A missed renewal packet can end your Texas Medicaid coverage even if you still qualify. Federal law requires Texas Health and Human Services Commission (HHSC) to try to renew you automatically from data it already holds before it asks you for anything, but when a packet does reach you, it has to come back on time. This guide explains how the Texas Medicaid recertification and renewal cycle works, what to do when your packet arrives, and the 90-day window to recover if you miss the deadline.

Renew online at YourTexasBenefits.com · By phone: dial 2-1-1 or 1-877-541-7905

In This Guide

Recertification is the most consequential recurring moment in a Texan's relationship with Medicaid. Eligibility is set once at initial application, but under 42 CFR 435.916 it is redetermined every 12 months thereafter, and a missed renewal can end coverage even for someone who still qualifies., A procedural closure usually means the person still qualified and simply missed the packet, which is what the 90-day reconsideration window below exists to fix.

The Texas Medicaid Recertification and Renewal Cycle

Under 42 CFR 435.916, HHSC redetermines eligibility for most recipients once every 12 months., Your renewal month is set when you are first approved and stays the same calendar month every year. Approved in October, you renew each October.

Texas renewals split into two procedural paths depending on your eligibility category:

Texas delivers most senior and disability Medicaid through managed care, chiefly STAR+PLUS. Your annual renewal runs through HHSC, not your health plan, but your managed care organization (MCO) is one of the addresses HHSC uses to reach you.

Ex Parte Texas Medicaid Renewal

The most important federal rule in modern Medicaid renewal is the ex parte default at 42 CFR 435.916(b)(1). Before HHSC asks you for any information, it must make a redetermination of eligibility without requiring information from you whenever it can do so from reliable information already in your account or otherwise available to the agency, including electronic data sources. Only when it cannot renew on that basis may it request information from you.

In Texas, HHSC attempts ex parte renewal using the same federal and state electronic data sources it uses at application:

If the data confirm you remain within the income threshold for your category and nothing categorical has changed, the renewal processes automatically and you receive a notice that coverage continues for another 12 months with no action required. When ex parte fails, the reason is usually income that does not appear in wage databases (self-employment, cash, or seasonal work), an asset check that automated data cannot complete, a household change, or income sitting close to the eligibility cutoff.

When ex parte cannot renew you, HHSC must send a renewal form containing the information the agency already has, and must give you at least 30 days from the date of the form (42 CFR 435.916(a)(3)) to respond, supply anything missing, and sign it. That duty, and the 90-day reconsideration window below, cover eligibility based on modified adjusted gross income (MAGI). If you qualify through age, disability, long-term care, a Medicare Savings Program, or the medically needy pathway, Texas may follow the same procedures but is not required to, so ask HHSC what deadlines apply to you. HHSC may not require an in-person interview to renew.

A renewal can also stall on citizenship or immigration status. When you declare U.S. citizenship or a satisfactory immigration status and the agency cannot promptly verify it electronically, federal law (42 CFR 435.956) requires a reasonable opportunity period to produce documentation, ending at the earlier of verification or 90 days after the notice. During that period the agency may not delay, deny, reduce, or terminate benefits for someone it otherwise finds eligible.

How to Renew Texas Medicaid: Five Channels

A Texas Medicaid renewal can be submitted through any of five channels, per HHSC's Form H1200. The fastest and most reliable is online through YourTexasBenefits.com, where you can complete the renewal, upload documents, and check your case status in real time.

Channel How Notes
Online YourTexasBenefits.com Fastest; real-time status, document upload, recommended
Phone Dial 2-1-1 or 1-877-541-7905 Telephonic signature accepted; used to apply, renew, and ask for help
Mail HHSC, PO Box 14600, Midland, TX 79711-4600 Return the signed renewal packet; allow processing time after receipt
Fax 1-877-447-2839 Fax both sides if the form is two-sided
In person Any local HHSC benefits office Call 2-1-1 to find the office nearest you

YourTexasBenefits.com is Texas's integrated portal for Medicaid, CHIP, SNAP, and TANF. If you already have an account from your application, use it; if not, create one with your name, date of birth, and case number from any HHSC notice. A caller who is deaf, hard of hearing, or speech impaired can reach any HHSC office through Relay Texas at 7-1-1 or 1-800-735-2989.

You can also name someone to handle your renewal for you. In Texas, you designate an authorized representative by filing Form H1003, which lets that person complete and submit your renewal form, receive your notices, and act for you with HHSC. You can have only one authorized representative for all your HHSC benefits at a time.

The 90-Day Reconsideration Window

If your coverage closed because you missed the renewal paperwork, you usually do not have to start over with a new application.

Under 42 CFR 435.916, when Medicaid closes for failure to return the renewal form (a procedural termination, not an eligibility-based one), the agency must reconsider eligibility and treat the late-returned form as the renewal if you submit it within 90 days of the termination, without requiring a new application (required for MAGI-based coverage; a state option otherwise).

In practice: if your renewal closed on June 30 because you did not return the form, you have until about September 28 to return it. The 90-day clock starts on the termination date, not the date of the notice, so read your closure notice carefully. The window covers procedural closures only, a line the table below draws in detail.

To use the window, resubmit the renewal form through any of the five channels above. If you no longer have it, call 2-1-1 or log in to YourTexasBenefits.com to request a new one, and note the closure date when you submit so HHSC routes the case correctly.

Children's 12-Month Continuous Eligibility

Section 5112 of the Consolidated Appropriations Act, 2023 requires every state to give children under age 19 enrolled in Medicaid or CHIP 12 months of continuous eligibility from the date of enrollment, effective January 1, 2024. In Texas, that covers children on Children's Medicaid and on the Children's Health Insurance Program (CHIP).

Once a child is enrolled, coverage is locked in for 12 months regardless of changes in family income. If a parent loses Medicaid mid-year because household income rose, the children stay covered until their next annual renewal. The exceptions written into the statute are narrow: the 12-month period ends, the child turns 19, or the child stops being a Texas resident.

If your income rises, report it anyway: accurate reporting protects you from later fraud findings, and your children keep coverage regardless.

A separate permanent option extends Medicaid postpartum coverage for a full 12 months after pregnancy ends, created by the American Rescue Plan Act of 2021 and made permanent by the Consolidated Appropriations Act, 2023. Where a state has elected it, coverage runs through the end of the 12th postpartum month regardless of income change, then the annual cycle resumes.

Long-Term Care and Waiver Renewals

If you receive Medicaid long-term care (a nursing facility or the STAR+PLUS HCBS waiver), your renewal has two independent parts, and both must stay current.

Financial redetermination

HHSC conducts the financial review on the annual cycle, and for MEPD it includes the asset test federal law requires the state to run at renewal through the Asset Verification System (AVS). The AVS is an automated system that requests account information directly from financial institutions; for institutional and waiver cases it pulls a 60-month response window that matches the transfer-of-assets look-back. The financial redetermination confirms you remain within the Texas figures below.

Figure 2026 amount Notes
Special income limit (individual) $2,982/month 300% of the 2026 Supplemental Security Income (SSI) federal benefit rate of $994/month
Special income limit (couple, both applying) $5,964/month Applies to nursing facility and HCBS waiver eligibility
Resource (asset) limit $2,000 individual / $3,000 couple The $2,000 individual limit is the one that applies to a spouse in a facility under spousal-impoverishment policy; the couple limit is for married adults living in the same household. Home, one car, and household goods and personal effects are exempt
Substantial home equity limit $752,000 Home equity above this can disqualify institutional or waiver coverage
Personal needs allowance (nursing facility) $75/month Income kept for personal use; the rest goes to the cost of care

One point married couples get wrong at renewal: the $3,000 resource limit is the limit for married adults who live in the same household. Texas applies the $2,000 individual limit to the institutional spouse under spousal-impoverishment policy, so if one of you has moved into a nursing facility, do not budget the renewal against $3,000.

Texas is an income-cap state. In 2026, its special income limit for a single applicant is $2,982 a month; if your countable income exceeds that, you can still qualify for institutional or waiver Medicaid by diverting the excess into a Qualifying Income Trust (a Miller Trust), which must be irrevocable and name the State of Texas as residuary beneficiary., A recipient using a QIT must keep funding it correctly at each renewal, and HHSC reviews bank statements for the review month and the three prior months.

Level of care reassessment

Separately, your continued need for nursing-facility level of care is reassessed on its own schedule by your STAR+PLUS MCO service coordinator (for the HCBS waiver) or the nursing facility. The two reviews are independent: you can pass the financial redetermination and fail the level-of-care reassessment, or the reverse. If the level-of-care finding ends your long-term care Medicaid, you may continue on regular Medicaid for other coverage if you remain otherwise eligible.

One caution for STAR+PLUS waiver members: access to the HCBS package is capped by funding, and Texas keeps a first-come, first-served interest (wait) list. If waiver coverage ends at renewal, getting back on can mean returning to that list, so treat a waiver renewal as time-sensitive. The HHSC interest-list line is 1-877-438-5658.

Returned Mail and Address Changes

The federal rule that required an agency to search for a new address before acting on returned mail, 42 CFR 435.919, was removed effective July 31, 2026. Federal law now says only that the agency may act without advance notice when your whereabouts are unknown (42 CFR 431.213(d)), and that coverage must be reinstated if your whereabouts become known while you are still eligible (42 CFR 431.231(d)). Texas may still have its own procedures, so if your packet came back as undeliverable, call 2-1-1 and ask where your case stands.

Texas STAR+PLUS is served by seven managed care organizations under contracts effective September 1, 2024: UnitedHealthcare Community Plan of Texas, Molina Healthcare of Texas, Superior HealthPlan, Wellpoint (formerly Amerigroup), Community First Health Plans, El Paso Health, and Community Health Choice Texas. After a move, update your address in every place at once:

  • Update through YourTexasBenefits.com or by calling 2-1-1
  • Update with your STAR+PLUS or Medicaid managed care plan
  • File a change-of-address form with the U.S. Postal Service

Procedural vs Eligibility-Based Termination

This distinction decides whether you have a 90-day reconsideration window under 42 CFR 435.916 or must file a new application.

Termination type What it means Reconsideration available?
Procedural Failure to return the renewal form, missing signature, or no response to a request for information Yes; 90 days from the termination date
Eligibility-based HHSC determined you no longer meet income, resource, residency, or categorical requirements No; file a new application or appeal

Read your termination notice closely: the reason it gives decides which remedy you have.

If Your Renewal Is Denied: Fair Hearing Rights

If your renewal is denied or your coverage is terminated, you have a federal right to a fair hearing under Section 1902(a)(3) of the Social Security Act and 42 CFR 431.220. Federal law caps the request window at 90 days from the date the notice of action is mailed. Read that as a ceiling, not a guarantee: 90 days is the longest window a state may give you, and a state is free to set a shorter one, which is fully enforceable against you. In Texas, HHSC allows an appeal within 90 calendar days from the effective date of the action or the notice-of-adverse-action date, whichever is later, and the agency-prepared record of the request is Form H4800. The deadline that governs your case is the one printed on your own notice. You can request a fair hearing in writing, by calling 2-1-1, or at a local HHSC office; late requests are reviewed for good cause.

To keep your coverage during the appeal ("aid paid pending"), you must request the hearing before the effective date shown on your notice, within the agency's advance-notice period., If the agency's action is later upheld, federal rules permit it to recoup the cost of services furnished solely because benefits continued.

If the denial concerns a service your STAR+PLUS plan cut rather than your eligibility, the path runs through the MCO first: file an internal appeal with the plan within 60 calendar days of its notice, and the MCO must decide within 30 days; if it upholds the denial, you can request a state fair hearing within 120 days of the plan's decision., For a managed care problem, the HHSC Ombudsman Managed Care Helpline is 1-866-566-8989.

What Changes After 2026

The COVID-19 continuous-enrollment rule ended in 2023, and the unwinding redeterminations ran through 2024. What matters for renewals now is a newer federal change.

Section 71107 of the 2025 federal budget-reconciliation law (H.R.1, Public Law 119-21) requires states to redetermine eligibility once every 6 months, rather than every 12, for the Affordable Care Act expansion adult population, for renewals scheduled on or after January 1, 2027. The statute's one exemption is narrow: an Indian or Urban Indian, a California Indian, or anyone otherwise determined eligible as an Indian for the Indian Health Service. Because the six-month cadence is keyed to the expansion adult group, most Texas seniors and people with disabilities renewing MEPD coverage stay on the annual cycle, but the law points the national direction toward more frequent renewals.

The same 2025 law also shortens retroactive eligibility for applications filed on or after January 1, 2027, to two months before the application month for most enrollees (one for the expansion group), down from the long-standing three-month default. The practical lesson does not change: the renewal packet remains the failsafe.

Common Texas Medicaid Recertification Mistakes

  1. Ignoring the renewal packet because it looks like junk mail. Pull anything from HHSC, Texas Medicaid, or YourTexasBenefits out of the pile and open it right away.
  2. Updating your address with Social Security or one MCO but not with HHSC. HHSC does not auto-sync those changes. Update through YourTexasBenefits.com and with your plan.
  3. Not knowing the 90-day reconsideration window exists. A procedural closure can be reconsidered within 90 days with no new application (required for MAGI-based coverage; a state option otherwise).
  4. Missing the AVS documentation for MEPD or long-term care. Federal law requires the asset check at renewal, and without your bank records HHSC cannot complete it, so the renewal stalls.

Frequently Asked Questions

How often do I have to renew Texas Medicaid?

Once every 12 months for most recipients. Your renewal month is the same each year and is tied to your initial approval date. Under 42 CFR 435.916, ongoing eligibility is renewed on a regularly scheduled annual basis. A change is coming for the ACA expansion adult population, which moves to a 6-month cycle for renewals scheduled on or after January 1, 2027.

What happens if I miss my Texas Medicaid renewal deadline?

Your coverage closes at the end of your renewal month. If the closure was procedural (you did not return paperwork or respond to a request for information), you have a 90-day reconsideration window under 42 CFR 435.916 to submit the renewal and have your eligibility reconsidered without a new application (required for MAGI-based coverage; a state option otherwise). If you miss the 90-day window, you must file a new application through YourTexasBenefits.com.

My child is on Medicaid. If my income goes up mid-year, does my child lose coverage?

No. Under federal continuous-eligibility rules, mandatory since January 1, 2024, children under 19 have 12 months of continuous eligibility from the date of enrollment, so your child keeps Texas Medicaid or CHIP until the next annual renewal even if your income rises. The statutory exceptions are narrow: the end of the 12-month period, turning 19, or no longer being a Texas resident.

Why does my MEPD or long-term care renewal need bank statements?

MEPD and long-term care Medicaid have an asset limit, and federal law requires HHSC to verify your assets at renewal through the Asset Verification System, which automated income data cannot do on its own. HHSC generally reviews bank statements for the month of the review and the three prior months to confirm you remain within the $2,000 single resource limit.,

Can I appeal if my renewal is denied?

Yes. Federal law caps the request window at 90 days from the date the notice is mailed, which is the maximum a state may allow rather than a minimum you are guaranteed. Texas allows the full 90 calendar days, measured from the effective date of the action or the notice date, whichever is later, but go by the deadline printed on your own notice., Requesting the hearing before the action's effective date keeps your coverage during the appeal. Request in writing, by calling 2-1-1, or at a local HHSC office.

Texas Medicaid Renewal: Contacts and Resources

Whether you need to complete your annual renewal, recover coverage lost in the past 90 days, or appeal a termination, these are the offices that can help. The renewal channels below are the ones HHSC publishes on Form H1200; the helpline numbers are current HHSC and enrollment-broker lines.,,,

YourTexasBenefits.com Renew online, upload documents, update your address, and check case status. yourtexasbenefits.com
2-1-1 Texas Apply, renew, request a new packet, update your address, or find your local HHSC office. Available 24/7. 2-1-1 or 1-877-541-7905
HHSC Benefits by Mail Return a signed renewal packet. Mail: HHSC, PO Box 14600, Midland, TX 79711-4600 Fax: 1-877-447-2839
Medicaid Enrollment Broker (Maximus) Choose, change, or disenroll from a managed care plan. 1-800-964-2777
HHSC Ombudsman Managed Care Helpline Problems accessing services or complaints about a managed care plan. 1-866-566-8989
HHS Office of the Ombudsman General questions and complaints about Texas HHS programs, including Medicaid. 1-877-787-8999
HHSC LTSS Interest List Get on a waiver interest list. 1-877-438-5658
Relay Texas For callers who are deaf, hard of hearing, or speech impaired. 7-1-1 or 1-800-735-2989

If you are unsure whether your renewal has been processed, log in to YourTexasBenefits.com to check your case status, or call 2-1-1. Brevy's guides to Texas Medicaid eligibility income limits, how to apply for Texas Medicaid, and the Texas Medicaid hub cover the broader eligibility picture and can help you judge whether you remain eligible at renewal.

Learn More

MedicaidHow to apply for Texas MedicaidHow to apply for Medicaid in Texas in 2026: the four ways to apply, the documents seniors need, the income-cap trap, timelines, and where to get free help. MedicaidTexas Medicaid eligibility income limitsTexas Medicaid income limits for 2026: why regular adults face a coverage gap, the long-term-care income cap and asset limit, and the aged and disabled track. MedicaidTexas Medicaid appeals and fair hearingsHow to appeal a Texas Medicaid denial or termination: the 90 and 120 day deadlines, keep benefits during the appeal, and request an HHSC fair hearing. MedicaidTexas Medicaid managed care plansCompare Texas Medicaid managed care plans for STAR+PLUS seniors. See which MCOs serve your area, how to switch plans, and what to look for when choosing. MedicaidTexas Medicaid long-term care and nursing homesTexas Medicaid pays for nursing home care under regular Medicaid, not a capped waiver. See the 2026 income and asset limits and what the at-home spouse keeps. MedicaidTexas Medicaid HCBS waiversTexas HCBS waiver programs help seniors stay home instead of a nursing facility. Learn how STAR+PLUS HCBS, CLASS, HCS, interest lists, and applying work.

Find personalized help renewing your Texas Medicaid coverage at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.