Navigating Medicaid in Texas: What You Need to Know

Understanding Medicaid eligibility for nursing home care can feel overwhelming, but it’s essential for accessing the support you or your loved ones may need. Medicaid is a vital program that helps individuals with limited financial resources cover long-term care expenses, including nursing home services. Let’s break down what you need to know about qualifying for Medicaid nursing home care.

Eligibility Criteria

To qualify for Medicaid coverage for nursing home care, individuals generally must meet the following criteria:

1.    Income Limits: Each state has specific income thresholds, and Texas is no different. Your income must fall below a certain limit, which is updated regularly, so it’s important to stay informed. Currently, the income limit is $2,829 for individuals and $5,658 for couples.

2.    Asset Limits: Medicaid also imposes asset limits, which include cash, property, and other resources. However, many assets are exempt, allowing you to retain more than you might expect. For example, one vehicle, livestock, business property, your primary residence, personal items, household furnishings, and burial plots and pre-paid funeral arrangements (with a face value of up to $1,500) are typically not counted against you, as long as certain criteria are met. Additionally, certain life insurance policies and retirement accounts like IRAs or 401(k)s may be exempt if they are making Required Minimum Distributions (RMDs).

3.    Medical Necessity: To qualify, the applicant must demonstrate a genuine need for the level of care provided by a nursing home. This involves a medical assessment to confirm that nursing home care is necessary.

4.    Citizenship and Residency: Applicants must be U.S. citizens or legal residents and must reside in the state where they are applying for Medicaid, which in this case, is Texas!

Planning and Application

Understanding these eligibility criteria is the first step to navigating the Medicaid application process. By ensuring that you or your loved one meets these requirements, you can streamline your journey toward securing the necessary care.

If you need assistance with Medicaid planning or have questions about eligibility, our experienced attorneys can provide the guidance you need. Call us at (512)374-4922 or email [email protected] to speak with one of our attorneys. We’re here to help you navigate the intricacies of Medicaid nursing home care so you can focus on what truly matters—ensuring your healthcare needs are met with the support and dignity you deserve.