Wednesday, September 26, 2012

Q&A Health Care Reform: If You Are on Medicaid

We know health reform is big and confusing. Some parts of the law started in 2010. Other parts are rolling out over the next eight years. Texas physicians carefully studied the law to help you understand what the changes mean to your health care.

Here are a few questions Texas patients asked their doctors. There are many more. Please feel free to submit your questions to Me&MyDoctor.


What If I'm on Medicaid?

Q. How can I find a doctor who takes Medicaid?

A. Health reform did little to increase the number of doctors who take Medicaid. State budget cuts in the past two years forced out even more doctors. Beginning in 2013, higher Medicaid payments to primary care doctors may help more participate in the program. Your doctors are working to find a solution.

Q. Can undocumented immigrants get Medicaid or CHIP?

A. The law has not changed. Medicaid coverage for undocumented immigrants is limited to emergency services. Under the Children's Health Insurance Program (CHIP), undocumented immigrant women can enroll in the CHIP Perinatal Program to receive basic prenatal care so they have healthier babies.

Q. How do I know if my children or I qualify for Medicaid?

A. Currently, low-income people may qualify for Texas Medicaid if they fit into certain eligibility categories and have low enough incomes. The chart below shows the rules based on the federal poverty level (FPL) for 2012, with income examples for a family of three:


Texas Medicaid Eligibility
Percent of FPL
Family of 3
Maximum Income
Allowed to Qualify
Child: 0-1 years 185% $35,316 
Child: 1-5 years 133% $25,390 
Child: 6-19 years 100% $19,090 
Working Parent  26% $4,963 
Pregnant woman 185% $35,316 
Adult with disability  77% $14,699 

If you think you are eligible and wish to enroll, you can find links to the application information at www.healthcare.gov.

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