Sexual and Reproductive Healthcare Coverage in Texas
Overview
There are a number of federal and state-based programs in Texas that provide either healthcare coverage or direct clinical care for sexual and reproductive health services. Each program has its own unique eligibility requirements and services. These vital programs help people who are uninsured or underinsured receive necessary care but can be difficult to navigate, making it challenging for clients to receive care even when they’re eligible.
On this page of the “No Wrong Door for Reproductive Life Goals Conversations” toolkit, we provide information on each program so providers can help their clients access the care they need based on their RLG conversation. The information provided includes:
Brief descriptions of the eligibility and services for each program
Videos with more in depth descriptions of Texas federal and state-based healthcare programs
Clinic finders
Job aids and client resources
The following videos explain key concepts useful for navigating and understanding Texas healthcare programs. We recommend watching them before learning about each individual program.
Eligibility and Services
Texas Sexual and Reproductive Healthcare Programs Eligibility and Services
Eligibility for many sexual and reproductive healthcare programs in Texas includes income limits at a certain percent of the federal poverty level (FPL). You can use this FPL calculator to help clients determine eligibility.
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Family Planning Program (FPP)
Eligibility
- Texas resident (regardless of immigration status)
- Ages 64 and under
- Ineligible for other plans that provide the same services
- All sexes and genders are eligible
- Income level at or below 250% of FPL
- Minors require parental consent
Services
- Contraception
- Screening for cervical and breast cancer
- Pregnancy testing
- STI testing and treatment
- Pelvic exams
- Screenings for cholesterol, diabetes, and blood pressure
Watch this video for more information on FPP:
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Federally Qualified Health Centers (FQHC)
Eligibility
No eligibility requirements but the client must be an established patient at the FQHC before receiving services. This can take some time, depending on the clinic. Payment is on a sliding scale fee.
Services
- Primary care
- Family medicine
- Women’s health
- Cardiovascular care and other specialty care
Watch this video for more information on FQHCs:
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Healthy Texas Women (HTW)
Eligibility
- Texas residents assigned female at birth, ages 15-44
- US citizen or legal resident for 5+ years
- Household income level at or below 204.6% of the federal poverty level
- Not pregnant
- Not eligible for other healthcare plans that provide the same services
- Minors require parental consent
Services
- Contraception
- Screenings for breast and cervical cancer
- STI testing and treatment
- Pelvic exams
- Treatment for postpartum mental health disorders
- Pap tests
Watch this video for more information on HTW:
In this video, the speaker refers to the income eligibility capped at 200% FPL. In 2021, eligibility increased to 204.6% FPL to offset changes in federal funding.
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Healthy Texas Women Plus (HTW+)
Eligibility
- Texas resident assigned female at birth, ages 18-44
- Meets the eligibility requirements for HTW
- Pregnant in the 12 months prior to enrollment
Services
Screening and treatment for health conditions that may contribute to maternal mortality and morbidity, including:
- Hypertension
- Asthma
- Diabetes
- Substance use
- Mental health
Watch this video for more information on HTW+:
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Medicaid for Pregnant Women & CHIP Perinatal
Medicaid for Pregnant Women
Eligibility
- Texas resident or qualified non-citizen
- Family income below 198% of the federal poverty level
- Pregnant, or within 60 days postpartum
Services
- Prenatal vitamins
- Doctors visits
- Labor and delivery
- Some coverage for the infant after leaving the hospital
- Full Medicaid benefits unrelated to pregnancy
CHIP Perinatal
CHIP Perinatal is a Medicaid program that provides coverage to some people who are ineligible for Medicaid for Pregnant Women. It’s more limited in the services it covers.
Eligibility
- Pregnant
- Ineligible for Medicaid
- Income level below 202% of federal poverty level
- No citizenship requirements
Services
Limited to services that support the growth and development of the fetus.
Watch this video for more information on Medicaid for Pregnant Women, CHIP Perinatal, and other programs that provide support for pregnant women:
Watch this video for more information on Texas Medicaid family planning services and CHIP. Adults without dependent children or a disability, who are not pregnant, are not eligible for Texas Medicaid.
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Title X
Eligibility
The only requirement is that the person receiving services can become pregnant or get someone else pregnant.
Services
Title X clinics provide confidential services on a sliding fee scale.
- Contraception
- Basic infertility services
- Preconception care
- STI testing & treatment
- Pregnancy testing
Watch this video for more information on Title X:
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Locally Administered Community Health Programs
In Texas, there are some locally administered community health programs funded by hospital districts, each with their own individual eligibility standards and services.
Learn more about these programs in the video below.
Local County Health Districts:
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Support for People with Reproductive Cancers
There are 2 programs in Texas for low-income residents that offer screening, treatment, and diagnostic services for reproductive cancers: Breast Cervical Cancer Services (BCCS) and Medicaid for Breast and Cervical Cancer (MBCC)
Watch this video for more information on support for people with reproductive cancers.
Further Information & Resources
We encourage those that will be making referrals for clients to consider taking the free training course by Cardea Services linked below. The other links in the box include further information, job aids, and resources for social service providers and for clients.
Free Training Course: Linking Clients to Women’s Health Program in Texas
The content on this page was written and reviewed in June 2023.
The information in the videos on this page is accurate as of March 2021, when they were filmed.