Healthy Texas Women: Marketplace Insurance?

Healthy Texas Women is a program that offers free health and family planning services to eligible, low-income women in Texas. It is not an insurance plan, but rather a government-funded program that provides access to various healthcare services. The program was launched by the Texas Health and Human Services Commission in 2016 and has been recently redesigned to make it easier for women to access information about the services offered. These services include family planning, disease screenings and treatments, breast and cervical cancer screenings, and mental health services. It is not considered a marketplace but rather a program that provides access to healthcare services for those who qualify.

Eligibility requirements for Healthy Texas Women

Healthy Texas Women is a program that offers women's health and family planning services at no cost to eligible, low-income women in Texas. The program provides comprehensive healthcare, including birth control, pregnancy tests and counselling, and health screenings and treatment for hypertension, diabetes and cholesterol. It also offers enhanced, cost-effective, and limited postpartum services for up to 12 months after the enrollment date.

To be eligible for Healthy Texas Women, applicants must meet the following requirements:

• Be a woman between the ages of 18 and 44 or between the ages of 15 and 17 with a parent or legal guardian applying and providing consent.
• Be a U.S. citizen or a qualified immigrant.
• Be a resident of Texas.
• Not have health insurance.
• Meet the income requirements, which are based on the Federal Poverty Level and depend on family size. For example, for the 2022-2023 period, the monthly maximum family income for a single person is 204.2% of the Federal Poverty Level.

Women who have been pregnant in the past year and meet the above criteria will be eligible for Healthy Texas Women Plus services, which include enhanced postpartum care for up to 12 months.

To apply for Healthy Texas Women, individuals can submit an application online, by mail or fax, at a clinic that offers the program's services, or by picking up an application form at a Women, Infants and Children (WIC) Nutrition Program office. They can also apply over the phone by calling 2-1-1. Proof of citizenship, immigration status, and income will be required.

The range of health services offered

Healthy Texas Women is a program dedicated to offering free women's health and family planning services to eligible, low-income women in Texas. The program helps women plan their families, whether they want to achieve, postpone or prevent pregnancy. It also has a positive effect on future pregnancy planning and general health.

• Sexually transmitted infection services
• Breast and cervical cancer screenings
• Clinical breast examination
• Screening and treatment for cholesterol, diabetes and high blood pressure
• Contraception (birth control)
• Women’s health exams
• Pre-pregnancy advice and screenings
• Screening and treatment for postpartum depression
• Cardiovascular and coronary conditions treatments
• Substance use disorder treatments, including drug, alcohol and tobacco misuse
• Permanent sterilization
• Other contraceptive methods such as condoms, diaphragm, vaginal spermicide, and injections

Healthy Texas Women Plus is an enhanced, cost-effective, and limited postpartum services package for women enrolled in the Healthy Texas Women program. Women in Healthy Texas Women Plus will have access to both Healthy Texas Women and Healthy Texas Women Plus benefits. To qualify for HTW Plus benefits, clients must have been pregnant within the last 12 months.

The HTW Plus postpartum package

To qualify for HTW Plus benefits, HTW clients must have been pregnant within the last 12 months. The program provides coverage for up to 12 months after the date of enrollment in the HTW program.

HTW Plus services focus on treating major health conditions that contribute to maternal morbidity and mortality in Texas. These include:

• Postpartum depression and other mental health conditions: Services include individual, family, and group psychotherapy services, and peer specialist services.
• Cardiovascular and coronary conditions: Services include imaging studies, blood pressure monitoring, and anticoagulant, antiplatelet, and antihypertensive medications.
• Substance use disorders, including drug, alcohol, and tobacco use: Services include screening, brief intervention, and referral for treatment (SBIRT), outpatient substance use counseling, smoking cessation services, medication-assisted treatment (MAT), and peer specialist services.

In addition to the above, HTW Plus also covers:

• Asthma medications and supplies
• Diabetes management services, including labs, additional injectable insulin options, blood glucose testing supplies, and voice-integrated glucometers for visually impaired women with diabetes

If a health condition such as cancer is found, women in the program will be referred to a doctor or clinic that can treat them. They may have to pay for these extra services.

How to apply for the program

Healthy Texas Women is a program that offers women's health and family planning services at no cost to eligible, low-income women in Texas. The program provides comprehensive healthcare, including birth control, pregnancy tests and counselling, and health screenings and treatment for hypertension, diabetes and cholesterol.

To apply for the Healthy Texas Women program, you can submit your application online at YourTexasBenefits.com. You will need to provide proof of your citizenship and immigration status. If you are using a mobile phone or tablet, you will need to use one of the alternative application options listed below, as the online application does not work on these devices.

You can also download the form, fill it out by hand, and mail it or fax it to:

Healthy Texas Women

P.O. Box 149021

Austin, TX 78714-9021

Fax (toll-free): 1-866-993-9971

You can also apply at a clinic that offers Healthy Texas Women services. You can fill out the form at the clinic and may receive services the same day. You can find a participating clinic by using the Find a Doctor tool on the Healthy Texas Women website.

Additionally, you can pick up an application form at a Women, Infants and Children (WIC) Nutrition Program office. You can call 1-800-942-3678 (toll-free) to find a WIC office near you.

Another option is to apply for Healthy Texas Women over the phone by calling 2-1-1. Phone lines are open from 8 am to 6 pm Central Time, Monday to Friday.

Regardless of the application method you choose, you will need to provide proof of your income and identity. Examples of acceptable documents include:

• Paycheck stub or copy of a check from the last 60 days
• A letter from your employer
• Court papers, divorce decree or separation agreement that show you receive alimony
• Unemployment benefit award letter or pay stubs
• Supplemental Security Income award letter or pay stubs
• Receipts or income tax returns that show what you pay for daycare costs
• A certificate of naturalization or U.S. citizenship
• Current driver's license with photo
• U.S. citizen ID card
• Work or school ID card with photo
• Northern Mariana ID card
• American Indian card with classification code KIC
• Religious record of birth with date and place of birth, such as a baptism record

Contact information for queries

Healthy Texas Women is a program that offers women's health and family planning services at no cost to eligible, low-income women in Texas. The program helps women plan their families, whether they want to achieve, postpone, or prevent pregnancy. It also has a positive effect on future pregnancy planning and general health.

If you have any questions about the Healthy Texas Women program, you can contact them at the following:

• Phone: 1-866-993-9972 (toll-free) from 8 a.m. to 6 p.m. Central Time.
• Mail: Healthy Texas Women P.O. Box 149021 Austin, TX 78714-9021
• Fax (toll-free): 1-877-466-2409 for new applications or 1-877-447-2839 for renewal applications
• Email: [email protected] or [email protected]

If you need help finding a Healthy Texas Women program provider, you can call 1-800-335-8957 (toll-free), select a language, and then choose option 5.

For questions about your coverage, you can also contact Texas Children's Health Plan at the following numbers:

• 1-866-959-6555 (CHIP)
• 1-866-959- 2555 (STAR)
• 1-800-659-5764 (STAR Kids)

If you have questions about your care, you can contact The Center for Children and Women at 832-828-1005.

If you need help with your Medicaid coverage, you can log into your account or call 2-1-1 and select Option 2. If you don't receive your Texas Benefits ID card or need a replacement, call 1-855-827-3748 (toll-free).

For general questions or to learn more about services, you can call 2-1-1 anytime, 24 hours a day, seven days a week. You can also visit the 2-1-1 website at www.211Texas.org.

Frequently asked questions