Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Texas program

Free health insurance for your child (Children's Medicaid)

Texas's free Medicaid plan for children under 19. It can sit behind insurance you already have.

What it is

Texas's free Medicaid plan for children under 19. It can sit behind insurance you already have.

Children's Medicaid covers treatment without a premium or copays. Work insurance does not block it. HHSC decides who counts in your child's household and which income counts.

Eligibility rules
  • Your child must be under 19. A cancer diagnosis is not required, and there is no savings test.
  • HHSC uses current monthly income. A yearly figure divided by 12 is only an estimate after a pay change.
  • The March 1, 2026 base monthly limits for four are $5,445 under age 1, $3,960 at ages 1–5 and $3,658 at ages 6–18. The additional five-point allowance is $137.50.
  • The household used for Medicaid can differ from everyone living at your address. HHSC checks tax relationships and which income belongs in that household.
  • A child who is lawfully in the country can qualify without a five-year wait. The counselor checks the child's own status, not a parent's.
What you get
  • No premium or copays for covered hospital care, chemotherapy, clinic visits and medicines.
  • Dental and vision care.
  • Rides to covered appointments and home nursing when your child qualifies.
  • Help with eligible bills from before you applied.
What the help covers
  • Home nursing, personal care and equipment need a separate review of medical needs. Medicaid enrollment does not promise staffed nursing hours.
  • For a covered, properly authorized service while your child is eligible, an enrolled provider bills the employer plan first and treats the insurance and Medicaid payments as payment in full. The provider cannot bill you the remaining deductible, coinsurance or copay even when Medicaid pays $0. A provider’s failure to obtain approval or bill correctly is not a reason to transfer a covered charge to you. Noncovered services, ineligible dates and a genuinely agreed private-pay service have different rules; the counselor should check those exceptions before you agree to pay.
If you decide to apply
  1. Ask your hospital financial counselor to help with the application at Your Texas Benefits.
  2. Have ready: recent pay stubs, birth dates, insurance cards and dated unpaid bills. Explain any change in pay.
  3. Ask whether the hospital can assess your child for temporary Medicaid while HHSC reviews the application.

Your Texas Benefits, 2-1-1 or 877-541-7905, option 2. Ask the hospital about temporary Medicaid. · Official page ↗

After you apply
  • The usual decision standard is 45 days. A participating hospital may be able to assess temporary Medicaid while the full application is pending. Your social worker can ask whether this hospital participates, when temporary coverage would end and what must be completed to avoid a gap.
  • Through 2026, up to three eligible months before the application month can be covered. For child applications from January 1, 2027, this changes to two months.
  • If your child is approved for SSI, Medicaid usually follows without a second application.
Good to know

Your employer plan gets billed first. For covered care, an enrolled clinic generally cannot collect the remaining cost from you, even when Medicaid pays $0.

Other details
  • The financial counselor can compare your exact cancer team, hospital, pharmacy and planned care against a Medicaid plan.
  • An employer family premium may stay the same when one child leaves the plan. HIPP can review reimbursement of an eligible work-plan premium after Medicaid starts.
  • MBIC is a separate disability route when ordinary child Medicaid does not fit. CHIP Perinatal concerns a pregnancy, not an older child’s cancer treatment.
  • Under the September 2026 Texas billing manual, the protection applies to covered care on eligible dates. Your counselor can check enrollment, prior approval and any noncovered or private-pay exception.

Federal background: Medicaid and Medicaid as second insurance.

Official sources
Ask your social worker

“Could Medicaid help with the treatment costs our insurance leaves, and what would managing both plans involve? If it makes sense, could you help us apply?”

Why I’m asking: I want to understand the costs Medicaid could cover and whether our cancer team can use both plans.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

File the application, list every income source and any insurance, and answer each verification letter by its date.

Your social worker

The hospital social worker or financial counselor files presumptive eligibility, sends your unpaid bills with the prior-month request, and checks the case reached the right category.

The care team

Supplies treatment records when HHSC or the plan asks. No disability packet is needed for income-based Medicaid.

Who decides
HHSC decides eligibility. The child's STAR or STAR Kids plan (or TMHP) approves services
Ask your social worker
“Can the hospital start presumptive Medicaid today, and who sends our bills from the last three months with the prior-month request?”

How to apply

First step: Apply at YourTexasBenefits.com or call 2-1-1, option 2. Ask the hospital financial counselor for same-day temporary Medicaid.

  1. Apply at YourTexasBenefits.com today. Ask the hospital financial counselor for same-day presumptive coverage.
  2. Ask for the three months before the application month.
  3. If over income, file MBIC the same week instead of stopping.

Official application / program page ↗

Where it starts: Apply through Your Texas Benefits, 2-1-1 or 877-541-7905, option 2. Ask the hospital about temporary Medicaid.

What to gather

  • Photo ID and the child's birth certificate or Social Security number
  • Last 30 days of pay stubs for everyone at home
  • Insurance cards, if any
  • Dated unpaid bills from the three months before you apply
  • Form H1265
  • Form H1200-MBIC

How long: The standard is 45 days. A participating hospital can start temporary coverage the same day. Ask for up to three earlier months. Each month needs its own review.

What a yes looks like

A letter with start dates and a plan-choice packet, a Your Texas Benefits Medicaid card, and 12 months of coverage regardless of later income changes.

What a no looks like, and the next move

Ask HHSC for the written income calculation, including its income deduction. If income is still too high, apply for MBIC the same week.

Watch out

  • Do not cancel an employer plan to apply: Texas child Medicaid has no rule against other insurance, and the employer plan pays first.
  • If income is the reason for a denial, ask for the written calculation including the five-point income disregard. Also ask about MBIC.
  • Answer every HHSC letter. A missed verification request is the usual reason a case closes.
  • Emergency Medicaid is a possible route when immigration status prevents full coverage and the other conditions are met. CHIP Perinatal concerns pregnancy, not an older child’s leukemia treatment.

Dates that change this

2026-03-01: Income tables effective March 1, 2026.

2027-01-01: For applications on or after January 1, 2027, back coverage is two months instead of three.

2026-10-01: From October 1, 2026, narrower immigration rules preserve Texas’s CHIPRA 214 option for qualifying lawfully residing children. HHSC checks exact status and the other Children’s Medicaid/CHIP requirements. SSI-associated Medicaid has a separate immigration review; Emergency Medicaid remains a limited route.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Full Medicaid with no premium. Base lines for four: $5,445 under age 1, $3,960 ages 1–5, $3,658 ages 6–18 a month, plus a $137.50 disregard.

  • $5,445/month — Under age 1, family of four, base monthly line
  • $3,960/month — Ages 1–5, family of four, base monthly line
  • $3,658/month — Ages 6–18, family of four, base monthly line
  • $137.5/month — Five-point MAGI disregard added to the base line, family of four

Covers: Hospital, oncology and physician care · Prescription drugs · Home nursing, personal care and equipment (Texas Health Steps CCP) · Rides, meals and lodging for treatment trips · Dental and vision

What it costs the family: No premium and no copays for a child.

The eligibility facts, as published

Age max exclusive
19
Income screen
base table plus five-point disregard by age band
Uninsured condition
none
Asset test
none
Retroactive months
3
Continuous eligibility months
12
Ssi link
SSI normally links to Medicaid without a separate application. From October 1, 2026, HHSC separately checks SSI-associated Medicaid immigration eligibility and considers the under-19 Children’s Medicaid route where applicable; cash SSI alone does not guarantee Medicaid.

The trap: Do not cancel an employer plan to apply: Texas child Medicaid has no rule against other insurance, and the employer plan pays first.

Where I read this

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