Medicaid Eligibility in Texas for Seniors

Between income limits, asset regulations, and varying long-term care options, it is easy to get lost in the details when applying for Medicaid in Texas. This guide is designed to simplify the process and help family and caregivers of seniors understand how to qualify for Medicaid in Texas, and how Medicaid can help with long-term care and assisted living needs.

Texas Medicaid Eligibility Requirements for the Elderly

To qualify for Medicaid in Texas, seniors applying for Medicaid’s long-term care need to be aged 65 or older, permanent residents of Texas, and U.S. citizens or legal residents. Additionally, applicants must meet the set income and asset requirements set by the Texas Health and Human Services Commission (HHSC).

Texas Medicaid Income Limit

The Texas Medicaid income limits for eligibility are outlined below. The limits differ according to the selected program and marital status. Please note that the Texas Medicaid eligibility income chart below is updated as of 2025 and is subject to change. 

The medicaid income limits in Texas for seniors include all countable assets, such as Social Security, pensions, and retirement distributions. Some deductions may apply for health insurance and certain medical expenses. 

If only one spouse of a married couple is applying for Institutional Medicaid or a Medicaid Waiver, only the applicant's income is counted in this limit. The non-applicant spouse’s income is disregarded and may additionally be entitled to a Monthly Maintenance Needs Allowance (MMMNA) to prevent spousal impoverishment. However, if only one spouse is applying for Regular Medicaid, both spouses' incomes are considered when calculating eligibility. 

Texas Medicaid Asset Limit

The Medicaid Asset limit in Texas is outlined below. The limits may vary according to the selected program and marital status. These numbers are subject to change. 

Countable assets include cash, savings, investments, and property, excluding the primary residence. Not included in the set asset limit are a primary home, one vehicle, personal belongings and household items, and certain burial funds and life insurance policies.

All assets are considered jointly owned in the case where one or both spouses in a marriage are applying. 

Medicaid’s Look Back Rule

Texas has a 5-year Medicaid Look-Back Period, during which all transfers made 60 months prior to application are investigated to ensure that no gifts or sales were made for under market value in order to meet eligibility requirements. This applies to Nursing Home Medicaid and Medicaid Waivers and not to Regular Medicaid. 

How to Qualify for Medicaid in Texas if You Exceed the Limits

If the applicant exceeds the Texas Medicaid financial requirements, there are ways to still qualify for long-term care. Some of these methods include:

Qualified Income Trusts (QITs)

This is also referred to as Miller Trusts. This is an irrevocable trust that allows individuals who are applying for Institutional Medicaid and Medicaid Waivers to meet the required income limits. Applicants can deposit access income into the QIT, where those funds can be used only for specific purposes, such as paying medical expenses. 

Asset Spend Down: How Does Medicaid Spend Down Work in Texas?

Applicants who exceed the asset limit can still become eligible by “spending down” assets on specific assets that are considered non-countable. This includes making home accessibility modifications, prepaying certain funeral and burial expenses, and paying off debt. All transfers made should be properly documented to ensure they comply with Medicaid’s Look-Back Rule. 

Medicaid Planning

Working with a Medicaid Planning Professional, such as Senior Planning Services, individuals who otherwise exceed the income or asset limit can strategically plan ahead to help them become Medicaid-eligible. 

How to Apply for Medicaid in Texas for Seniors

To apply for Medicaid:

1. Select the Right Medicaid Program: Medicaid offers several programs. For seniors, consider Institutional/Nursing Home Medicaid, Medicaid Waivers/Home and Community-Based Services, or Regular Medicaid.

2. Confirm Eligibility Requirements: Review the Texas Medicaid eligibility requirements, such as the income and asset limits, to ensure you qualify for the selected program.

3. Gather Required Documents: To verify your eligibility, there are several documents needed to apply for Medicaid in Texas. Some of these documents include:  

• A valid identification document (like a driver's license or government ID)

• Social Security card

• Bank statements

• Proof of income and assets

• Health insurance cards

• Medical records

4. Complete the Application: Fill in the application online or in person at a local HHSC office.

5. Submit the Application: Submit the application along with all the necessary documents.

Medicaid for Nursing Homes in Texas

Does Medicaid pay for nursing homes in Texas?

In Texas, Medicaid may cover the costs of nursing home care, either in whole or partially, for seniors who meet the specific requirements outlined above for the Nursing Home Medicaid or Institutional Care Medicaid programs. 

If approved, Medicaid may cover:

• Room and board

• Nursing and medical care

• Meals and personal assistance

• Therapy and rehabilitation services

Medicaid for Assisted Living in Texas

While Regular Medicaid does not cover assisted living in Texas, the STAR+PLUS Waiver program may cover care services provided in licensed assisted living facilities. This waiver is designed to give seniors more flexibility to remain in community settings. Services may include:

• Personal care assistance

• Medication management

• Meal preparation

• Transportation to medical appointments.

How much Medicaid pays for assisted living in Texas varies depending on the facility, the level of care needed, and more.

Texas Medicaid Long-Term Care Eligibility Support

Need help navigating the Texas Medicaid application process for long-term care? Senior Planning assists seniors and their families, guiding you through every step of the journey to ensure you or your loved one gets the care they need. Contact Senior Planning today to get started.

Frequently Asked Questions about Medicaid Eligibility in Texas

Which Medicaid plan is the best in Texas?

The STAR+PLUS program is the most comprehensive Medicaid plan for seniors who need long-term care. It covers a range of medical and personal care services, both at home and in assisted living facilities.

Does Medicaid pay for nursing homes in Texas?

Yes. Once approved, Medicaid may cover all or part of the cost of nursing homes.

How to check eligibility for Texas Medicaid?

To check eligibility for Texas Medicaid, contact Senior Planning, and we will guide you through the process step by step, from gathering the necessary documents to selecting the program best suited for you or your loved one.