Texas Medicaid for Pregnant Women: Income Limits, CHIP Perinatal, and How to Apply

Key facts

1Who may qualify for Texas Medicaid for Pregnant Women?

HHS lists three basics for Medicaid for Pregnant Women and CHIP Perinatal: (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal)

• You must live in Texas.
• To get Medicaid, you must be a U.S. citizen or a qualified non-citizen.
• You cannot have other health insurance to qualify for CHIP Perinatal.

Then income decides which program fits. HHS says that when you apply, it will ask about your family's monthly income to see which program fits. (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal) Texas does not count savings, a car, or other resources for this coverage. The handbook says that for Medical Programs (other than two spend down groups for children), "Resources are not considered a factor in determining eligibility." (Texas Works Handbook A-1210)

Age is not a bar. The handbook lists this coverage for a "Minor or adult pregnant woman." (Texas Works Handbook A-241.1.5) A teen certified while pregnant stays covered through her pregnancy and 12-month postpartum period even if she turns 19 during it. (Texas Works Handbook A-830)

2What are the Texas pregnancy Medicaid income limits for 2026?

"Income means the money your family earns before taxes are taken out." (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal) If your family's monthly income is the same as or less than the line for your family size, you may qualify. These are official limits from HHSC, not estimates. (Texas Works Handbook C-131.1)

The HHS consumer page shows the same figures for family sizes 1 to 5. (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal) Sizes 6 to 8 come from the handbook chart. (Texas Works Handbook C-131.1)

3How does your unborn baby count in your household size?

The handbook says: "The expected number of unborn children are included in the MAGI household composition of: a pregnant woman; and any individual whose MAGI household composition includes a pregnant woman." (Texas Works Handbook A-241.1.5)

Here is how that plays out with the official chart. A pregnant woman who lives alone and expects one baby is a family of 2, so her line is $3,571 a month, not the $2,634 line for 1. If she expects twins, she is a family of 3, with a line of $4,508. (Texas Works Handbook C-131.1)

HHS also accepts your own statement for this. A verbal or written statement from the applicant, the pregnant woman, the head of household, or an authorized representative is acceptable proof of the start month, the number of expected children, and the due date. (Texas Works Handbook A-820)

4What is CHIP Perinatal, and who is it for?

CHIP Perinatal "provides services to unborn children of pregnant women, regardless of age." It is for pregnant women who cannot get Medicaid because their income is above 198 percent of the poverty level but at or below 202 percent, or who cannot get Medicaid or CHIP because of immigration status. (Texas Works Handbook D-110)

• What it covers: "care during pregnancy and two doctor visits within 60 days after the pregnancy ends." (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal)
• Who it covers: the unborn child gets 12 months of continuous eligibility, counting months before and after birth. The mother gets coverage related to the birth only, not her own full health coverage. (Texas Works Handbook D-110)
• Other insurance: you cannot have other health insurance to get CHIP Perinatal. (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal)

Because CHIP Perinatal covers pregnancy services only, the handbook says women on it must apply for Emergency Medicaid or Medically Needy with Spend Down to get coverage for medical conditions not related to the pregnancy. (Texas Works Handbook D-110) You do not pick the program yourself. If you are on CHIP Perinatal and report a change, Texas automatically tests you for Medicaid without a new application. (Texas Works Handbook D-110)

5How long does Texas pregnancy Medicaid last, and can it cover past bills?

Start: coverage can begin "the first day of the month her pregnancy starts, not before." (Texas Works Handbook A-820)

Past bills: if you had unpaid medical bills in any of the three months before the month you apply, and you met the rules then, coverage can start in that earlier month. (Texas Works Handbook A-820) For pregnant women, gaps do not apply: once eligibility is found in one of those prior months, it continues even if a later prior month had no unpaid bills. (Texas Works Handbook A-830)

End: you stay covered "through the 12th month following the month her pregnancy ends" if you met the rules when certified. (Texas Works Handbook A-820) After approval, you remain eligible "regardless of any changes" unless you voluntarily withdraw, move out of state, are found ineligible because of agency error or fraud, or die. (Texas Works Handbook A-820) Under that rule, a change in income after approval does not by itself end this coverage.

6How fast does Texas decide, and what proof do you need?

Texas expedites pregnancy Medicaid. Applicants are entitled to "have their eligibility determined no later than 15 business days from the date HHSC receives the application," and to postpone all verification except identity until the 30th calendar day. (Texas Works Handbook A-140) The handbook adds: "An interview is not required when processing a TP 40 application." (Texas Works Handbook A-140)

Proof of pregnancy is usually your word. HHSC accepts the pregnant woman's, case name's, or authorized representative's verbal or written statement unless it is questionable. The statement must give the name of the woman who is pregnant, the pregnancy start month or due date, and the number of expected children. (Texas Works Handbook A-140) If it is questionable, HHSC may ask for Form H3037, Report of Pregnancy, or another document with the same information from an acceptable source such as a physician. (Texas Works Handbook A-140)

7How do you apply for Medicaid while pregnant in Texas?

• Online: YourTexasBenefits.com can be used to apply for health care for pregnant women, alongside SNAP and TANF. (Texas Works Handbook A-113.1)
• Paper: Form H1010 (Texas Works Application for Assistance) or Form H1205 (Texas Streamlined Application, health care only) both cover pregnant women. (Texas Works Handbook A-113.1)
• By phone for help: call 2-1-1 or 877-541-7905, select your language, then Option 2. (Texas HHS, Contact)

After approval, you choose a health plan from the ones available in your service area, because services are delivered through the STAR managed care program. (Texas HHS, Medicaid for Pregnant Women and CHIP Perinatal)

You submit your application yourself on the official site. Benefit Bull is free, always. It never files for you.

8What happens when your postpartum coverage ends?

When Medicaid for Pregnant Women ends, the woman "is automatically tested for other types of medical assistance," using current case information without a new application in most cases. If she is eligible, a new certification period starts after the pregnancy coverage ends. (Texas Works Handbook A-820)

Healthy Texas Women (HTW) is one path. To be eligible, applicants must be female, 15 through 44, with countable income at or below 204.2 percent of the poverty level, a Texas resident, not pregnant, without other insurance that covers family planning, and not on Medicaid, CHIP, or Medicare Part A or B. A parent or legal guardian must apply for applicants 15 to 17. (Texas Works Handbook W-110)

HTW Plus adds enhanced postpartum services, including care for postpartum depression and other mental health conditions, heart conditions, and substance use disorders, for HTW members whose pregnancies ended within the 12 months before they enrolled. There is no separate application for it. (Texas Works Handbook W-110)