Healthy Texas Women covers preventive women’s health care, family planning, and contraception at no cost for eligible low-income Texas women who don’t qualify for Medicaid. The benefit package includes cancer screenings, STI testing and treatment, screenings for high blood pressure, diabetes, and cholesterol, a full range of birth control methods, postpartum depression care, and certain vaccines. It does not cover pregnancy care, elective abortion, or treatment for serious conditions the program screens for.1Program overview and FY2023 enrollment of more than 142,000 women served, average monthly enrollment of roughly 435,000.
Preventive Screenings and Women’s Health Services
The core benefit is preventive. Covered services include pregnancy testing, pelvic examinations, clinical breast exams, mammograms, and breast and cervical cancer screenings. The program also covers screening and treatment for sexually transmitted infections, including HIV, and screening and treatment for high blood pressure, diabetes, and cholesterol.
Postpartum depression screening and pharmaceutical treatment are part of the standard benefit, available even outside the enhanced postpartum package. Covered immunizations include HPV, hepatitis A, hepatitis B, chickenpox, MMR, Tdap, and flu vaccines.
Cervical cancer screening follows U.S. Preventive Services Task Force guidelines. Women ages 21 to 29 get a Pap smear every three years. For women 30 and older, the preferred approach is either co-testing with a Pap smear and HPV test every five years, or a primary HPV screening test every five years; Pap smears alone every three years remain an alternative. If results come back abnormal, follow-up diagnostic procedures such as colposcopy are covered according to clinical guidelines.
Contraception and Family Planning
Enrollees can choose from the full range of contraceptive methods, and providers must make all covered options available either directly or by referral. The program emphasizes freedom of choice in method selection.
- Long-acting reversible contraceptives, meaning IUDs and implants, available through providers or as a pharmacy benefit through specialty pharmacies.
- Oral contraceptive pills; providers with pharmacy licenses can dispense up to a one-year supply within a 12-month period.
- Injectable contraceptives, covered under the program’s procedure codes.
- Barrier methods, including condoms, diaphragms, and vaginal spermicide.
- Permanent sterilization, covered once per lifetime for enrollees aged 21 and older, with a signed consent form required at least 30 days before the procedure, or at least 72 hours in an emergency.
Emergency contraception is not reimbursed by the program.
Prescription Drugs
Prescriptions tied to the program’s covered health categories are filled at no charge at any participating pharmacy when the enrollee shows a Your Texas Benefits ID card. STI treatments are covered for conditions including chlamydia, gonorrhea, syphilis, herpes, and trichomoniasis, among others.
The drug coverage is set to broaden on July 1, 2026. The formulary will expand to include all Medicaid-eligible drugs within the health care categories HTW covers. On the same date, the program will adopt the Medicaid preferred drug list and begin requiring clinical prior authorizations for certain medications, aligning pharmacy rules with the broader Medicaid program. The change is part of a transition from state-funded to Medicaid-funded status.
HTW Plus Postpartum Benefits
Healthy Texas Women Plus is an enhanced package for enrollees who were pregnant within the previous 12 months. It was created by Senate Bill 750 during the 86th Texas Legislature in 2019 and launched on September 1, 2020. In fiscal year 2023, about 3,185 women received HTW Plus services. The package targets conditions that drive maternal morbidity and mortality in Texas, grouped into three categories.
Mental health benefits include individual, family, and group psychotherapy, along with peer specialist services for postpartum depression and other conditions.
Cardiovascular and coronary care covers imaging studies, blood pressure monitoring, and medications including anticoagulants, antiplatelets, and antihypertensives. Additional injectable insulin and asthma medications are also included.
Substance use disorder services include screening and brief intervention, outpatient counseling, smoking cessation, medication-assisted treatment, and peer specialist services for drug, alcohol, and tobacco use.
HTW Plus benefits begin after the first 60 days of the postpartum period and run for up to 12 months from the date of enrollment. Women receiving HTW Plus keep access to all standard HTW services as well.
One recent change affects who ends up on HTW Plus in the first place. Under House Bill 12, which took effect March 1, 2024, Texas extended full postpartum Medicaid coverage from two months to 12 months. Women who had already transitioned from Medicaid to HTW but were still inside their 12-month postpartum window were moved back to full Medicaid or CHIP, which covers a broader set of services than HTW, including hospital care, specialist visits, and vision and hearing care.
What the Program Does Not Cover
Several categories fall outside the HTW benefit, and the gaps matter because the program is often mistaken for broader coverage.
Pregnancy care is not included. HTW does not pay for prenatal visits, labor and delivery, or postpartum medical care beyond what the HTW Plus package provides. An HTW enrollee who becomes pregnant is referred to Medicaid for Pregnant Women. When that coverage ends, she may be automatically enrolled back into HTW and receive a confirmation letter from Texas Health and Human Services.
Elective abortions are explicitly excluded.
Treatment for serious conditions found through HTW screenings is not covered. If a screening identifies a condition such as cancer, the enrollee is referred to an outside provider or clinic for treatment, and the program itself will not pay for that care.
Emergency contraception is not reimbursed, as noted above.
Cost to Enrollees
All covered services are free. There are no copays, premiums, or other cost-sharing for HTW services, and prescriptions tied to covered categories are filled at no charge at participating pharmacies. If an enrollee needs care that falls outside the program’s scope, including treatment for conditions identified through its screenings, she may have to pay for that care out of pocket.