Revision 22-3; Effective July 1, 2022

HTW provides for a continuous 12-month certification period with the following limited health care benefits:

  • Annual family planning exams
  • Family planning counseling and education
  • Treatment of certain sexually transmitted infections
  • Birth control (except emergency birth control), including methods to permanently prevent pregnancy (tubal ligations or Essure)
  • Follow-up family planning visits related to the method of birth control

Note: For people 15-17, a parent or legal guardian's signature is required.

HTW Plus (HTW+)

Enhanced and limited postpartum care services are available to HTW members whose pregnancies ended within the 12 months preceding their enrollment into HTW.

Enhanced postpartum benefits include services that address:

  • postpartum depression and other mental health conditions;
  • cardiovascular and coronary conditions; and 
  • substance use disorders, including drug, alcohol and tobacco use.

There is no separate eligibility determination for HTW+. If a woman is determined eligible for HTW and her pregnancy ended within the 12 months before her HTW eligibility date, she is eligible for HTW+ benefits during her 12-month HTW certification period. TIERS automatically adds an HTW+ indicator flag to the woman’s HTW EDG.

W-111 Type of Assistance (TA) 41 – MA – Healthy Texas Women

Revision 24-4; Effective Oct. 1, 2024

To be eligible for HTW, applicants must:

  • be female, 15 through 44;
    • a parent or legal guardian must  apply on behalf of applicants 15-17;
  • have countable income of less than or equal to 204.2% of the federal poverty level;
  • be a U.S. citizen or a legally admitted alien who meets all eligibility requirements for Medicaid;
  • be a Texas resident;
  • not be pregnant;
  • not have creditable health insurance that covers family planning services; and
  • not currently receive Medicaid, Medicare Part A or B, or Children's Health Insurance Program benefits. Receipt of Medicare Part B-ID does not affect eligibility for HTW benefits.

Notes:

  • A legal guardian is a person appointed by a judge to care for a child younger than 18.
  • Deny applications received for minors, 15-17, without a parent or legal guardian signature if they are not eligible for full coverage Medicaid or CHIP. Use the denial reason, Denied 15-17 without parent or legal guardian’s signature.
  • Married minors, 15-17, are not eligible for HTW. Deny applications for married minors if they are not eligible for full coverage Medicaid or CHIP. Use the denial reason, Denied 15-17 married minors.

Related Policy

Income Limits, C-131
General Policy, W-510

W-112 Application Procedures

Revision 21-3; Effective July 1, 2021

Applicants can use any Texas Works medical benefits application form to apply for HTW.

Related Policy

Application Requests and Submissions, A-113

W-113 Requesting an Application

Revision 21-3; Effective July 1, 2021

Applicants can request and submit an application using any of the medical program application channels.

If an applicant applies in-person at a local office or through participating family planning providers or other community-based organizations and requests help completing an application, a volunteer or staff member must give help and initial the parts completed or sign the application to show the applicant received help.

Related Policy

Application Requests and Submissions, A-113