Health Care Assistance Guide

Travis County residents who are not covered by Medicare, Medicaid, or private insurance can access healthcare and a variety of services through Central Health. To determine eligibility and apply for the Medical Access Program (MAP), visit the Central Health website or call the number above.

Individuals will need:

• Proof of Travis County residency
• Proof of US citizenship
• Picture ID
• Proof that you are the legal guardian of any child in your household
• Proof of any other health care benefits that you have been approved, denied, or have a pending application
• Proof of household income and other forms if requested

Note: Enrollment in MAP is not tied to the Federal Government's "public charge" regulations, and therefore any eligible enrollee should not fear impact to a green card.

Part of the City of Austin, APH is tasked with promoting a healthy community for Austinites, preventing illness, injury and disease, and protecting the community from infectious diseases, environmental hazards and epidemics. APH provides immunizations, shelter, food, clothing, job assistance, blood pressure, diabetes and STD screenings including HIV/AIDS, hepatitis and tuberculosis screenings.

In addition, APH offers nutritional support through the WIC program (Women, Infants, Children), birth and death certificates, inspection of restaurants, and outreach and education on topics such as smoking cessation, mother-friendly workplaces and injury prevention.

Medicaid is a federal government insurance partnership between the federal government and each state. Therefore, eligibility and benefits can differ from state to state. In Texas, Medicaid and CHIP provide health coverage for low income children, families, seniors, and people with disabilities.

Once approved for eligibility in Medicaid or CHIP, individuals then select a health plan.

• STAR is a program for children, newborns, pregnant women, and some families.
• STAR+PLUS is a program for adults with a disability, people age 65 and older, and women with breast or cervical cancer.
• STAR Kids is a program for children and adults age 20 and younger with a disability.
• CHIP is a program for children and unborn children in families that earn too much money to qualify for Medicaid but cannot afford private insurance.

Medicare is federal health insurance for people 65 or older, or for younger individuals with disabilities, End Stage Renal Disease (ESRD), or ALS (Lou Gehrig's disease).

If an individual is eligible for both Medicare and Medicaid, there are Medicare Advantage plans for these "dual eligible" individuals to join if available in their area. Eligibility requires that a dual eligible individual live in the service area of the Medicare Advantage plan. This is also true for those who are not disabled or diagnosed with ESRD or ALS. All Medicare Advantage enrollees must live within the service area of the Advantage plan.

To enroll in a Medicare Advantage Plan, a Dual Medicare Advantage plan, or a Medicare Supplemental Plan, one must be enrolled in Medicare Part A and Part B.

All individuals who have worked full time in the US for a minimum of 10 years (or 40 quarters) earn Medicare Part A free of charge. Medicare Part A provides for hospital (usually inpatient care) coverage. Enrollment in Part A of Medicare is automatic for most at age 65.

Part B provides "medical insurance" (usually outpatient care) and has an associated cost based on an individual's past income. One can enroll in Part B by visiting a local Social Security office or by calling Social Security at 1-800-772-1213.

When an individual is enrolled in Part A and B, they can choose to elect a Medicare Advantage plan to cover the cost sharing that Medicare does not cover (Medicare provides 80% coverage, leaving individuals with a 20% cost share). Individuals may also elect to enroll in a Medicare Supplemental plan to cover the cost sharing not covered by Medicare. Medicare representatives can help enroll an individual in a Medicare Advantage plan.

For those who are not eligible for Medicaid or Medicare, or do not have access to health insurance through their employer, they may purchase an individual policy through the government marketplace.

If a person has a "life event," such as losing their current health plan or losing eligibility for Medicaid, or they turn 26 and fall off of their parent's plan, they can enroll in an ACA plan immediately.

If not, the annual open enrollment for the ACA Exchange is November 1 through December 15, with coverage effective January 1 of the following year. The site helps users determine if they are eligible for financial subsidies as well.

Healthcare option for residents of the neighboring county of Hays.

Healthcare option for residents of the neighboring county of Williamson.

Central Texas mental health services.