Medicaid Renewal in Texas: The 12 Month Cycle, the Form, and the 90 Days After It Ends

Texas Medicaid has to be renewed every 12 months, the state has to try to renew you from its own records first, and if it cannot, you get a pre-filled form with at least 30 days to send it back. Those are the federal floor, set in 42 CFR 435.916, for Medicaid based on modified adjusted gross income, which in Texas means Children’s Medicaid, Medicaid for Pregnant Women and parents and caretaker relatives¹ (checked 24 October 2026). Every Texas program sits on top of that rule, and the details of how HHSC applies it to your case arrive in one place: the YourTexasBenefits account².

At the front desk on Thursdays, renewal is the quietest problem I see and one of the most common. Nobody is denied. A family qualifies, nothing changes, and then a child’s coverage ends because a form sat unread in an online account. The parent usually finds out at a pharmacy counter. Most of what follows is about making sure that is not you, and about what to do if it already is.

How often renewal happens, and who it covers

Once every 12 months, and no more often than that, for Medicaid that is based on modified adjusted gross income. That is the federal wording in 42 CFR 435.916(a)(1)¹ (checked 24 October 2026). In Texas the MAGI programs are the ones on HHSC’s medical programs chart, including Children’s Medicaid, Medicaid for Pregnant Women and the parents and caretaker relatives category³. Medicaid based on age, blindness or disability follows its own renewal rules, which this page does not cover.

A renewal is not a fresh application. HHSC is checking whether a household it has already approved still meets the rules of the same program. The income limits it checks against are the ones in Texas Medicaid eligibility, and the income that counts is worked through in what counts as income in Texas. Both are worth rereading in the month before a renewal, because the question at renewal is the same question as at application, asked again a year later.

Step one: the state tries to renew you without asking

Before it sends you anything to fill in, the agency must try to renew your coverage from information it already has. The rule says the agency “must make a redetermination of eligibility without requiring information from the individual if able to do so”¹ (checked 24 October 2026). That means records already in your case and data it can check electronically, such as wage information.

If that works, you will get a notice saying coverage has been renewed, and you do not need to do anything except check that the facts in it are right. If a fact is wrong, for example a household member who has moved out or income that has changed, tell HHSC. Being renewed on wrong information is not a favor; it can produce a problem later.

Step two: the pre-filled renewal form

If HHSC cannot renew you from its records, it sends a renewal form already filled in with what it knows, and you have at least 30 days from the date of the form to respond. That is the federal minimum in 42 CFR 435.916(a)(3)¹ (checked 24 October 2026). The form will ask you to confirm or correct the household, the income and anything else that decides eligibility, and it may ask for documents.

Three habits make this step uneventful:

• Put a working email address and phone number on the case, so a new notice in the account produces something you actually see.
• Log into the account once a month whether or not you are expecting anything. Notices, verification requests and renewal packets are delivered there, and I have watched families lose coverage they still qualified for because nobody had logged in since the year before. How the account works is covered in applying through YourTexasBenefits.
• Answer what is asked, with the documents asked for. Recent pay stubs for every earner are the usual request. If a document is hard to get, say so before the deadline rather than after it; 2-1-1 Texas can put you in touch with free help⁴.

Children: 12 months of continuous coverage

A child under 19 who is eligible and enrolled in Medicaid keeps coverage for a 12 month continuous eligibility period, even if household income changes during the year. That is federal rule 42 CFR 435.926, which sets the length of the period at 12 months⁵ (checked 24 October 2026).

The rule lists the only reasons coverage can end inside the period: the child reaches 19, the child or a representative asks to end it, the child moves out of the state, the agency finds the eligibility was granted through its own error or through fraud, abuse or perjury, or the child dies⁵. A raise, a second job or a new partner moving in is not on that list. It will be looked at at the next renewal, not before.

This matters because parents often assume a pay increase ends a child’s Medicaid immediately and stop using it. It does not, inside the 12 months. Keep using the coverage, report changes as HHSC asks, and let the renewal decide. What happens when a child turns 19, which is the one exception every family eventually reaches, is a separate page: turning 19 in Texas.

If coverage ended because the form was not returned

You have 90 days after the termination to send the form back and have your eligibility reconsidered, without filling in a new application. The federal rule says that if someone is terminated for not returning the renewal form, the agency must reconsider their eligibility if they submit it within 90 days after the termination, or a longer period the state chooses, and that a new application is not required¹ (checked 24 October 2026).

So the order of operations, if you find a termination notice in the account:

1. Find the termination date on the notice. The 90 days run from there, not from the day you found it.
2. Return the renewal form, or ask HHSC to reconsider using the information it asked for. Say plainly that coverage ended because the renewal was not returned.
3. Mention any unpaid medical bills from the gap. Whether a reconsidered case reaches back over the gap is an HHSC decision on your facts, and the separate prior months rule is set out in Medicaid for bills from before you applied.
4. If more than 90 days have passed, apply again. Medicaid has no enrollment season, so a household can apply on any day of the year⁶.

How HHSC handles the reconsidered case, including whether coverage is restored back to the termination date, is a detail I cannot settle on this page. Ask HHSC or 2-1-1 directly, and write down the name and date of whoever answers.

If you think the renewal decision was wrong

A renewal outcome is an HHSC action, and HHSC’s rule is that you can request a fair hearing within 90 days from the effective date of any action, orally or in writing. That is Texas Works Handbook B-1020⁷ (checked 30 July 2026). The reconsideration window above is for a form that was not returned; the fair hearing is for a decision you think got the facts or the rules wrong. They are different tools, and if you are unsure which fits, it is reasonable to ask for both. The hearing process itself is in appealing a denial in Texas.

If you no longer qualify

Losing Medicaid or CHIP opens a Marketplace special enrollment period, and federal rule 45 CFR 155.420 gives a person who loses Medicaid or CHIP 90 days after the loss to select a plan. That is longer than the usual 60 day window for other losses of coverage⁸ (checked 24 October 2026). Do not leave it to day 89; the plan has to be chosen inside the window.

Whether that plan is affordable is a separate question. Premium tax credits begin at 100% of the federal poverty level, and the enhanced credits expired at the end of 2025, so the pre-2021 rules apply for plan year 2026 (checked 30 July 2026). For a child, CHIP may be the next program up. For an adult in Texas who loses a parent or pregnancy category with income below 100% of the poverty level, there is usually nothing between the two, which is the mechanism described in the Texas coverage gap. The places to be seen in that position are in getting care without insurance in Texas.

What I tell people at the desk

Open the account every month, read every notice the week it arrives, and if coverage has already ended, count 90 days from the date on the notice and act inside them. That is the whole of it. Renewal is not complicated. It is just easy to miss, and the cost of missing it lands on a child at a pharmacy counter. Only HHSC can decide your case, and nothing on this page is a determination that you qualify for anything; it is the rule, where it is published, and the date it was checked.

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Figures and rules on this page were checked on the dates shown. Federal and Texas program rules change, and only HHSC can decide a Medicaid or CHIP case. For free help, dial 2-1-1.