Short answer: Yes, Texas Medicaid can cover up to three months before the application month if the person qualified then and has unpaid bills; for applications made on or after January 1, 2027, federal law cuts that to two months for most groups.
Today HHSC can certify Medicaid for any of the three months before the application month in which the person met all the rules and has unpaid bills for covered services (Form H1113 requests it; for Children’s Medicaid the form is not required if the family gives enough information). Pregnancy Medicaid cannot start before the month the pregnancy began.
The 2025 federal law shortens the lookback for applications made on or after January 1, 2027: two months before the application month for most people, and one month for expansion adults (Texas has none). For CHIP, retroactive coverage is a state option and cannot reach back more than two months.
Tell families with big unpaid bills, such as a new baby’s hospital stay, to apply right away and to say so on the application.