid is a program for children in low-income families, while CHIP is a program for children without health insurance whose families earn too much to qualify for Medicaid but cannot afford health insurance. CHIP fees vary based on income, with enrollment fees of $50 or less per family per year.
If your child is approaching adulthood, you should be aware that most programs will stop considering your family's income when your child turns 18, and will only look at your child's income, property, and savings to determine eligibility for services or benefits. This is also the age when a person assumes the rights and privileges of adulthood in Texas, and a healthcare professional may not share information with parents unless the youth invites them to participate.
To ensure continued coverage for your child as they transition to adulthood, you should contact your health insurance company one year before your child turns 26 to see if the coverage can continue. Your child may be able to stay on your family plan until age 26, especially if they have a disability.
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Transitioning to adult care
In Texas, children might be able to get low-cost or free health coverage through Children's Medicaid or the Children's Health Insurance Program (CHIP). Children's Medicaid is a free healthcare program for children from low-income families, while CHIP is for children without health insurance whose families earn too much to obtain Medicaid but cannot afford health insurance. Children with disabilities can receive Medicaid until they are 19 or 20 years old, and children with STAR Kids can stay with the program until they are 20 years old.
When a child turns 18 years old, most programs, including Children's Medicaid and CHIP, stop looking at the family's income and consider only the child's income, property, and savings to determine eligibility for services or benefits. At this point, the child may be eligible for Medicare if they have been receiving Social Security Disability Insurance benefits for a minimum of 24 months. Additionally, Medicaid offers health insurance and some dental benefits for children based solely on their income, starting at 18 years old.
To prepare for the transition to adult care, Texas Parent to Parent has created Transition Action Groups (TAGs) as part of their Pathways to Adulthood program. These groups of parents and children provide mutual support and share information to help each other through the transition process. Texas Health Steps also offers a training course for health care professionals to address the health, education, and social needs of children and youth with chronic health conditions or disabilities as they approach adulthood.
It is important to note that childhood doctors and specialists might not be able to treat a child after they turn 18, and adult doctors will expect the individual to take charge of their own care. To facilitate this transition, parents can encourage their children to take responsibility for their health by teaching them to greet doctors, ask questions, and describe their symptoms. Additionally, children can gain independence by taking on tasks and chores around the house and exploring neighborhood or volunteer job opportunities.
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Frequently asked questions
Yes, children over 2 can get medical insurance in Texas. Children's Medicaid and the Children's Health Insurance Program (CHIP) are available to children aged 18 and younger.
To get your child on Medicaid or CHIP, you must apply. You can apply for both programs using the same application. When you apply, you will be asked about your family's income to see which program your child is eligible for. If your child is approved for Medicaid, there is no cost to receive services. If your child is approved for CHIP, your enrollment fee and co-pays will be based on your family's income.
Children's Medicaid covers doctor visits, prescription drugs, dental care, eye exams, glasses, and more.
When your child turns 18, they will no longer be covered by Children's Medicaid or CHIP. At this point, they may be eligible for other programs based on their income, property, and savings.
