The HTW Program provides access to women's health and family planning services at no cost to eligible women in Texas. The program serves approximately 300,000 people annually. Women eligible for the HTW Program are:
- At or below 200 percent of the federal poverty level
- Age 15 – 44
- Not pregnant
- Texas residents
- United States citizens or qualified immigrants
The HTW Program is jointly funded by the state and federal governments.
HHSC must add the drug to the Medicaid formulary before adding it to the HTW formulary.
The HTW drug rebate program covers products in the program. Participation in the rebate programs for HTW varies depending on the budget source used to pay for the original claim or encounter eligible for a rebate.
- Claims and encounters for clients under 18 (Rebate Programs called TWHP) are paid by the State of Texas General Revenue funding. Participation in this rebate program is voluntary with some exceptions.
- Claims and encounters for postpartum clients (Rebate Programs called HTW+) are paid by State of Texas General Revenue funding. Participation in this rebate program is voluntary with some exceptions.
- Claims and encounters for clients 18 and over (Rebate Program called HTW) are paid with Federal Funding and are subject to CMS federal rebate rules. Participation in this rebate program is mandated if the manufacturer has signed a National Drug Rebate Agreement with CMS.
HHSC and CMS agreed to provide comprehensive women's health services through a Medicaid demonstration waiver over the next five years as of Feb. 18, 2020.
Refer to the contact information for questions related to program formulary coverage.
Healthy Texas Women Plus
The Healthy Texas Women Plus Program is an enhanced postpartum care services package for women in the HTW Program. The state-funded program began on Sept. 1, 2020.
HTW Plus services focus on treating major health conditions recognized as contributing to maternal morbidity and mortality in Texas, including postpartum depression and other mental health conditions, cardiovascular and coronary conditions, and substance use disorders, including drug, alcohol, and tobacco use. Eligible individuals meet the standard HTW eligibility criteria and have been pregnant 12 months before HTW enrollment.