TEXAS MEDICAID BENEFITS

Medicaid Benefits in Texas

The Social Security Act specifies a set of benefits that state Medicaid programs must provide and a set of optional benefits that states may choose to provide.

Medicaid covers a diverse array of medical and long - term services and supports.

Mandatory and Optional Services Covered by Texas Medicaid

The state may choose to provide some, all, or no optional services specified under federal law. Some optional services Texas chooses to provide are available only to clients under age 21, and one optional inpatient service is available for clients who are under 21 or are 65 or over in an institution for mental disease (IMD). Note: If the client is under age 21, all federally allowable and medically necessary services must be provided as required under federal law.

The "Your Texas Benefits Medicaid card" is your Medicaid ID card. Take it with you whenever you go to the doctor, dentist, or drug store. Protect it the way you would your driver’s license or credit card. If you lost your card or it got damaged, you can order a new one by calling 1-855-827-3748. That’s a toll-free call.

Coverage for Children in the state of Texas

Children with Medicaid coverage are eligible to receive a broader array of health care services than commercial health insurance policies or Medicaid services for adults. Medicaid for children provides certain health care services including long-term physical, occupational, and speech therapies, and comprehensive dental services.

Programs for People age 65 and older and those with Physical Disabilities

LTSSfor people age 65 and older and those with physical disabilities allow people of all ages to receive services in a nursing facility or in the community. If eligible, they may receive an array of services, from non - skilled personal care to  skilled nursing services. Services may be provided in peoples’ home or in community settings (e.g., adult day care or hospice).

Prescription Drugs

The Texas Medicaid program covers most outpatient prescription drugs either through a Medicaid MCO or through the Vendor Drug Program (VDP). The Texas Medicaid drug benefit is an optional service that has been available to all Texas Medicaid clients since September 1971.

There is more.......

Here are the FULL current set of benefits covered by the Texas Medicaid program. DOWNLOAD (PDF)