Medicaid Buy-In for Children

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Medicaid Buy-In for Children Launched January 1, 2011

What is the Texas Medicaid Buy-In for Children?
Medicaid Buy-In for Children can help pay medical bills for children with disabilities. This program helps families who need health insurance, but make too much money to get traditional Medicaid. Families “buy in” to Medicaid by making a monthly payment (premium).

Here’s the Medicaid Handbook section on this program.

To be in this program a child must:

  • Be age 18 or younger.
  • Meet the same rules for a disability that are used to get Supplemental Security Income (SSI).
  • Live in Texas.
  • Be a U.S. citizen or legal resident.
  • Not be married.

Monthly payments (premium)
Most families make monthly payments to be in the Medicaid Buy-In for Children program.
The monthly payment is based on:

  • The amount of money your family gets from jobs and other sources (income).
  • The number of people in your family.

Here are the official rules for calculating a premium based on income.

Some families have to pay part of the cost for their child’s doctor visits, hospital stays, medicine, therapy, and other health services. These costs are usually for the monthly buy-in payments, co-pays, and deductibles. There is a limit to the amount of costs a family has to pay every 12 months. When the family meets the limit, Medicaid will pay all costs for the rest of that 12 month term.

To find out more & apply:

After submitting your application, you can confirm it was received by calling 2-1-1, selecting Option “2”, then entering the social security number for the Head of Household on your application.


7 Responses to Medicaid Buy-In for Children

  1. Wayne boone says:

    I am trying to get the address to mail my payment to I have lost the address


  2. Heather Smith says:

    This program is a ghost. If you call 211 they have no idea what you are talking about. I can’t find the form online either.


    • Heather says:

      Not true! My family is currently enrolled in this program. It’s listed in the Medicaid handbook. I just redirected the links on this page to current HHSC pages.


      • Brandy says:

        Hi Heather. So I’m looking into this because I am a nurse and would like to work full time ASAP. But I would be making 3000-5000 per month. Is there a place we can go to see exact income limits that you know of?


      • Heather says:

        It’s a math equation you can find in the Medicaid handbook.


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