Texas

Texas

What is Texas Medicaid Long-Term Care?

Texas Medicaid is a joint federal and state program that provides health coverage to low-income individuals, including seniors aged 65 and older. When it comes to long-term care, Medicaid in Texas helps pay for services in nursing homes, assisted living facilities, adult foster care homes, and supports that allow seniors to remain in their homes.

What types of Medicaid long-term care programs are available in Texas?
What is Institutional / Nursing Home Medicaid?

This is a guaranteed benefit program—if an applicant qualifies, they receive assistance. Care is provided only in licensed nursing facilities.

What are Medicaid Waivers / Home and Community Based Services (HCBS)?

This is not an entitlement program. Enrollment is limited, and waiting lists (interest lists) may apply. The purpose is to prevent or delay nursing home placement by offering services at home, in adult day care, foster care homes, or assisted living.

What is Regular Medicaid / Medicaid for the Elderly and People with Disabilities (MEPD)?

This is also an entitlement program. Those who qualify receive benefits such as personal care help or adult day care. This option is for seniors needing help with daily living activities.

What are the financial eligibility limits for long-term care Medicaid in Texas?

Eligibility depends on the type of Medicaid program, marital status, and annual updates to income and asset limits. Below is a simplified overview for single applicants:

  • Income: Below $2,901/month
  • Assets: Below $2,000
  • Must require Nursing Home Level of Care
What are the 2025 eligibility limits for all marital situations?
Program TypeSingleMarried (both applying)Married (one applying)
Institutional / Nursing Home Medicaid$2,901 / $2,000$5,802 / $3,000$2,901 for applicant / $2,000 applicant + $157,920 non-applicant
Medicaid Waivers / HCBS$2,901 / $2,000$5,802 / $3,000$2,901 for applicant / $2,000 applicant + $157,920 non-applicant
Regular Medicaid (MEPD)$967 / $2,000$1,450 / $3,000$1,450 / $3,000

*Note: Some income is excluded, such as a $75 personal needs allowance and Medicare premiums. For Waivers, living arrangement may limit income retention. SSI eligibility grants automatic Medicaid access for Regular Medicaid.*

How is income counted for Medicaid eligibility?
What counts as income?

Income includes wages, Social Security, pensions, alimony, investment returns, and IRA withdrawals. Exclusions include Holocaust restitution and VA Aid & Attendance benefits.

How is income treated for married couples?

If only one spouse applies for Institutional or Waiver Medicaid, only their income is counted. The non-applicant may receive a Monthly Maintenance Needs Allowance (MMNA) of up to $3,948/month. For Regular Medicaid, both spouses’ incomes are considered.

What counts as an asset for Medicaid purposes?
What are countable and exempt assets?

Countable assets include cash, stocks, bonds, investments, non-resident property, and bank accounts. Exempt assets include the primary home (with conditions), personal belongings, household goods, one car, burial trusts, and IRAs/401Ks in payout status.

How are assets treated for married couples?

Assets are jointly owned. A Community Spouse Resource Allowance (CSRA) lets the non-applicant spouse retain up to $157,920 in countable assets. If the spouse’s share is below $31,584, they may keep the entire amount up to that level.

What is the Medicaid Look-Back Period in Texas?

Texas enforces a 5-year look-back for Nursing Home and HCBS Waivers. Transfers of assets below market value during this time can result in a penalty period. Regular Medicaid is not subject to this rule.

How is the home treated for Medicaid eligibility?
When is the home exempt?

The home is exempt if the applicant or their spouse resides there. If no spouse lives there, the applicant must have intent to return, and the equity interest must be below $730,000 (2025). Regular Medicaid has no equity limit.

Is the home protected after death?

Not necessarily. Texas’ Medicaid Estate Recovery Program (MERP) may seek reimbursement from the estate, including the home, unless planning strategies are in place.

What medical requirements must be met?
What level of care is needed?

Nursing Home Medicaid and Waivers require a Nursing Facility Level of Care (NFLOC). Regular Medicaid requires help with Activities of Daily Living (ADLs) but not a full NFLOC.

What if someone is over the income or asset limit?
How do Qualified Income Trusts (QITs) help?

Also known as Miller Trusts, QITs allow applicants over the income cap to become eligible. Excess income is deposited into an irrevocable trust and managed by a trustee.

What is asset spend down?

Applicants may use excess assets on exempt expenses, such as home modifications, prepaid funerals, or debt repayment. Gifting assets violates the look-back rule and may result in penalties.

What is Medicaid planning?

Those who are over income or asset limits, yet cannot afford care, should consider working with a Medicaid planning professional to qualify legally and protect their estate.

What specific Medicaid programs exist for Texas seniors?
 STAR+PLUS Waiver

This managed care waiver covers services like assisted living, adult foster care, and in-home help for seniors at risk of nursing home placement.

Community First Choice (CFC) 

CFC is an entitlement program offering personal care services, home support, and the ability to choose one’s caregiver, including some family members.

Primary Home Care (PHC)

PHC provides in-home personal assistance, with the option to hire family caregivers.

Day Activity and Health Services (DAHS)

This program delivers adult day care and basic medical services during the day at community centers.

Community Attendant Services (CAS)

CAS helps individuals with personal care, homemaking, and transportation to medical appointments, especially for those not already enrolled in Medicaid.

PACE program

PACE combines Medicaid and Medicare benefits into one program, offering comprehensive care, including dental and vision.

Money Follows the Person (MFP)

MFP supports Medicaid-eligible individuals in transitioning from nursing facilities back to their homes or community settings.

How do I apply for Medicaid in Texas?

Seniors can apply online at Your Texas Benefits, by calling 2-1-1 or 1-877-541-7905, or through their local Area Agency on Aging. Before applying, make sure all eligibility requirements are met or consider Medicaid planning assistance.

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