Health Care Coverage: Children and Youth

 

 

 
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1. Children's Medicaid and Children's Health Insurance Program

Low-income children may receive health care coverage through the Children's Medicaid program or the Children's Health Insurance Program (CHIP). Both programs provide a wide range of benefits to keep kids healthy, including doctor’s visits, immunizations, prescription drugs, lab and X-ray charges, hospital care, eyeglasses and dental services.

There is one application for both programs. HHSC will look at the application and will let the parent or caretaker know if his or her children can receive either Children’s Medicaid or CHIP.

A. Children’s Medicaid -- http://www.chipmedicaid.org

Two Programs Children's Medicaid offers free health care services to children under 19 years of age whose families have limited incomes and resources.
The Children’s Medicaid program provides six months of health care coverage. (Newborns receive 12 months of coverage if the mother was receiving Medicaid when the child was born). Coverage begins as soon as the application is approved. Before the end of each six-month period of coverage, a renewal application is sent to the family.

If a child is receiving Medicaid and has an intellectual or developmental disability or chronic condition, HHSC will look at the child’s case to decide if the child can receive special services such as:

  • Long-term care services at home or in the community.
  • Treatment in a long-term care facility.
  • Help with high medical expenses.
  • Home and vehicle modifications.
  • Hospice care.
  • Mental health services.
  • Special equipment.

To learn more about some of these services, visit the Department of Aging and Disability Services’ website.

B. Children's Health Insurance Program (CHIP) -- http://www.chipmedicaid.org

HHSC CHIP is a health insurance program for children under 19 years of age whose families haves low incomes and resources, but earn too much to receive Medicaid and do not have private health insurance.
CHIP will provide 12 months of health care coverage. Before the end of each 12-month period of coverage, a renewal application will be sent to the child’s parent or caretaker. As long as a family meets requirements and returns the renewal application by the due date, health care coverage for the children will continue without interruption.
CHIP enrollment fees and co-payments are based on the family's income.  Enrollment fees are $50 or less per family for each 12-month period of coverage, and most co-payments for doctor visits and prescription drugs range from $3 to $10.
CHIP coverage also is available for unborn children. To learn more about maternity care, visit the CHIP perinatal coverage section of this website.

2. Medicaid Buy-In for Children -- http://yourtexasbenefits.hhsc.state.tx.us/programs/health/child/buy-in.php

Application -- http://yourtexasbenefits.hhsc.state.tx.us/docs/H1200-MBIC.pdf

MBIC

This program is for families who have a child with a disability, but earn too much money to get traditional Medicaid. Through this program, families can “buy-in” into Medicaid coverage by making monthly payments.
To be in this program the child must:

  • Be age 18 or younger.
  • Not be married.
  • Meet the same rules for a disability that are used to get Supplemental Security Income (SSI). The child doesn’t have to get SSI.
  • Live in Texas.
  • Be a U.S. citizen or legal resident.
The benefit period for this program is usually one year. Before the end of the benefit period, a renewal application will be sent to the family.This program pays for many health-care services for children. Here are some examples:
  • Doctor and clinic visits.
  • Hospital visits.
  • Emergency care.
  • Medicine.
  • Glasses.
  • Dentist visits.
  • Mental health care.
  • Care in the home.

3. Former Foster Care in Higher Education -- https://www.dfps.state.tx.us/txyouth/health/default.asp

This program offers health-care benefits for young adults who:

  • Are age 21 or 22.
  • Were in foster care or the unaccompanied refugee minor program on their 18th birthday.
  • Are enrolled in a college or technical school.

For questions about this program or to ask for a copy of the application and School Enrollment Verification form with a pre-paid envelope, call 2-1-1 (pick a language, then pick option 2). When you talk with someone with 2-1-1, let them know you’re calling about the Former Foster Care in Higher Education program.

To learn more about services for young adults who are no longer in foster care, visit the DFPS Texas Youth Connection website.

4. Medicaid for Transitioning Foster Care Youth -- https://www.dfps.state.tx.us/txyouth/health/default.asp

This Medicaid program is for young adults to have continuous medical coverage from age 18 to 21. This coverage is available to young adults who meet all of the following eligibility criteria:

  • Aged out of Texas foster care / DFPS custody at age 18.
  • Current Texas resident between 18 and 21 years old.
  • U.S. citizen or qualified alien.
  • No other medical coverage (including private insurance or other category of Medicaid).
  • No resources valued at more than $10,000.
  • Meet the Texas Health & Human Services Commission (HHSC) income guidelines for this category of Medicaid.

For questions about this program or to ask for a copy of the application with a pre-paid envelope, call 2-1-1 (pick a language, then pick option 2). When you talk with someone with 2-1-1, let them know you’re calling about the Medicaid for Transitioning Foster Care Youth program.

To learn more about services for young adults who are no longer in foster care, visit the DFPS Texas Youth Connection website.

 

   
 
 
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