Texas Medicaid Unwinding:
Information and Resources
Attention Texas Families!
The state is re-checking eligibility for Medicaid for millions of Texans. You must take action to keep your Medicaid coverage. Eligibility checks are normally routine, and known as renewing your Medicaid. Since the pandemic began, most Texans have been able to stay on Medicaid even if they didn’t complete paperwork or were no longer eligible. But starting in April 2023 and running through May 2024, Texas Medicaid will re-check everyone’s eligibility.
It will take an all-hands-on-deck approach to keep eligible Texans covered.
Texas families should expect to complete a renewal once a year from now on. The process can be confusing and we’re worried families who still qualify may fall through the cracks because the state can’t find them or they don’t know what steps to take.
Texans with Medicaid:
Take Action to Keep Your Health Coverage
- Keep an eye out for notices from Texas Health and Human Services. The notice will be mailed in a yellow envelope (see example here), or you’ll get an electronic notice in your Your Texas Benefits account. Respond to requests for information right away.
- Update your contact information with Texas Medicaid, especially if you’ve moved since 2019. Update at YourTexasBenefits.com or call 2-1-1, Monday through Friday, 8 a.m.–6 p.m. Central time. Select a language, then press 2.
- Make sure you have access to your Medicaid case through YourTexasBenefits.com or through the Your Texas Benefits mobile app.
- You don’t have to go through this alone—local help is available. If you’re confused or unsure about a notice, or need help accessing your account, you can reach out to the Texas Community Partner Program, or the Texas Association of Community Health Centers. Find help near you.
- You do NOT have to pay anyone to apply for or renew Texas Medicaid, CHIP or HealthCare.Gov coverage. Watch out for scam phone calls, emails, and texts.
Resources
- Stay Covered Texas: information for Texans with Medicaid on renewing Medicaid, other coverage options, and finding local help.
- Find free, local help to renew your Medicaid or switch to other affordable coverage.
- Steps to keep Medicaid or switch to other affordable coverage.
- Pandemic-era Food and Health Benefits are Ending — Here’s What Texans Need to Know
- #SickOfItTX: Are you eligible for Medicaid or HealthCare.Gov coverage?
- Questions? Email unwinding@everytexan.org for help
Las reglas de Medicaid están cambiando, y todos deben tomar acción para que su familia no pierda el seguro médico. No espere.
- Asegúrese de tener acceso a su cuenta en YourTexasBenefits.com o la aplicación móvil de Your Texas Benefits.
- Actualice su dirección y información con Texas Medicaid, especialmente si se mudó desde 2019.
- Busque un aviso amarillo en el correo o una alerta en la aplicación móvil. Responda de inmediato a las solicitudes de Texas Medicaid.
- Si está confundido o inseguro sobre un aviso, encuentra ayuda cerca de ti.
Những quy định của Medicaid đã thay đổi và mọi người phải hành động ngay. Đừng chờ đợi.
- Đảm bảo rằng bạn có quyền truy cập vào tài khoản của mình trên trang YourTexasBenefits.com hoặc thông qua ứng dụng di động Your Texas Benefits.
- Cập nhật thông tin cho Texas Medicaid, đặc biệt nếu bạn đã chuyển nhà từ năm 2020.
- Hãy tìm thư thông báo màu vàng trong hòm thư hoặc thông báo trong ứng dụng di động. Trả lời những yêu cầu từ Texas Medicaid ngay lập tức.
- Nếu bạn không rõ hoặc không chắc chắn về một thông báo, hãy tìm sự trợ giúp gần bạn.
Did You Lose Coverage?
You may lose coverage if the state can't find you or you missed a deadline. If you lose Medicaid because you didn't submit your renewal or information, you can submit within 90 days for your case to reopen. After that, you have to reapply.
- Families may lose coverage because the state couldn’t find them or they missed a deadline – even though they might still be eligible. Families may also be incorrectly denied due to immigration status, income, or other errors. To get these cases corrected, please escalate them through the Office of the Ombudsman. If the case still can’t get corrected, families have the right to a fair hearing.
- If you are denied Medicaid because they didn’t submit their renewal or needed information, you have a 90-day window to send the renewal or missing information after losing coverage. Unfortunately, the renewal link on YourTexasBenefits.com is currently not active during the 90-day reconsideration period. To submit information to complete a renewal after a denial, you can submit during this time period by calling 2-1-1 Option 2 or completing a paper application and either faxing, mailing, or bringing it into a local HHSC office.
Resources
- If you are denied Medicaid but think you should still be eligible, you may be able to get this corrected. Community organizations are standing by offering free assistance renewing health coverage or exploring new options. Find help near you to see what your options are.
If you are no longer eligible for Medicaid, there may be other affordable health coverage options for you and your family:
The Children’s Health Insurance Program (CHIP) is available for eligible children in families who saw an increase in their income – No extra application is needed! During the Medicaid renewal process, HHSC evaluates eligibility for other HHSC health care programs, including the Children’s Health Insurance Program (CHIP). CHIP does require people to select a plan and there is a sliding scale of fees based on income.
Low-cost, high-quality insurance is available on HealthCare.Gov for eligible adults and children. If you are no longer eligible for Medicaid, your information will be sent to HealthCare.Gov. You can apply now for HealthCare.gov, or wait for your notice that your case has been transferred. From 3/31/23 – 7/31/24, HealthCare.Gov will provide flexibility for Marketplace-eligible consumers who lose Medicaid or CHIP to enroll in Marketplace coverage.
Job-Based Insurance may be available for you and your family. Check with your employer! There’s a special enrollment period to enroll in job-based insurance within 60 days of losing Medicaid or CHIP. If insurance through your job isn’t affordable for your family, there’s a new rule that makes it easier for your family to qualify for help paying for premiums through HealthCare.Gov. Check with local help near you about your options.
Healthy Texas Women provides well-woman exams and family planning services for eligible women between the ages of 18-44 who are not pregnant. Some women losing Medicaid will be enrolled into HTW, if they submit all renewal information requested by HHSC. You should be sure to check all your options to see if you can qualify for more comprehensive coverage through the Marketplace. Eligible women should apply to the Marketplace and, once covered, report that change to HTW, so they can be disenrolled.
Federally Qualified Health Centers provide safety net services for the insured, under- insured, and uninsured. Find a health center near you.