Healthy Texas Women: The Highest Published Limit on the HHSC Chart

Healthy Texas Women is a Texas program of women’s preventive and family planning services, and at 204.2% of the federal poverty level it carries the highest published income limit of any program on HHSC’s eligibility chart. That figure sits under the code TA 41 in the Texas Works Handbook chart effective 1 April 2026¹ (checked 30 July 2026), above CHIP Perinatal at 202%, CHIP at 201%, and both Medicaid for Pregnant Women and Children’s Medicaid for infants at 198%.

I went with a client to her first appointment after a Healthy Texas Women approval, and the part of that morning worth writing down happened at the check-in window rather than in an exam room. Her approval letter named the program and carried the code, and the preventive visit she had been approved for went ahead without a problem. The thing she had actually been saving herself up to ask about, a medication she had been stretching for two years, came back from the desk as a separate self-pay charge, because it belongs to a part of health care this program is not built to pay for. She had assumed that a card was a card. That is the single most useful thing to understand before the appointment, and nobody had said it to her.

Nothing on this page is an eligibility determination, and no website can make one. Only the Texas Health and Human Services Commission can decide a Healthy Texas Women case. What this page does is set out what HHSC publishes, name where it published it, and stamp the date we last read it.

Who is Healthy Texas Women for?

It is for women whose household income falls under the program’s limit, and in practice it is the one state program that reaches deep into the group Texas otherwise has nothing for. That matters because of the shape of adult eligibility here. A parent or caretaker relative qualifies for Texas Medicaid only up to about 15% of the federal poverty level, the lowest parent threshold in the nation² (KFF, as of January 2026), and a non-disabled, non-pregnant adult with no dependent children has no Medicaid category at any income at all.

Against that, a limit of 204.2% FPL is a wide door. It is not a wide benefit, which is the subject of two sections below, but the eligibility reach is real: a household well above every Medicaid line in the state can still be inside this one. The whole state list, and how these programs sit next to each other, is in Texas health programs, and the Medicaid categories themselves are in Texas Medicaid eligibility.

HHSC also sets an age range for the program. This page does not publish one, for the reason given under the gaps section further down.

Why is 204.2% the highest number HHSC publishes?

Because it is, straightforwardly, the top line of the chart. HHSC states each limit as a percentage of FPL against a Type Program or Type Assistance code rather than against a program name, and Healthy Texas Women appears as TA 41¹ (effective 1 April 2026, checked 30 July 2026). Set against its neighbors on the same chart:

Program	Percent of FPL	HHSC code
Healthy Texas Women	204.2%	TA 41
CHIP Perinatal	202%	TA 85
CHIP	201%	TA 84
Children’s Medicaid, infants under 1	198%	TP 43
Medicaid for Pregnant Women	198%	TP 40
Transitional Medicaid	185%	TP 07
Children’s Medicaid, ages 1 to 5	144%	TP 48
Children’s Medicaid, ages 6 to 18	133%	TP 44

You will find other tables printing every Texas limit exactly five points higher than the figures above. Those are not wrong. KFF and MACPAC fold the standard MAGI income disregard into the headline figure, while HHSC lists it as a separate line on its own chart. This site publishes HHSC’s number for one reason: HHSC decides the case, and its figure is the one that turns up on a Texas notice. Do not mix the two conventions and never average them.

What does 204.2% look like in dollars?

Take the percentage, apply it to the current federal poverty guideline for the household size, and treat the result as scale rather than as a line you can measure yourself against. At the 2026 guidelines, where a household of one is $15,960 a year³ (checked 30 July 2026), 204.2% works out at roughly $32,600 a year. That calculation uses the 2026 guidelines, and it is an illustration, not a threshold.

Two things pull the real figure away from that number, both in the applicant’s favor.

• The five percentage point MAGI income disregard. HHSC lists a “Standard MAGI Income Disregard: Five Percentage Points of FPL” as a separate line on the same chart, worth $66.50 a month for one person plus $23.70 for each additional household member at the 2026 guidelines¹ (checked 30 July 2026). The income a household can actually have therefore runs a little above the stated limit.
• Countable income is not gross pay. Which dollars count, and who counts as being in the household, decide more cases than the limit does. That is worked through in what counts as income in Texas.

There is a related trap worth naming. As at 30 July 2026 HHSC is publishing two different poverty guideline vintages at the same time across its own websites, so a dollar table copied off a consumer page may be last year’s. Take the percentage from the handbook chart and name the guideline year you used, which is what this page has just done.

What does the program cover, and what does it not?

It covers women’s preventive and family planning services. It is not full health coverage, and it will not behave like a health plan when something outside that scope comes up. This is the distinction that decides whether a reader is disappointed at the front desk, and it deserves saying plainly rather than in the language of benefit design.

Two consequences follow.

• It does not replace Medicaid or a Marketplace plan. Premium tax credits on the Marketplace run from 100% to 400% of the federal poverty level³ (checked 30 July 2026), and for a household inside that range a Marketplace plan is a different and broader thing. See how Marketplace subsidies work.
• It does not close the coverage gap, though it reaches into it. About 605,000 poor uninsured Texan adults aged 19 to 64 sit in the gap between the categories Texas operates and the bottom of the subsidy range⁴ (KFF estimates based on the 2024 American Community Survey, checked 30 July 2026), and in 2024 Texas recorded 21.6% of adults aged 19 to 64 uninsured, the highest rate in the country⁵ (2024 data, checked 30 July 2026). This program is a genuine door into that population, and it is a narrow one. The Texas coverage gap explains the mechanism.

For the current list of services the program pays for, the program’s own site is the source of record⁶, and it is worth reading immediately before an appointment rather than from memory. HHSC also publishes Breast and Cervical Cancer Services on the same website⁷, which is a separate program with its own rules: see Breast and Cervical Cancer Services.

What the card does and does not get you at the appointment

Ask the clinic, before the visit, which parts of the appointment this program pays for, and what the charge is for anything outside it. The mistake in the story at the top of this page was not a mistake about eligibility. She was correctly approved. It was a mistake about scope, and scope questions are answered by the clinic’s billing staff, not by the approval letter.

When something falls outside the program, the useful next step is usually a federally funded community health center rather than a private practice. Every health center in the federal Health Center Program must run a sliding fee discount schedule: a full discount at or below 100% of the poverty guidelines unless the center elects a nominal charge, partial discounts in at least three pay classes between 100% and 200%, and no discount above 200%, with the standing rule that a center “must operate in a manner such that no patient shall be denied service due to an individual’s inability to pay”⁸ (HRSA, page last reviewed November 2025, checked 30 July 2026). The discount applies to the center’s own charges, so labs, imaging, referrals and prescriptions can still be billed separately. See community health centers in Texas and how the sliding scale works.

What happens when pregnancy coverage ends?

Healthy Texas Women is the program women are most often pointed toward when pregnancy coverage runs out, and how much warning you get depends entirely on which pregnancy program you were on. Medicaid coverage “lasts during pregnancy and up to 12 months after the baby is born” in HHSC’s own words⁹ (checked 30 July 2026), an entitlement created by House Bill 12 of the 88th Legislature, Regular Session, 2023. CHIP Perinatal is not the same and the gap is large: the same HHSC page says it “covers care during pregnancy and two doctor visits within 60 days after the pregnancy ends”.

So the 12 month figure belongs to Medicaid, and a reader on CHIP Perinatal who plans around it is wrong by ten months. Read the program name on the approval letter. The detail is in Medicaid for pregnant women in Texas and CHIP Perinatal.

What this page does not publish, and why

Two things: an age range for the program, and the Healthy Texas Women Plus service list. Neither omission is an oversight, and in both cases the reason is the same. A figure that is slightly wrong in the generous direction sends somebody to an office to be turned away, which is annoying. A figure slightly wrong in the strict direction stops somebody applying for something they would have received, and that reader never finds out they were eligible. The second failure is worse and it is invisible, so this site leaves the slot empty and names the office that holds the answer.

• The age range. HHSC sets one. The only age range in this site’s verified figure set comes from a Texas Medicaid and CHIP reference PDF that corroborates other numbers but does not stand alone, because an automated read of that same document also returned figures four other sources contradict. Until an age range has been read off a live HHSC page and dated, it is not going here. Ask HHSC, ask when you apply, or call 2-1-1¹⁰.
• Healthy Texas Women Plus. HHSC operates an enhanced set of services on top of the program for women who qualify. The program’s own pages were restructured and the current service list could not be confirmed against a live source on 30 July 2026⁶. The income limit is unaffected and remains verified at 204.2%¹. Ask what Plus adds at the point of application.

How do you apply, and what happens after a denial?

One application at YourTexasBenefits is screened against several programs at once, which is why applying is worth doing even when you expect a no. The application, the document uploads and the notices all live in the same HHSC account¹¹, and a household frequently gets a split result: children approved on one program, an adult approved on another, a third denied. See applying through YourTexasBenefits.

If the answer is a denial, Healthy Texas Women follows the appeals policy for medical programs under Texas Works Handbook W-2210, which means the standard fair hearing rule applies. HHSC’s wording is that “individuals have the right to appeal within 90 days from the effective date of any Texas Health and Human Services Commission (HHSC) action”¹² (checked 30 July 2026), the clock runs from that effective date rather than from the day the letter arrived, and a request can be made orally or in writing. Being late is not automatically fatal, because only the hearings officer has authority to decide timeliness and good cause can be accepted. Ask anyway. The full process is in appealing a denial in Texas.

An appeal is the right tool when the facts were wrong: income counted twice, a household member missed, a document that never attached. It is the wrong tool when the answer is that no category fits, and in that case the productive route is getting care without insurance in Texas.

Where the decision is actually made

Every figure above describes a published rule, and a rule is not a decision about your household. HHSC applies it, and 2-1-1 Texas will point you at a local organization with certified counselors who can sit with you while you apply¹⁰. Two habits help more than they should have to: write down the date of every call and the name of whoever helped you, and keep the notice itself, because the 90 day appeal clock runs from the effective date printed on it. For where this program sits against everything else available here, start at health coverage in Texas.

This site is run independently of the agencies it writes about. Texas Care Map has no affiliation with the State of Texas, the Texas Health and Human Services Commission, the Texas Department of Insurance, or the Centers for Medicare and Medicaid Services, and it cannot approve or deny anything.