What to Know About Low-Income Health Insurance in Texas for 2025
Children have more options for low-income health insurance in Texas than adults. It's very hard for adults without children to qualify for Medicaid in Texas.
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Families and children can get low-income health insurance in Texas, but adults have limited options. It's extremely difficult to qualify for Medicaid in Texas as an adult.
Community health centers and low-cost health insurance plans might be options if you don't meet the Medicaid requirements. If you make at least $15,060 per year, you might get free or low-cost health insurance from the federal marketplace.
Texas low-income health insurance income limits
Texas has several low-income health insurance programs. To qualify, you need to earn less than the income limit, which changes with the number of people in your household.
Depending on your income, children in your family might qualify for Medicaid in Texas, even if the adults don't. Most adults without children can't get Medicaid in Texas, no matter how little they make.
Low-income health insurance program | Monthly income limit for a family of three |
|---|---|
| Medicaid for adults with children | $333 |
| Medicaid for children | $2,862 |
| Medicaid for pregnant women | $4,261 |
| Medicaid for breast and cervical cancer | $4,442 |
| CHIP for children | $4,325 |
| CHIP for pregnant women | $4,347 |
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A household with three people can make up to $2,862 per month and still get Medicaid for their child. But for adults to qualify, a family of three can make no more than about $333 per month.
Medicaid income limits are not keeping up with inflation. Many limits in Texas hardly changed for 2025, and those that did increase only went up a small amount. The limit for parents actually decreased from $344 in 2024 to $333 in 2025.
The low-income threshold combined with the rapidly increasing cost of living makes it even harder for people in Texas to get Medicaid and CHIP coverage.
Medicaid for low-income adults in Texas
Unless you have kids, are a senior or have a disability, you can't get Medicaid in Texas as an adult.
Parents, seniors and people with disabilities are eligible, but qualifying for Medicaid as an adult in Texas is difficult. The requirements are tied to monthly income and differ based on the number of people in your household. Parents in a family of three, for example, can make no more than about $333 per month.
Pregnant women in Texas have two different program options for low-income health insurance, and it's easier to qualify than it is for other adults.
Adults who have been diagnosed with breast or cervical cancer may have an easier time qualifying for Medicaid in Texas. To qualify, single individuals can make up to $2,608 per month ($31,300 per year), which is 200% of the federal poverty level. For a family of three, the cap is $4,442 per month, or $53,500 per year. You also have to meet other requirements.
- Are between 18 and 64
- Are a U.S. citizen or eligible immigrant
- Live in Texas
- Have no other health insurance
- Need breast or cervical cancer treatment
What to do if you have a low income but don't qualify for Medicaid
If you have a low income but you make too much to get Medicaid, there are three ways to get cheap health insurance or medical care.
- Get a health insurance plan through the marketplace where plans can cost as little as $0 per month if you earn at least $15,060 per year as an individual.
- Get health insurance through a job. If you work full-time, most employers offer you health insurance. On average, you pay about 16% of the policy cost. That's an average of $119 per month deducted from your paycheck.
- Look at other coverage options like a short-term health insurance plan, which typically covers you if you get very sick but doesn't usually pay for routine care, or use a community health center to get discounted medical care without insurance.
Why is it so hard to get Medicaid in Texas?
It's more difficult to qualify for Medicaid in Texas than in many other states because Texas has not expanded Medicaid.
That means there is a coverage gap where an estimated 726,000 people in Texas make too much to qualify for Medicaid but make too little to get subsidies, which are tax credits that lower your monthly rate, on the federal health insurance marketplace. There are more people in Texas who make too much for Medicaid but too little for marketplace discounts than anywhere else in the country.
A senior in Texas usually has to make less than $11,581 per year to qualify for Medicaid. That's 26% below the federal poverty level. Seniors also have to meet other requirements, such as being enrolled in Medicare Part A. However, in the 40 states with expanded Medicaid, a single person can make up to $21,597 per year and still get Medicaid without meeting other requirements.
Texas Children's Medicaid
Children's Medicaid can provide low-cost or free health insurance in Texas.
Children's Medicaid is the best low-income health insurance for children in Texas. About 75% of the 3.9 million people in Texas on Medicaid are children. The program provides coverage for most common health care services.
- Checkups at the doctor
- Dental visits
- Medicine and vaccines
- Hospital care and services
- X-rays and lab tests
- Vision and hearing care
- Access to medical specialists
- Access to mental health care
- Special health needs
- Pre-existing conditions
When your child is covered by Medicaid in Texas, doctor visits and medicine costs between $3 and $35.
Children's Medicaid in Texas also covers some forms of long-term care for children with disabilities, which sets it apart from the other low-income health insurance programs in Texas.
- Home care and personal care
- Transportation to medical appointments
- Nursing home care
- Hospitalization for mental illnesses
- Care for children with intellectual disabilities
To be able to get coverage, a child must be under 18, although some 19- and 20-year-olds with disabilities qualify. A child must also be a Texas resident and either a U.S. citizen or legally allowed to remain in the country.
There are also monthly income caps for Children's Medicaid.
Texas Children's Medicaid income limits
People in household | Monthly income limit |
|---|---|
| 1* | $1,670 |
| 2 | $2,266 |
| 3 | $2,862 |
| 4 | $3,458 |
| 5 | $4,055 |
*A single household member is a child who doesn't live with a parent or relative.
If your household has more than eight people in it, add $597 to the income limit for each additional person.
If you make too much for your child to qualify for Children's Medicaid, your child may qualify for the Texas Children's Health Insurance Program (CHIP).
About 1.8 million people in Texas, including more than a million children, were taken off Medicaid during the "Medicaid unwinding" that started in April 2023.
Most people who lost Medicaid in Texas had paperwork issues like an incomplete renewal form or a non-updated address. Contact the Texas Health & Human Services Commission to see if you are still eligible for Medicaid and to re-enroll.
Children's Health Insurance Program (CHIP) in Texas
If your income is too high to qualify for Children's Medicaid, the Children's Health Insurance Program (CHIP) may be a good option.
Texas CHIP coverage is similar to Children's Medicaid but does not include any coverage for long-term disability support or services.
Health care with CHIP is nearly as cheap as with Medicaid, and a child's doctor appointment could cost between $5 and $25.
Children must be 18 or under, Texas citizens and either U.S. citizens or qualified noncitizens. The income limits for CHIP are higher than those for Children's Medicaid. This means you can make more money and still qualify for the Texas Children's Health Insurance Program.
CHIP income limits in Texas
People in household | Monthly income limit |
|---|---|
| 1* | $2,523 |
| 2 | $3,424 |
| 3 | $4,325 |
| 4 | $5,226 |
| 5 | $6,128 |
*A single household member is a child who doesn't live with a parent or relative.
Households with more than seven people add $902 per person to the income limit.
Low-income health insurance for pregnant women in Texas
Pregnant women in Texas have two options for low-income health insurance: Medicaid for pregnant women and CHIP for pregnant women.
The monthly income limit for CHIP is slightly higher, so it's easier to get coverage.
Medicaid for pregnant women in Texas
Medicaid provides health insurance coverage for pregnant women with low incomes in Texas.
Medicaid for pregnant women in Texas covers services including:
- Prenatal doctor visits
- Prenatal vitamins
- Labor and delivery
- Checkups for the baby after birth
To be able to get coverage, you must be a Texas resident and a U.S. citizen or qualified noncitizen.
You also have to meet monthly income requirements. The requirements vary based on how many people are in your household.
Texas Medicaid income limits for pregnant women
People in household | Monthly income limit |
|---|---|
| 1 | $2,485 |
| 2 | $3,373 |
| 3 | $4,261 |
| 4 | $5,148 |
| 5 | $6,036 |
For each person over five in the household, add $888 per month to the income limit.
CHIP for pregnant women
Pregnant women might also qualify for the Children's Health Insurance Program in Texas. If you are pregnant but make too much to qualify for Medicaid, you could consider CHIP Perinatal.
Medical care is cheap with CHIP Perinatal, and being admitted to the hospital for childbirth could cost between $35 and $125.
CHIP Perinatal and Medicaid cover similar things, including prenatal doctor visits, labor and delivery, and baby checkups after birth.
The income limits for CHIP Perinatal are slightly higher, which means you can make more and still qualify.
CHIP income limits for pregnant women in Texas
People in household | Monthly income limit |
|---|---|
| 1 | $2,536 |
| 2 | $3,441 |
| 3 | $4,347 |
| 4 | $5,252 |
| 5 | $6,158 |
For households with more than five members, add an additional $906 per month per person.
Getting Medicaid in Texas if you have high medical bills
Children and pregnant women with high medical bills can subtract their medical costs from their income to see if they can get Medicaid. This is called the the Medicaid spend down program.
To get Medicaid spend down in Texas, you first must apply for Medicaid and be rejected. Then you or your doctor can submit medical bills, and you'll work with Medicaid to calculate your adjusted income using Form H1119.
Other low-income health insurance options in Texas
If you don't qualify for Medicaid or CHIP, there are other options for low-income health insurance in Texas.
Vaccines for Children program
If you or your child are 18 or under, the Texas Vaccines for Children program is a good way to get low-cost vaccinations. You or your child must be one of the following to qualify.
- Covered by Medicaid
- Covered by CHIP
- Uninsured
- Underinsured
- Of American Indian or Alaska Native heritage
If you can get into the Vaccines for Children, you can use the doctor search tool to find a doctor that can give you or your children certain vaccines for free.
Community centers
Community health care centers don't sell insurance. But they do offer low-cost health care. If you can't afford insurance, a community center can be a good way to get the health care you need.
Find a community health center near you through Texas Association of Community Health Centersor through the government's health center tool.
Health centers can offer medical, dental and behavioral health services. You might also be able to get medications through health centers.
If you go to a Federally Qualified Health Center (FQHC), you might get discounted health care. Fees are adjusted based on your income and family size.
A Federally Qualified Health Center also cannot deny your care just because you can't afford to pay.
Alternative health plans
An alternative health plan is any plan that doesn't work like traditional health insurance.
Alternative health plans include short-term health insurance, supplemental health insurance and healthcare sharing ministries.
These plans may limit the length of your coverage or only cover certain situations. Some alternative plans are not regulated by the state, so there's no guarantee that claims will be paid. While these plans can be a good option if you have no other choice, make sure you research them carefully and understand their limitations.
Cheap health insurance on HealthCare.gov
If you don't qualify for Medicaid, you could get free or cheap health insurance through HealthCare.gov.
In most cases, the cost of insurance is discounted based on your income because of premium subsidies. The less you make, the more you'll save. But you have to make at least a certain amount to get subsidies.
To qualify, you have to make at least the federal poverty level based on your household size.
Minimum income to be eligible for health insurance subsidies
People in household | Minimum annual income |
|---|---|
| 1 | $15,060 |
| 2 | $20,440 |
| 3 | $25,820 |
| 4 | $31,200 |
| 5 | $36,580 |
For families with more than eight people, add $5,380 for each additional person.
Rates are set on a sliding scale. That means health insurance is free for individuals earning between $15,060 and $22,590. A family of three can make between $25,820 and $38,730 and get a free plan.
If you earn more, you'll pay more. So an individual in Texas earning $30,000 per year will pay about $50 per month for a typical health insurance plan.
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In Texas, it is possible to earn too much to qualify for Medicaid or CHIP, but too little to qualify for federal subsidies. This "coverage gap" happens in states that have not expanded their Medicaid program under the Affordable Care Act (ACA). Texas is one of 10 states that have not expanded Medicaid to provide access to affordable health insurance for all people who have a low income.
Frequently asked questions
What is the best low-income health insurance in Texas?
Medicaid is the best low-income health insurance in Texas for children, but it's very difficult for adults to get. If you do qualify, Medicaid is a good option. If you make too much for Medicaid, you could buy an alternative health plan, get health care at a community center or look for cheap traditional health insurance.
What company has the cheapest health insurance in Texas?
Blue Cross Blue Shield has the cheapest health insurance in Texas. If you can't get Medicaid, you could consider buying a regular health insurance policy. If you shop through HealthCare.gov, you might get premium subsidies that can make your health insurance cheaper.
What is Texas STAR Medicaid?
If you have STAR Medicaid, also called managed care, your Medicaid benefits come from a health insurance company. In most parts of Texas, you'll have at least two companies you can choose from, which may include Aetna, Amerigroup or Blue Cross Blue Shield. You'll then get your health care from doctors and hospitals within your company's network.
Sources
Sources include HealthCare.gov, the Kaiser Family Foundation, the Texas Department of State Health Services, the Texas Health & Human Services Commission and Texas.gov.
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