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 21-3; Effective July 1, 2021
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.
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