Postpartum Medicaid and CHIP Coverage Extension FAQs The

Postpartum Medicaid and CHIP Coverage Extension FAQs

The Texas Health and Human Services Commission (HHSC) extended its

postpartum Medicaid coverage from two to 12 months for eligible women,

effective March 1, 2024.

HHSC is also providing 12 months of postpartum CHIP (Children’s Health

Insurance Program) coverage. The 12 months of postpartum coverage

begins the month after a pregnancy has ended.

Q: Who is eligible for the 12-month postpartum coverage?

A: Effective March 1, 2024, eligible recipients include:

• Medicaid or CHIP recipients who are pregnant or become pregnant

and women who enroll because they become pregnant.

o CHIP Perinatal (CHIP-P) recipients are not eligible for 12

months of postpartum coverage. They’ll continue to receive

CHIP-P coverage through the end of the month when their

pregnancy ends plus two postpartum visits.

• Medicaid or CHIP recipients who were enrolled in Medicaid or CHIP

while pregnant or are no longer pregnant but are still within their

12-month postpartum period.

o Women who transitioned from Medicaid or CHIP to Healthy

Texas Women (HTW) after their pregnancy ended and who

are within their 12-month postpartum period will be

reinstated to full coverage Medicaid or CHIP.

• Women who received services while pregnant in Texas that would

have been covered by Medicaid but who apply for Medicaid after

their pregnancy ends. Medicaid applicants with unpaid medical bills

can apply for coverage for up to three months before their

application month. This doesn’t apply to CHIP applicants.

Q: I’m not a current recipient, but I’m within my 12-month

postpartum period. Does my coverage start from the date my

benefits were terminated until the end of my 12-month postpartum

period?

A: Your Medicaid or CHIP coverage will be reinstated beginning on March 1,

2024, until the end of your 12-month postpartum period.

Q: Do I have to apply for postpartum coverage?

A: No, you don’t need to apply to have your coverage extended. Coverage

will be extended for current Medicaid and CHIP recipients.

Coverage will be reinstated for women who are not current Medicaid or CHIP

recipients but who were enrolled in Medicaid or CHIP in Texas while pregnant

and are still within their 12-month postpartum period (if they are still

residents of Texas).

Women who transitioned from Medicaid or CHIP to HTW after their

pregnancy ended and who are within their 12-month postpartum period will

be reinstated to full coverage Medicaid or CHIP.

Only women who are not currently enrolled in Medicaid or CHIP and were

not enrolled in Medicaid coverage during their pregnancy need to apply to

receive this benefit. Medicaid recipients with unpaid medical bills can apply

for coverage for up to three months prior to their application month. This

doesn’t apply to CHIP recipients.

Q: What kind of coverage is included in the 12-month postpartum

period?

A: Medicaid or CHIP covered services remain available in the 12-month

postpartum period. This is including but not limited to:

 Regular medical checkups.

 Prescription drugs and vaccines.

 Hospital care and services.

 X-rays and lab tests.

 Vision and hearing care.

 Access to medical specialists and mental health care.

 Treatment of special health needs and pre-existing conditions.

Q: If I’m eligible for the rest of my 12 months of postpartum

coverage, how will I be notified?

A: You’ll get a notice by mail or through Your Texas Benefits (if you’ve

chosen to receive notices electronically).

All Medicaid and CHIP recipients should go to YourTexasBenefits.com or call

2-1-1 and choose Option 2, to make sure your mailing address and contact

information are up to date.

Q: My pregnancy ended before the effective date of March 1, 2024,

and I was previously receiving Medicaid or CHIP services. Will my

coverage be extended?

A: Yes, if you are still within your 12-month postpartum period. Beginning

on March 1, your coverage will be reinstated for the rest of your 12-month

postpartum period.

Q: My pregnancy didn’t go to term or there was a miscarriage/loss

of pregnancy. Am I still eligible?

A: Yes, you’re still eligible for coverage for 12 months after your pregnancy

ended.

Q: If I get pregnant again during my 12-month coverage, what

happens to my coverage?

A: If you report a new pregnancy while in your 12-month postpartum period,

your eligibility will be reviewed for Medicaid or CHIP.

If you’re eligible for Medicaid or CHIP for your new pregnancy, you’ll receive

coverage for the pregnancy and for 12 months after the new pregnancy

ends.

Q: What happens if I report a new pregnancy in that 12-month

postpartum period, but when my eligibility is reviewed, I’m no

longer eligible and can’t get certified for the new pregnancy?

A: You would remain enrolled in Medicaid or CHIP for your entire first 12-

month postpartum period unless you:

 Voluntarily withdraw.

 Move out of Texas.

 Are determined ineligible because of fraud, abuse or perjury.

 Die.

Q: Will I get a new Medicaid card for my 12-month postpartum

coverage?

A: If you are currently receiving Medicaid or CHIP services you won’t get a

new Medicaid or CHIP ID card for the 12-month postpartum coverage period.

If you previously received Medicaid or CHIP services that are being

reinstated or you’re newly applying for coverage, you’ll get a new Medicaid

or CHIP ID card.

Q: Will I receive services through my managed care organization?

A: In most cases, you’ll be enrolled in your prior managed care plan. If you

have questions about enrollment in managed care, contact the Enrollment

Broker at 1-800-964-2777.

Q: If I’m currently on CHIP and am eligible for 12-month postpartum

coverage, will I need to pay another enrollment fee to get the

extended coverage?

A: If you’re currently receiving CHIP services and were found eligible by

HHSC to receive 12-month postpartum coverage, you won’t need to pay

another enrollment fee to get 12-month postpartum coverage.

Q: Will my eligibility be automatically renewed when my 12-month

postpartum period ends?

A: We’ll attempt to automatically renew your Medicaid or CHIP coverage

about two months before your 12-month postpartum period ends.

If you aren’t eligible for full coverage Medicaid or CHIP, we’ll determine if

you’re eligible for the HTW program. If we can’t automatically verify your

eligibility, we’ll send you a renewal packet. Your renewal application must be

returned within 30 days.

Q: I have more questions, who do I contact?

A: To learn more, visit the HHS Medicaid for Pregnant Women and CHIP

Perinatal webpage, or call 2-1-1 and choose Option 2.