Texas Medicaid

About the Texas Medicaid Program

What is the Difference in Texas for Children’s Medicaid and CHIP?

Texas Medicaid, like many states, has a few options to make sure that the children of the state are taken care of from a health insurance angle.  To understand when your child may be insured you should understand the difference between the two major coverage options.  Here is the difference between Children’s Medicaid and CHIP (Children’s Health Insurance Program) in Texas. Continue reading

Texas Medicaid Coverage for Prenatal

There are times where you or a loved one may not be able to qualify for benefits from Medicaid or Medicare but you can get partial benefits.  This is something to look in to, especially if you happen to be pregnant in the state of Texas and you don’t have health insurance.  The following is a look at a few of the benefits from Texas Medicaid and their “CHIP Prenatal” coverage: Continue reading

Texas Medicaid Program: A Brief Overview of Medicaid in Texas

Medicaid is a Federal and State program that Texas began offering to qualified citizens in September of 1967. Both the federal and state agencies responsible match funds to provide low income individuals and families with medical coverage. Thanks to this program, people who could not normally afford to seek medical care can do so without difficulty. If you do not have health insurance and have difficulty paying your medical bills, you may qualify for Medicaid. Before applying, it helps to understand the criteria you will need to meet before being approved.

Individuals and families who receive TANF, an acronym that means Temporary Assistance for Needy Families, automatically qualify. Those who receive SSI benefits and/or Refugee Cash Assistance are also automatically eligible. Medicaid is also awarded to low income families who fall under a certain income level, as well as children under the age of 19 and pregnant women. Youths who are in foster care and aging out of their facility, certain senior citizens who require nursing home care and disabled individuals may also qualify for coverage.

For each specific group listed above, there are different requirements for eligibility. To find out more about the requirements and the application process, contact your local Department of Social Services. When you apply for Medicaid, you will be assigned a case worker who will handle your case and answer all your questions. If you are approved, you will receive a card which you will present when obtaining medical care or prescription medication. Some individuals will be subject to a co-payment, which means you need will pay a small amount of money. Co-payments are usually very reasonable.

One of the best things about Medicaid is that it covers a wide range of things. In addition to acute medical care, you will receive coverage for checkups and certain diagnostic tests. Dental and vision are also covered, as well as certain mental health services. Various types of necessary medical equipment may be covered under Medicaid as well. Your case worker can inform you regarding exactly what is covered under your Medicaid plan.

Texas Medicare Supplemental Insurance – A Brief Look

Medicare is the health insurance program administered by the U.S. Government, as most citizens know. Many residents are automatically enrolled in Medicare on their 65th birthday.  Certain persons less than 65 years old can be eligible for Medicare insurance according to specific disability requirements.  The Texas Medicare program offers additional benefits to its members.

Medicare Part D, the Medicare prescription drug program, is offered by both the Centers for Medicare and Medicaid Services (CMS) and the Department of Health and Human Services. The Texas Department of Health and Human Services has created an online resource website to assist dual-eligible Texans transition to the new Medicare prescription program.

Dual-eligible Texans are those Texas citizens who receive both financial assistance from the Medicaid program and who are eligible for the Texas Medicare program.  This website is located at TexasMedicareRx.org.

The CMS (Federal Medicare agency) announced that “Medicare beneficiaries whose only Medicaid benefit is community attendant services are not automatically eligible for the low-income subsidy for Medicare prescription drug program.”

In response to community attendant service recipients being ineligible for the low-income Medicare prescription drug subsidy, Texas became the only state (currently) to adopt the Medicaid 1929(b) program.  This program operates outside the Texas Medicare program and makes available community attendant services that assist elderly, low-income persons to live at home instead of in nursing homes.  If you are aware of nursing home costs, you know how much money this program can save.

To receive reduced-cost Texas Medicare prescription drug coverage, the only Medicaid assistance a Texan can be receiving is the community attendant services.  If that condition is met, the person must take the following actions to apply for Texas Medicare drug coverage at reduced prices.

First, the individual must determine if he or she meets the financial eligibility requirements.  Second, the person must prepare and file the application for the Texas Medicare low-income assistance.  Third, the person must select among the numerous Texas Medicare Part D drug plans and choose one that is suitable to his or her health situation.

The Texas Medicare program placed a deadline of May 15, 2006 for these actions to be completed.  Persons who missed this deadline should contact their local Texas Medicare professional or office or their caseworker from the Texas Department of Aging and Disability Services.

Both Federal and Texas Medicare rules and deadlines are subject to change.  Texas residents requesting coverage under the Texas Medicare program are encouraged to seek the most recent information before taking any actions.



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