A missed renewal packet can end your Texas Medicaid coverage even if you still qualify. Texas Medicaid recertification runs on a 12-month clock, and federal law requires the 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 covers the cycle, what to do when the packet arrives, and the 90-day window to recover a missed deadline.

Renew online at YourTexasBenefits.com · Questions, a replacement packet, or case status: 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. A procedural closure usually means the person still qualified and simply missed the packet, which is what the 90-day reconsideration window 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 at first approval and stays the same every year: approved in October, you renew each October. Renewals split into two procedural paths:

  • MAGI populations (children, pregnant women, parents and caretaker relatives): renewed on Modified Adjusted Gross Income methodology, income verified through electronic data. Federal law forbids any asset test for these groups.
  • MEPD populations (Medicaid for the Elderly and People with Disabilities, including nursing-facility Medicaid, the STAR+PLUS HCBS waiver, Community First Choice, and Medicare Savings Programs): renewed under the non-MAGI framework, which includes an asset test verified electronically at redetermination through an Asset Verification System, a check a MAGI renewal does not carry.

Your renewal runs through HHSC, not your health plan, though 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(a)(2). Before HHSC asks a MAGI beneficiary for anything, it must redetermine eligibility from reliable information already available, including electronic data sources, whenever it can. Only when it cannot may it send a renewal form. The duty reaches non-MAGI cases through 42 CFR 435.916(b), which requires redetermination under (a)(2) "if sufficient information is available to do so."

HHSC attempts it using the same electronic sources it uses at application: Social Security earnings, retirement and disability records; IRS tax data; state wage records and other state agency data (SNAP, TANF, unemployment insurance); Medicare entitlement and premium data; and prior renewal documentation.

If the data confirm you remain within the income threshold and nothing categorical has changed, the renewal processes automatically and coverage continues another 12 months. 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 automated data cannot complete, a household change, or income near the cutoff.

When ex parte cannot renew you, HHSC must send a form containing the information it already has and give you at least 30 days from the date on it (42 CFR 435.916(a)(3)) to respond, supply anything missing, and sign. That duty, and the 90-day reconsideration window below, cover MAGI-based eligibility; 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 what deadlines apply. 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 verify it electronically, 42 CFR 435.956 requires a reasonable opportunity period to produce documentation, running from the day you receive the notice (deemed five days after its date) until verification or 90 days later. During it the agency may not delay, deny, reduce, or terminate benefits for someone it otherwise finds eligible, and must keep working on the verification itself. It can be extended past 90 days for an immigration status while you make a good-faith effort, and a state may not cap how many you get.

How to Renew Texas Medicaid: Four Channels

A renewal reaches HHSC one of four ways: online, or by returning a paper form by mail, fax, or in person, the three routes Form H1200 lists. The fastest is online, where you can complete the renewal, upload documents, and check case status in real time.

Channel How Notes
Online YourTexasBenefits.com Fastest; real-time status, document upload, recommended
Mail HHSC, PO Box 14600, Midland, TX 79711-4600, or your local benefits office Two valid destinations; call 2-1-1 for your local office address
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

Two things matter before you use that list. 2-1-1 is a help and status line, not a way to file: it answers questions, checks the status of a form you already sent, and mails replacements. And the Form H1200 HHSC serves online carries a 2011 revision stamp, so call 2-1-1 to confirm the mailing address and fax number first.

YourTexasBenefits.com is Texas's integrated portal for Medicaid, CHIP, SNAP, and TANF. If you 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 HHSC through Relay Texas at 7-1-1 or 1-800-735-2989.

You can also name someone to handle your renewal. An authorized representative can complete and submit your form, receive your notices, pick a health plan, and act for you with HHSC in all other matters. Form H1003 is the dedicated form, but HHSC also accepts your signature designating a representative on an application or renewal form, guardianship or power-of-attorney documentation, a signed letter, an electronic signature through YourTexasBenefits.com, or a telephonic signature by calling 2-1-1. The representative must be 18 or older, you may have only one at a time across all HHSC benefits, and a new one replaces the old. If HHSC asks you to verify the designation, return the H1003 by the date on the notice, or HHSC designates no representative.

The 90-Day Reconsideration Window

If your coverage closed because you missed the paperwork, you usually do not have to start over. 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, with no new application (required for MAGI-based coverage; a state option otherwise).

In practice: if your renewal closed on June 30, you have until about September 28 to return the form. The 90-day clock starts on the termination date, not the notice date. The window covers procedural closures only, a line the table below draws. To use it, resubmit through any of the four channels above; if you no longer have the form, call 2-1-1 or log in to YourTexasBenefits.com for a new one, and note the closure date 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 19 enrolled in Medicaid or CHIP 12 months of continuous eligibility from enrollment, effective January 1, 2024. Coverage is locked in for those 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 statutory exceptions are narrow: the period ends, the child turns 19, or the child stops being a Texas resident. Report a rise in income anyway; accurate reporting protects you from later fraud findings.

A separate permanent option extends Medicaid postpartum coverage for 12 months after pregnancy ends. Where a state elects it, coverage runs through the 12th postpartum month regardless of income change.

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, both of which must stay current.

Financial redetermination

HHSC conducts the financial review annually, and for MEPD it includes the asset test federal law has the state run through the Asset Verification System (AVS), which requests account information from financial institutions. At renewal it pulls a short window: the month the renewal was received and the three months before it. The 60-month pull that matches the transfer-of-assets look-back is an application-stage rule, so a nursing-facility renewal does not trigger it.

One step is yours, and skipping it ends the case. The AVS is not automatic. It runs on consent, from everyone whose resources count: you (or your guardian, agent, or authorized representative), a spouse whose resources are deemed to you, and the community spouse in a spousal-impoverishment case. You give it by signing an application or renewal form carrying the asset-verification consent language, or Form H0003, and it holds until the case is denied, benefits end, or you withdraw it in writing. HHSC denies the person if it is missing. The records cost you nothing.

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 For nursing facility and HCBS waiver eligibility
Resource (asset) limit $2,000 individual / $3,000 couple The $2,000 limit applies to a spouse in a facility under spousal-impoverishment policy; the couple limit to married adults in the same household. Home, one car, household goods and personal effects are exempt
Substantial home equity limit $752,000 Does not apply at all if your spouse, child, or adult child with a disability lives in the home
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: if one of you has moved into a nursing facility, budget the renewal against $2,000, not $3,000. And home equity over the $752,000 line is not automatically fatal: a reverse mortgage or home equity loan can bring it down, HHS maintains a hardship waiver process, and it never costs Qualified Medicare Beneficiary or Specified Low-Income Medicare Beneficiary coverage.

Texas is an income-cap state, and the 2026 limit of $2,982 a month applies to your countable income, not your gross. Above it, you can still qualify for institutional or waiver Medicaid by diverting the excess into a Qualified Income Trust (a Miller Trust). A trust settles the income test and nothing else: HHSC is explicit that it does not address citizenship, residency, medical necessity, or countable resources, all of which the renewal still checks. Keep funding it correctly at each renewal.

Level of care reassessment

Your continued need for nursing-facility level of care is reassessed separately, 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 if otherwise eligible.

One caution for STAR+PLUS waiver members: Texas keeps an interest (wait) list for the HCBS program, holding 13,519 people as of July 31, 2026, part of an unduplicated 200,128 Texans across HHSC's six interest-list programs. But the list is not everyone's door. HHSC's STAR+PLUS Handbook says Supplemental Security Income recipients and other people on full Medicaid never go on the STAR+PLUS HCBS interest list: someone already enrolled with a STAR+PLUS managed care organization is referred to that plan for the waiver instead. The person the handbook actually places on the list is the medical-assistance-only applicant. So if you keep your Medicaid but lose the waiver at renewal, start with your plan, not the interest-list line. That line is 1-877-438-5658.

Returned Mail and Address Changes

The federal rule requiring 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 they 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 undeliverable, call 2-1-1. STAR+PLUS is served by seven managed care organizations under contracts effective September 1, 2024. After a move, update your address everywhere at once:

Procedural vs Eligibility-Based Termination

This decides whether you get the 90-day reconsideration window or must file a new application.

Termination type What it means Reconsideration?
Procedural Failure to return the 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: its stated reason decides your remedy.

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, covering anyone who believes the agency acted erroneously, denied a claim, or failed to act with reasonable promptness. The one carve-out: no hearing is owed where the sole issue is a law requiring an automatic change affecting a whole group. Federal law caps the request window at 90 days from the date the notice is mailed, a ceiling rather than a guarantee. Texas allows the full 90 calendar days from the effective date of the action or the notice date, whichever is later, recorded on Form H4800. File even if you think you are late: HHSC staff may not refuse an appeal they believe is untimely, and the hearings officer decides timeliness and good cause. Request in writing, by calling 2-1-1, or at a local HHSC office.

To keep coverage during the appeal ("aid paid pending"), request the hearing before the effective date shown on your notice. If that date has passed, ask anyway: 42 CFR 431.231 lets the agency reinstate services when you request a hearing within 10 days of the date of action. And where the agency acted without the advance notice it owed you, 42 CFR 431.231(c) makes reinstatement mandatory, provided you request a hearing within 10 days of receiving the notice (receipt treated as five days after its date unless you show otherwise) and the action did not flow from applying federal or state law or policy. If the action is later upheld, the agency may recoup the cost of services furnished solely because benefits continued. Do not assume continuation is automatic: HHSC does not continue services where Medicaid eligibility itself has been terminated, unless eligibility is reinstated while the appeal is pending, which is what a renewal closure usually is.

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 within 60 calendar days of its notice. The plan has 30 calendar days to resolve it, plus up to 14 more if you ask or it shows HHSC more information is needed. If it upholds the denial, request a state fair hearing within 120 days; if the plan misses its own notice and timing requirements, you are deemed to have exhausted the appeal.

The clock that keeps a service running is far shorter than the clock to appeal. To keep a previously authorized service at its current level, file for continuation by the later of 10 calendar days after the plan sends its notice or the intended effective date of the action; continuation covers only a termination, suspension, or reduction of something already authorized. After the plan decides against you, benefits stop unless you request both the state fair hearing and continuation within 10 calendar days of that decision. You have 120 days to ask for the hearing and 10 to keep the service; file on day 40 and you keep the hearing but lose the care. HHSC's handbook states the first condition more strictly, as an appeal filed by the effective date of action, so act by the earliest date either rule allows. For a managed care problem, the HHSC Ombudsman Managed Care Helpline is 1-866-566-8989.

What Changes After 2026

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 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 that cadence is keyed to the expansion group, most Texas seniors and people with disabilities on MEPD stay annual.

The same law 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 three. The 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.
  2. Updating your address with Social Security or one MCO but not HHSC. HHSC does not auto-sync those changes. Report it through YourTexasBenefits.com or 2-1-1, and tell your plan separately.
  3. Not knowing the 90-day reconsideration window exists. A procedural closure can be reconsidered within 90 days with no new application.
  4. Not signing the asset-verification consent for MEPD or long-term care. The AVS check runs on consent from everyone whose resources count, including a community spouse, and HHSC denies the case without it.

Frequently Asked Questions

What happens if I miss my Texas Medicaid renewal deadline?

Coverage closes at the end of your renewal month, but a procedural closure can be reopened within the 90-day reconsideration window.,

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

It may not. HHSC's rules tell staff to use electronic sources before asking for paper, and not to request documentation unless the electronic information conflicts with what you reported and the difference might make you ineligible. Where AVS returns your balances, turns up no potential transfer of assets, and points to no ineligibility, staff are directed not to request bank statements at all. If a transfer shows up, they can still be asked for, up to 60 months. The renewal window is the renewal month and the three before it.,

Can I appeal if my renewal is denied?

Yes, within 90 calendar days in Texas, measured from the effective date of the action or the notice date, whichever is later., Requesting the hearing before the effective date puts continuation of benefits on the table but does not guarantee it.,

Texas Medicaid Renewal: Contacts and Resources

The mail, fax, and in-person routes below are the ones HHSC's Form H1200 publishes.,,,

YourTexasBenefits.com Renew, upload documents, update your address, check case status. yourtexasbenefits.com
2-1-1 Texas Questions about your form, a new packet, case status, a change, or your local office. Free, 24 hours a day. 2-1-1 or 1-877-541-7905
HHSC Benefits by Mail Return a signed renewal packet to the Midland box or your local office. Confirm the address at 2-1-1 first. Mail: HHSC, PO Box 14600, Midland, TX 79711-4600 Fax: 1-877-447-2839
Texas Enrollment Broker Helpline Change your Medicaid managed-care health or dental plan. A change takes 15 to 45 days. 1-800-964-2777
HHSC Ombudsman Managed Care Helpline Complaints about a managed-care plan, including access to care. 1-866-566-8989
HHS Office of the Ombudsman General complaints about Texas HHS programs, after your caseworker. 1-877-787-8999
Long-term Care Ombudsman For a nursing home or assisted living problem. 1-800-252-2412
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

Unsure whether your renewal has been processed? Check case status at YourTexasBenefits.com or call 2-1-1. Our guides to Texas Medicaid income limits, how to apply, and the Texas Medicaid hub help you judge whether you remain eligible.

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 with your Texas Medicaid renewal 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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