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HB 12 Postpartum Extension

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As part of House Bill 12 (HB 12) passed during the 88th legislative session, the Texas Health and Human Services Commission (HHSC) extended its postpartum Medicaid coverage from 2 to 12 months for eligible women. The extension is effective March 1, 2024.

HHSC is also providing 12 months of postpartum Children’s Health Insurance Program (CHIP) coverage. The 12 months of postpartum coverage begins the month after a pregnancy has ended.

Provider enrollment and claims filing processes will not change because of the postpartum extension implementation.

Who Is Eligible?

The following clients are eligible for extended coverage:

  • Medicaid or CHIP recipients who are pregnant or become pregnant.
    • CHIP Perinatal (CHIP-P) recipients are not eligible for 12 months of postpartum coverage. They’ll continue to receive CHIP-P coverage through the end of the month during which their pregnancy ends plus two postpartum visits.
  • Medicaid or CHIP recipients who were enrolled while pregnant and are no longer pregnant but are still within their 12-month postpartum period, including women who transitioned from Medicaid or CHIP to Healthy Texas Women (HTW) after their pregnancy ended, who will be reinstated to full Medicaid or CHIP coverage.
  • Women who received services while pregnant in Texas who would have been covered by Medicaid and apply for Medicaid after their pregnancy ends.
    • Medicaid applicants with unpaid medical bills can apply for coverage for up to three months prior to their application month.
    • This does not apply to CHIP applicants.

Coverage

Medicaid and CHIP recipients don’t need to apply to have their coverage extended.

Coverage will be reinstated for the remainder of the 12-month postpartum period for women who are not current Medicaid or CHIP recipients but who were enrolled in Medicaid or CHIP in Texas while pregnant and are still within their 12-month postpartum period (if they are still residents of Texas). They’ll get a notice by mail or through their Your Texas Benefits account.

The full array of Medicaid or CHIP covered services remains available in the 12-month postpartum period, including but not limited to:

  • Regular checkups.
  • Prescription drugs and vaccines.
  • Hospital care and services.
  • X-rays and lab tests.
  • Vision and hearing care.
  • Access to medical specialists and mental health care.
  • Treatment of special health needs and preexisting conditions.

Exceptions to Eligibility

Medicaid and CHIP recipients will receive the extended coverage through their postpartum period regardless of any change in circumstances unless they:

  • Voluntarily withdraw.
  • Move out of state.
  • Are determined to be ineligible because of fraud, abuse, or perjury.
  • Die.

Additional Information

For more information about the 12-month postpartum coverage, visit texashhs.org/postpartum, or call 2-1-1 and choose option 2.

For all other information, call the TMHP Contact Center at 800-925-9126.