How To Apply For Emergency Medicaid In Texas
In this community resource guide, you will learn how to apply for Texas emergency Medicaid in Texas.
As a healthcare professional with over a decade of experience, I have seen firsthand the importance of having access to quality healthcare services. Unfortunately, many individuals and families struggle to afford the cost of medical care, even in the event of an emergency. This is where Emergency Medicaid comes into play, offering assistance to those in need and helping to reduce the financial burden of medical expenses.
I’m Nick Bryant, author of Understanding Healthcare Is Half The Battle, and a Senior Counselor with 13+ years of experience connecting clients to various healthcare programs like emergency Medicaid.
In this article, we’ll explore Emergency Medicaid in Texas, including eligibility requirements, coverage for undocumented citizens, and special provisions for pregnant women.
Let’s dive in!
Emergency Texas Medicaid Eligibility
In Texas, Emergency Medicaid is available to individuals and families who meet certain financial and residency requirements. To be eligible for Emergency Medicaid, you must be a resident of Texas, a U.S. citizen or qualified non-citizen, and have a household income that is below the federal poverty level.
Additionally, the program is only available for those who require emergency medical care for a sudden illness or injury that poses a threat to their health. Examples of covered services include hospitalization, ambulance services, and surgery.
Who Typically Qualifies For Emergency Medicaid In Texas?
Essentially anyone who has little to no income is uninsured and has a medical emergency that requires hospitalization could potentially qualify for emergency Medicaid. Typically pregnant women who need medical care during pregnancy and delivery are the main types of individuals who qualify for emergency Medicaid in Texas.
Emergency Medicaid for Pregnant Women in Texas
In Texas, emergency Medicaid for pregnant women provides health coverage to expectant mothers with limited financial means, ensuring that they receive the necessary medical attention they need to have a healthy pregnancy and delivery.
To qualify for emergency Medicaid you will need to be pregnant, meet income guidelines and of course, be a Texas resident.
Pregnant women with a household income at or below 198 percent of the federal poverty level (FPL) are eligible for emergency Medicaid. This is well above the federal requirement of 133 percent of the FPL. Women who meet this income requirement can receive medical services through the STAR program. STAR is particular Medicaid coverage that is available to low-income pregnant women and children in Texas.
Emergency Medicaid for pregnant women in Texas covers a wide range of medical services, including:
- Prenatal care
- Labor and delivery
- Postpartum care
This comprehensive coverage ensures that pregnant women have access to the medical care they need to have a healthy pregnancy and delivery.
Suppose a woman named Sarah is expecting her first child and is struggling to make ends meet. She works part-time at a minimum-wage job and has no health insurance. Sarah’s household income is 150 percent of the federal poverty level, which qualifies her for emergency Medicaid. With emergency Medicaid, Sarah is able to receive prenatal care, labor and delivery services, and postpartum care, all at no cost to her. She is also able to enroll her newborn in Children’s Medicaid, which provides 12 months of continuous coverage from the date of birth.
How Long Does It Take To Get Approved For Pregnancy Medicaid In Texas?
It typically takes 15 business days to get a determination for pregnancy Medicaid.
Income Guide Lines For Pregnant Women Medicaid In Texas
| Household Size | Monthly Income |
| 1 | $2243 |
| 2 | $3022 |
| 3 | $3800 |
| 4 | $4579 |
| 5 | $5358 |
| Each additional person | $779 |
Texas Emergency Medicaid For Undocumented Citizens
Undocumented citizens in Texas can potentially receive emergency Medicaid if they have a medical emergency that requires immediate medical attention. Emergency Medicaid for undocumented citizens in Texas is available to individuals who have a medical emergency and meet all other eligibility requirements, except for their alien status.
This means that even if someone is not a legal resident of the United States, they may still be eligible for Texas Medicaid coverage during an emergency medical situation. Emergency Medicaid coverage is limited, and once the individual has recovered or stabilized their condition, they will no longer be eligible for this form of healthcare.
An example of a situation where an undocumented man might qualify for emergency Medicaid would be if he were to experience a sudden and serious medical emergency, such as a heart attack or stroke. In this case, the individual may be eligible for emergency Medicaid coverage, even if they are not legally able to provide a Social Security number. This coverage would allow them to receive the necessary medical care to stabilize their emergency medical condition, without having to worry about the cost.
It’s important to note that emergency Medicaid for undocumented citizens only covers the individual until their emergency medical condition is stabilized. Once stabilized, the individual may no longer be eligible for Medicaid coverage and would be responsible for paying for any additional medical expenses. However, in emergency situations, having access to Medicaid coverage can be a lifesaving resource for those who might otherwise be unable to afford the cost of medical care.
How To Apply For Emergency Medicaid In Texas
To get Texas emergency Medicaid coverage, you will complete the regular Texas Medicaid application. There is no special application to apply for emergency Medicaid. The agency that you apply for Medicaid through is called the Texas Health and Human Services Department. They are the state health department in Texas.
You can apply for emergency Medicaid in Texas by:
- Calling Texas Health and Human Services at 877.541.7905
- Visiting the Your Texas Benefits website
- Visiting your local Texas Health and Human Services office
When applying for emergency Medicaid for pregnant women in Texas, be sure to complete Section C of the Medicaid application. Here it asks if you are pregnant and what your due date is. This section will signal to Texas Health and Human Services that you need emergency Medicaid due to your pregnancy.
Applying For Emergency Medicaid If You Are Undocumented With A Medical Emergency
If you have a medical emergency and are admitted to the hospital, the social worker at the hospital will likely help you to apply for emergency Medicaid.
Texas Medicaid Retroactive Coverage (Help With Past Due Hospital Bills)
This program can help you to pay medical bills from the past 3 months. You will need to meet income guidelines, as well as show proof of your medical/hospital bills to qualify.
When applying for Medicaid Retroactive Coverage, you’ll need to complete Section L on the Texas Medicaid application. This will indicate that you need assistance with the past-due hospital or medical bills.
Alternatives To Texas Emergency Medicaid
As I’ve mentioned before emergency Medicaid is temporary healthcare coverage. You will only have this coverage until you are stabilized or recovered. Typically pregnant women have pregnancy Medicaid 2 months after their delivery. After that, Medicaid goes away.
Below are a few alternatives ways to get affordable medical care in Texas, once your emergency Medicaid goes away.
Federally Qualified Health Centers
Federally Qualified Health Centers (FQHCS) are places that provide low-cost healthcare options. They can help you get to treatment for illnesses, injuries, and other health needs.
They also offer preventive care and services like mental health counseling, prescription drugs, and lab tests at a lower cost than regular doctors’ offices.
You do not need health insurance or even a monthly income to get treatment at these clinics. They bill you based on a sliding scale, which takes into consideration your monthly income. Even if you have $0 in monthly income these clinics will work with you.
If you need to find FQHC clinics in Houston, this guide can help you. This guide will provide you with a list of FQHC clinics in Dallas.
If you are somewhere else in Texas use the HRSA website to find FQHCs near you. Just type in your zip code and you’ll see clinics on a map.
County Indigent Health Care Programs
The County Indigent Health Care Program is a great alternative to emergency Medicaid.
These are known as the “county clinics”. Examples of these types of clinics include Harris Health System (Gold Card) in Houston, Parkland in Dallas Texas, and JPS in Forth Worth.
These clinics are open to any resident of the state who has an income level at or below 21% of the federal poverty guidelines as well as resources less than $2,000 and who is not eligible for Medicaid.
The program offers a variety of benefits to those enrolled, including primary, preventative, and some specialty health services such as vaccines, annual physicals, medical screenings, inpatient and outpatient hospital visits, laboratory and radiology services, skilled nursing facility services, and more.
To find the “county clinics” in your area you can visit the 211 Texas website. From there type “County Indigent Healthcare” in the search box and include your zip code. This website will show you a listing of county clinics.
You can also call 211 Texas by dialing 211 or 877.541.7905. You can also call your local city health department and they will be able to connect you to the county clinic that serves your area.
Conclusion
Texas emergency Medicaid is typically offered to low-income pregnant women. This coverage helps with the cost of medical care while you are pregnant and during your labor/delivery.
Undocumented immigrants can also get emergency Medicaid if they meet income guidelines and have a medical emergency.
You should know that emergency Medicaid is only temporary. Once you are stabilized, then the Medicaid goes away.
If you want to apply for emergency Medicaid in Texas you can either call Texas Health and Human Services at 877.541.7905 or visit the Your Texas Benefits website.
For any additional questions about Texas emergency Medicaid, you can also leave a comment below. I have worked in community health clinics for the past 13 years and have lots of experience waiting on hold for Texas Health and Human Services. If there is anything I can do to help you better understand the process please let me know!
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- How To Apply For The Harris Health Gold Card
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- How To Apply For San Antonio Carelink Health Insurance (for the uninsured)
Emergency Medicaid Texas FAQ
There is no special emergency Medicaid application. You simply complete the regular Medicaid application. If you are pregnant and want emergency pregnancy Medicaid in Texas be sure to complete Section C of the application. This will indicate that you are pregnant and need your determination in less than 15 business days
You can call 800.252.8263 if you already have Medicaid to have your questions answered. If you are needing to apply for Medicaid or check your status you can dial 211 or 877.541.7905 to reach the Texas Health and Human Services Department.
Yes, Texas does offer Emergency Medicaid. It provides health coverage to eligible individuals with limited income and resources who are facing an emergency medical condition and require immediate treatment to stabilize their condition. Emergency Medicaid coverage is limited to emergency services only, and eligibility is determined based on a number of factors such as income, citizenship status, and other eligibility requirements.
On average, it takes about 45 days for the Texas Health and Human Services Commission (HHSC) to process a Texas Medicaid application. However, in emergency situations, the application can be processed within 24 hours. It is important to note that HHSC has a goal to process 90% of Medicaid applications within 45 days and 98% within 90 days. The time it takes for a Medicaid application to be approved in Texas can vary depending on various factors, such as the individual’s eligibility, the completeness of the application, and the workload of the Medicaid office.
Children’s Medicaid is free. If you or your child qualify for CHIP there are fees that you would pay based on your income. If you fall within a certain income bracket, there may be an enrollment fee and co-payment requirements for doctor visits and medications. These fees are relatively economical – the yearly family cost is no more than $50 with lower-income families facing prices of between $3-$5 per session or item while higher earners should expect to pay somewhere in the range of $20 -$35.
Nick Bryant is the author of Understanding Healthcare Is Half The Battle and a Senior Counselor with 13+ years of experience working in community health and mental health. He enjoys spending time with his family, watching WWE on Friday nights, and working toward a Google Data Analytics certification. If you have additional questions about community resources or government assistance programs, simply leave a comment below and he will follow up as soon as possible.
Nick – this is useful information. Thank you! I ordered your book via Amazon.
Is there any way to contact you if I have a question. My name and email are in my signature below.
Please do let me know if I could connect with you.
Thank you again!
Thank you so much Vineet! I’ll shoot you an email.
Nick
Hello Nick,
I am currently in a situation, my mother which is 69 years old. fall down at home and broke her hip, she had to have emergency surgery and has been hospitlized since last Tuesday August 28, 2023. She doesn’ t have any insurance, I work fulltime and I am not able to provide her with the care she needs and they are refusing to send her to rehab because she doesnt have insurance and they are wanting me to take her home like this.
She lives alone and she is not able to take care of her self and she is not a resident or citizen, would this accident coudl be consider for emergency medicaid.
I would definitely walk into a Medicaid office to get clarification, but my understanding is that Medicaid “can” be provided to help someone with an emergency situation. Example they a broken bone, they’ll fix the broken bone, but once a person’s health is “stabilized” that is when Medicaid ends.
Again either visit a Medicaid office to see if this qualifies or reach out to the Texas Health and Human Services Ombudsmans office. They handle complains and general questions about state benefit programs like Medicaid. You can call them at 877.787.8999.
If she has not applied for the Harris Health System’s Gold Card, I would encourage you/her to do so. As long as she lives in Harris County and her income falls below certain thresholds she should be able to qualify. This will provide her with an outpatient doctor and potentailly some help as far as rehab.
Harris Health Info:
Main website – https://www.harrishealth.org/
Eligibility Center Number – 713.566.6509