Texas Medicaid Income Limits

Updated August 2026

Texas HHSC uses the 2026 Federal Poverty Level (FPL) published by HHS for Medicaid and CHIP eligibility determinations effective March 1, 2026. The 2026 base FPL for a single person is $15,960/year ($1,330/month). All figures below are monthly unless noted, per the HHSC Texas Works Handbook C-131 income limits chart (effective March 1, 2026).

~15%

FPL — parents limit

133%

FPL — children (Medicaid)

198%

FPL — pregnant women

GAP

Adults ~15%–100% FPL

Texas has not expanded Medicaid — most working-age adults do not qualify

Texas did not adopt the ACA Medicaid expansion. Non-disabled adults without dependent children do not qualify for Texas Medicaid at any income level. Adults who earn too little for ACA marketplace subsidies (below 100% FPL) but do not qualify for Medicaid fall into the coverage gap. The income figures below apply only to qualifying coverage groups.

Texas Medicaid income limits by coverage group (2026)

Coverage group	FPL threshold	Monthly limit (1 person)	Monthly limit (family of 4)
Children (ages 0–18) — Medicaid	133% FPL	$1,769/mo*	$3,658/mo
Children (ages 0–18) — CHIP	~201% FPL	$2,674/mo*	$5,528/mo
Pregnant women — Medicaid (STAR)	198% FPL	$2,634/mo	$5,445/mo
Pregnant women — CHIP Perinatal	~202% FPL	$2,687/mo	$5,555/mo
Parents and caretaker relatives	~15% FPL	~$188/mo (single)	~$319/mo (fam. of 3)
Elderly and people with disabilities (MEPD)	~100% FPL (varies)	~$1,330/mo	Varies
SSI recipients (automatic)	SSI limit	Auto-enrolled	—
Non-disabled adults without children	Not eligible	—	—

Children (ages 0–18) — Medicaid

FPL threshold: 133% FPL
Monthly limit (1 person): $1,769/mo*
Monthly limit (family of 4): $3,658/mo

Children (ages 0–18) — CHIP

FPL threshold: ~201% FPL
Monthly limit (1 person): $2,674/mo*
Monthly limit (family of 4): $5,528/mo

Pregnant women — Medicaid (STAR)

FPL threshold: 198% FPL
Monthly limit (1 person): $2,634/mo
Monthly limit (family of 4): $5,445/mo

Pregnant women — CHIP Perinatal

FPL threshold: ~202% FPL
Monthly limit (1 person): $2,687/mo
Monthly limit (family of 4): $5,555/mo

Parents and caretaker relatives

FPL threshold: ~15% FPL
Monthly limit (1 person): ~$188/mo (single)
Monthly limit (family of 4): ~$319/mo (fam. of 3)

Elderly and people with disabilities (MEPD)

FPL threshold: ~100% FPL (varies)
Monthly limit (1 person): ~$1,330/mo
Monthly limit (family of 4): Varies

SSI recipients (automatic)

FPL threshold: SSI limit
Monthly limit (1 person): Auto-enrolled
Monthly limit (family of 4): —

Non-disabled adults without children

FPL threshold: Not eligible
Monthly limit (1 person): —
Monthly limit (family of 4): —

Children's Medicaid income limits by household size (2026)

The table below reflects HHSC's published 2026 monthly income guidelines for Children's Medicaid (STAR program). These figures are effective March 1, 2026 and reflect the 133% FPL threshold, per the official HHSC Children's Medicaid page. If your child's income is too high for Medicaid, HHSC will automatically check CHIP eligibility.

Household size	Monthly income limit
1 person	$1,769
2 people	$2,399
3 people	$3,028
4 people	$3,658
5 people	$4,288
6 people	$4,917
7 people	$5,547
8 people	$6,176
Each additional person	add $630

1 person

Monthly income limit: $1,769

2 people

Monthly income limit: $2,399

3 people

Monthly income limit: $3,028

4 people

Monthly income limit: $3,658

5 people

Monthly income limit: $4,288

6 people

Monthly income limit: $4,917

7 people

Monthly income limit: $5,547

8 people

Monthly income limit: $6,176

Each additional person

Monthly income limit: add $630

Why the parent income limit is so low — and what it means

Texas covers parents and caretaker relatives of dependent children at approximately 15% FPL — the lowest threshold for parents in the entire country, per Every Texan. That translates to roughly $319/month gross income for a family of three. A parent working even part-time at minimum wage will typically earn too much.

This is not a budgeting choice unique to HHSC — it reflects Texas's decision not to expand Medicaid. In expansion states, parents qualify at 138% FPL. Texas has remained at its pre-ACA baseline. The result: most Texas children on Medicaid have parents who do not qualify for Medicaid themselves, leaving families without coverage for the adults.

Parents who earn between ~15% FPL and 100% FPL fall into the coverage gap. ACA marketplace subsidies do not apply below 100% FPL. These families have no subsidized coverage option under current law.

Income and asset rules for seniors and people with disabilities (MEPD)

Medicaid for the Elderly and People with Disabilities (MEPD) uses income and asset tests. For most MEPD categories, the income limit is approximately 100% FPL ($1,330/month for an individual, as of March 2026). However, certain disregards and deductions apply — for example, the standard $20 monthly disregard and earned income deductions for working disabled individuals.

For long-term care Medicaid (nursing facility coverage), income rules differ from community-based MEPD. Texas uses an income cap: applicants with monthly income above the special income limit for nursing facility care (approximately $2,982/month for an individual in 2026, or 300% of the SSI federal benefit rate) may still qualify by establishing a Qualified Income Trust (also called a Miller Trust). This must be done with an attorney's help before the application is submitted.

Asset limits for MEPD: $2,000 for a single individual, $3,000 for a married couple (where both apply). The primary home, one vehicle, and certain personal and burial property are excluded. A spouse remaining at home may protect additional assets under the Spousal Impoverishment protections of the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985 — currently up to approximately $162,660 (2026 CSRA limit, per CMS).

Medicaid Buy-In programs for working people with disabilities

Texas offers two buy-in programs for people with disabilities who work or whose income exceeds standard MEPD limits.

Medicaid Buy-In (MBI) — for working adults with disabilities: Covers adults with disabilities whose income is at or below 250% FPL ($3,325/month for an individual in 2026, per HHSC Bulletin 26-04). A monthly premium based on income applies. Disability must be documented and meet MEPD standards.
Medicaid Buy-In for Children (MBIC): For families of children with disabilities who earn too much for standard Children's Medicaid or CHIP. Income limit is 150% FPL based on family size (e.g., $4,125/month for a family of four in 2026, per HHSC Bulletin 26-04). A monthly payment applies based on income.

What counts as income under MAGI

For children, pregnant women, and parents, Texas uses Modified Adjusted Gross Income (MAGI) methodology — the same approach used for ACA marketplace coverage. MAGI is based on federal tax filing rules.

Wages, salaries, tips
Self-employment net income
Unemployment compensation
Social Security benefits (taxable portion)
Alimony received (pre-2019 divorces)
Capital gains and investment income

What does not count as income under MAGI

MEPD (Medicaid for the Elderly and People with Disabilities) uses a different income counting methodology — not MAGI. The $20 general disregard and earned income deductions apply.

Child support received
SSI payments
Veterans' disability compensation
Gifts and inheritances
SNAP (food stamps)
Workers' compensation

The Texas coverage gap: who it affects

The coverage gap describes adults who earn too much for Texas Medicaid but too little for ACA marketplace subsidies. ACA premium tax credits begin at 100% FPL ($1,330/month for a single adult in 2026). Texas Medicaid covers parents only at ~15% FPL (~$319/month for a family of three). Adults without children qualify at 0%.

Income range	Coverage option
$0 – ~15% FPL (~$0–$319/mo, family of 3)	Texas Medicaid — if you are a parent or caretaker with qualifying dependents
~15% – 100% FPL (~$319–$1,330/mo, single adult)	Coverage gap — no subsidized option available for adults without dependents
100% FPL and above ($1,330+/mo single adult)	ACA marketplace plans with premium tax credits (healthcare.gov)

$0 – ~15% FPL (~$0–$319/mo, family of 3)

Coverage option: Texas Medicaid — if you are a parent or caretaker with qualifying dependents

~15% – 100% FPL (~$319–$1,330/mo, single adult)

Coverage option: Coverage gap — no subsidized option available for adults without dependents

100% FPL and above ($1,330+/mo single adult)

Coverage option: ACA marketplace plans with premium tax credits (healthcare.gov)

If you fall in the coverage gap, check healthcare.gov to confirm you don't qualify for a special enrollment period or other coverage option.

Texas Medicaid

Visit the official Texas Medicaid website