Texas Medicaid Income Limits 2026: Who Qualifies

Key takeaways

• Childless non-disabled adults under 65 in Texas do NOT qualify for Medicaid at any income, even $0/month, because Texas never expanded under the ACA
• Parents qualify only under about 12-15% of the poverty level, roughly $230/month for a family of 3
• Children qualify at much higher limits: 198% FPL ages 0-1, 144% ages 1-5, 133% ages 6-18, plus CHIP up to 201%
• Aged, blind, or disabled adults qualify at $994/month income with a $2,000 asset limit (single)
• Nursing home and HCBS waiver care allows up to $2,982/month (300% of SSI); over that, a Miller trust is required

Start with the hard truth: Texas did not expand Medicaid

If you are a childless adult under 65 and not disabled, here is the direct answer: you do not qualify for Texas Medicaid at any income. Not at $0, not at $1,000/month, not at any number. Texas is one of the states (along with Florida and Georgia) that chose not to expand Medicaid under the Affordable Care Act.

In states that did expand, adults qualify up to 138% of the Federal Poverty Level ($1,835.40/month for one person in 2026). Texas never opened that door. So the eligibility rules here are the old, narrow categories: children, pregnant women, very low-income parents, and people who are aged, blind, or disabled.

This is the single most misunderstood fact about Medicaid in Texas. People assume that low income alone qualifies them. It does not. You have to fit one of the specific categories below, and for most working-age adults without kids, no category fits.

The coverage gap: too much for nothing, too little for a subsidy

Because Texas did not expand, there is a group stuck in the middle called the coverage gap. These are adults who earn too much for the tiny old Medicaid limits but too little to get the income needed for ACA marketplace subsidies, which historically started at 100% FPL ($1,330/month for one person in 2026).

A single parent earning $300/month is a clear example: that is above the roughly $230/month parent cutoff, so no Medicaid, yet often below the threshold where marketplace help kicks in. The result is no affordable coverage at all. If you are in this gap, the practical move is to check HealthCare.gov directly, because marketplace rules and your exact household math can change the outcome.

Who DOES qualify: Texas Medicaid income limits by category (2026)

Here are the actual income limits by pathway, using the 2026 Federal Poverty Level numbers. The percentages convert to a monthly dollar amount based on your household size. The table below shows the limit for a household of 3 as a concrete example, since that is a common family size.

The math: the 2026 FPL for a household of 3 is $2,276.67/month (100%). So 198% works out to roughly $4,508/month, and 133% to roughly $3,028/month. Your exact figure depends on your exact household size, so confirm yours in YourTexasBenefits.com. Note how generous the children's limits are compared to the adult ones: a family of 3 earning $4,000/month earns far too much for the parents to get Medicaid, but the kids can still be covered.

One reason the rules feel confusing is that Texas Medicaid uses two different counting systems. Children, pregnant women, and parents are evaluated under MAGI rules tied to the Federal Poverty Level, which is why their limits read as percentages of FPL. Aged, blind, and disabled coverage, plus long-term care, uses non-MAGI rules tied to the Social Security SSI program, which is why those limits read as flat dollar amounts ($994/month and $2,982/month) instead of FPL percentages. You apply for every MAGI pathway in one place, YourTexasBenefits.com, and Texas HHS routes your case to whichever category fits your household and age.

Aged, blind, and disabled (ABD) adults

If you are 65 or older, blind, or have a qualifying disability, you fall under different rules that track Social Security's SSI program, not the poverty level. The 2026 income limit for Regular ABD Medicaid in Texas is $994/month for a single person, which matches the 2026 SSI Federal Benefit Rate. The asset (resource) limit is $2,000 for a single person, not counting your home and one car.

Long-term care: nursing homes, waivers, and the Miller trust

Long-term care Medicaid in Texas has a much higher income ceiling than regular ABD coverage, because it is meant to help people pay for nursing homes that cost thousands per month. The income limit for nursing home care and Home and Community-Based Services (HCBS) waivers is $2,982/month in 2026, which is 300% of the SSI rate.

Texas is what is called an income-cap state. That means there is no medically needy spend-down option, the route some other states use to let you subtract medical bills and qualify. In Texas, if your income is even one dollar over the $2,982/month line, you are over, period.

The fix is a Miller trust, also called a Qualified Income Trust (QIT). You route the income above $2,982/month into this special trust each month, which legally lets it not count toward the limit. It is a real, routine planning tool in Texas, not a loophole. If a parent's $3,400/month pension puts them over, a Miller trust is usually how they still get nursing home coverage.

Children and CHIP: the widest door in Texas

Children have by far the most generous limits. A baby under 1 qualifies up to 198% FPL, kids 1-5 up to 144%, and kids 6-18 up to 133%. Above those Medicaid lines, the Children's Health Insurance Program (CHIP) catches kids in families up to 201% FPL.

So even in a non-expansion state, a working family that earns too much for adult Medicaid can almost always get their children covered through Medicaid or CHIP. Apply at YourTexasBenefits.com; CHIP charges small premiums and copays but stays affordable.

Pregnancy coverage

Pregnant women qualify for Texas Medicaid up to 198% FPL, the same generous limit as infants. For a household of 2 (mother plus the expected baby counted), 198% of the 2026 FPL works out to roughly $3,571/month. Coverage includes prenatal care, labor, delivery, and postpartum care, so pregnancy is one of the clearest paths to Medicaid for an adult in Texas.

Bottom line

Texas Medicaid is narrow for adults and wide for kids. Childless non-disabled adults get nothing regardless of income. Parents qualify only under roughly $230/month for a family of 3. But children (to 198-201% FPL), pregnant women (198%), the aged and disabled ($994/month), and people needing long-term care ($2,982/month, with a Miller trust if over) all have real paths in. Match yourself to a category first, then check the dollar limit for your household size.