Texas Health and Human Services Commission
Medicaid Buy-In for Children · About this organization
What you get
Medicaid health coverage through a disability-based option. Monthly premiums range from $0 to $230, depending on your circumstances.
How to start
Fill out a separate H1200-MBIC application for each child, with evidence of income and your address ready.
Good to know
- The household must document income, insurance, and nonfinancial eligibility; HHSC verifies all factors.
- You may need to enroll in available employer insurance.
The details, as published
Texas Medicaid Buy-In for Children provides regular Medicaid coverage to a Texas child under 19 who meets the disability and financial rules, including families with gross income up to 300% of the federal poverty level. Depending on income and employer-sponsored insurance, a family may owe a monthly premium; the 2026 schedule ranges from $0 to $230. A parent, guardian, or authorized representative applies with Form H1200-MBIC and verifies disability, income, household, residency, citizenship or qualified status, and available employer insurance; a cancer diagnosis by itself does not establish disability eligibility.
What help you may get
Medical And Insurance Costs
Medicaid Buy-In for Children — practical items and home help
Texas Medicaid Buy-In for Children provides regular Medicaid coverage to a Texas child under 19 who meets the disability and financial rules, including families with gross income up to 300% of the federal poverty level. Depending on income and employer-sponsored insurance, a family may owe a monthly premium; the 2026 schedule ranges from $0 to $230. A parent, guardian, or authorized representative applies with Form H1200-MBIC and verifies disability, income, household, residency, citizenship or qualified status, and available employer insurance; a cancer diagnosis by itself does not establish disability eligibility.
Noncash help
Can cover
- Medicaid identification card and MBIC member handbook
- Regular Texas Medicaid health benefits
Does not cover
- Cash assistance
- Services excluded from or not authorized under the member's Medicaid coverage
- This is health coverage that pays enrolled providers under Medicaid rules, not a cash award to the family.
- Coverage continues for the certified period and is subject to renewal, premium payment when required, and continuing eligibility.
Check the main eligibility rules
Diagnosis
B-ALL is in scope. A Texas child with B-ALL may qualify when the illness and its effects satisfy the Social Security disability standard and every financial and nonfinancial Medicaid requirement; diagnosis alone is not sufficient.
Age
Age 0 to age 18, measured at application.
- The program covers children under age 19.
Treatment status
No specific treatment status is published.
- A provider must verify the patient or diagnosis.
- Medical, education, and functional evidence may be required if disability is not already established by Social Security.
- The child must meet Medicaid citizenship or qualified immigration status rules.
- Employer-sponsored insurance must be reported.
- When qualifying employer-sponsored coverage is immediately available to a parent in the home, enrollment may be required before MBIC certification; HIPP status also affects the premium.
Financial need is required.
- Current dollar limits vary by family size and are published in the HHSC Budget Reference Chart.
- Gross countable family income is screened against 300% FPL; HHSC then applies the MBIC exclusion of $85 plus one-half of the remaining income and compares the result with 150% FPL for family size.
- The public program overview describes the family-income ceiling as 300% FPL.
- For 2026, families at or below 150% FPL have a $0 MBIC premium.
- With employer-sponsored insurance and state-paid HIPP, the 2026 monthly premium ranges from $25 to $70 above 150% FPL; with employer-sponsored insurance and no state-paid HIPP, HHSC lists no MBIC premium.
- Without employer-sponsored insurance, the 2026 monthly premium is $90 for a family of one or two and $115 for a family of three or more at 151-200% FPL; it is $180 or $230 respectively at 201-300% FPL.
Where you live and where your child is treated
Where your family lives
You must live in: TX.
- Full Medicaid generally requires U.S. citizenship or an eligible qualified immigration status with required verification.
- The child must meet Texas Medicaid residency requirements.
Where your child is treated
No treatment-location restriction is published.
How to get started
Does a social worker or care team need to start it? No. A required care-team start is not published; the family can use the available route below.
Who can start: Caregiver, Parent Or Guardian
- If approved, pay any required monthly MBIC premium and comply with employer-sponsored insurance or HIPP instructions.
- Obtain and complete Form H1200-MBIC for each child applying.
- Provide household, income, employment, employer-insurance, other-insurance, residency, identity, and citizenship or immigration information and requested verification.
- Return the signed application to the Texas HHSC Document Processing Center or a local benefits office and respond to verification requests.
- Submit medical and functional evidence for a disability determination if Social Security has not already established disability.
Ways to apply or ask
- Online Portal · Open form or page
Documents to prepare
- Child identity, residency, and citizenship or qualified immigration verification
- Completed and signed Form H1200-MBIC
- Employment and employer-sponsored insurance verification when applicable
- Income and household verification requested by HHSC
- Medical, education, and functional evidence needed for disability review when disability is not already established
- HHSC determines Medicaid and disability eligibility and sends the family its premium amount, if any.
- Medicaid pays enrolled health-care providers for covered and authorized services rather than issuing cash to the family.
Availability and timing
| Program | Active |
|---|---|
| Applications | Open |
| Funding or space | Available |
| Application window | Rolling |
| Last checked | Aug 24, 2026 |
- The official program, current 2026 financial chart, and H1200-MBIC application were active on the verification date.
- The official MBIC application form remains published for ongoing applications.
Limitations and things to confirm
- A parent may need to enroll in qualifying employer-sponsored insurance when it is available.
- Cancer or B-ALL alone does not establish disability eligibility.
- MBIC is Medicaid coverage, not a cash grant, and individual services remain subject to coverage, network, and authorization rules.
- Monthly premiums can reach $230 under the 2026 schedule and failure to pay a required premium can affect coverage.
- The application creates an electronic case record containing child identity, disability, household financial, employment, and insurance information.
- The household must document income, insurance, and nonfinancial eligibility; HHSC verifies all factors.
- Is employer-sponsored insurance immediately available and does HIPP apply?
- What exact countable family income and monthly premium will HHSC calculate?
- Which Medicaid managed-care plan, providers, and prior authorizations will apply after enrollment?
- Will HHSC find that the child's current condition satisfies the disability standard?
Official sources
Program details were last verified Aug 24, 2026. Availability can change, so check the official program before applying.
- Appendix XXXI, Budget Reference Chart · checked Aug 24, 2026
- Form H1200-MBIC, Application for Benefits - Medicaid Buy-In for Children · checked Aug 24, 2026
- D-1400, Disability · checked Aug 24, 2026
- N-5100, ESI Chart · checked Aug 24, 2026
- N-1200, Program Overview · checked Aug 24, 2026