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Texas Medicaid Requirements for Nursing-Home Patients

Nursing-home care costs several thousand dollars a month. At that rate, nursing home residents often burn through their life savings quickly. When a nursing home resident's assets are depleted, he or she must usually resort to the state's Medicaid program to cover the cost of long-term care. Texas has some Medicaid requirements and regulations that nursing home residents should be aware of.

  1. Exempt Assets

    • Some items are exempt from Medicaid calculations; in other words, they are not included in your countable assets. In Texas, these exempt items include a home valued at $500,000 or less; a car; a funeral plan or burial plot as long as it cannot be sold for cash; and a life insurance policy with a death value of $1,500 or less.

    Countable Assets

    • Countable assets include cash assets and assets that can be easily converted to cash, such as checking and savings accounts, certificates of deposit, retirement funds and some types of life insurance. To qualify for Texas Medicaid, your countable assets must be worth $2,000 or less. State guidelines are strict about how countable assets may be spent in the years before qualifying for Medicaid. For instance, you may be penalized if you give away money or property. For more information about allowable ways to spend down your assets, call the Legal Hotline for Texans at 1-800-622-2520.

    Income

    • Income guidelines change frequently, but Texas has an income cap for nursing home residents. Nursing home residents whose incomes exceed the monthly cap will not qualify for Medicaid unless an attorney helps them make special arrangements.

    Miller Trust

    • A Miller Trust, also called a Qualified Individual Trust, must be set up by an attorney. The Miller Trust is designed to meet the needs of Texas nursing home residents whose income is greater than the Medicaid income limit, but who still do not have enough money coming in to cover the cost of their nursing home care.

    Applied Income

    • Texas Medicaid does not cover the full cost of nursing home care. Applied income is the portion of your income that must be paid to the nursing home to help cover your care costs. For an individual, the monthly applied income equals total monthly income minus $45 for personal needs plus any money spent on incurred medical expenses, such as insurance premiums.

    Medicaid Estate Recovery

    • This program, adopted in 2005 to comply with federal laws, allows the state to file a claim against the estate of a deceased Medicaid recipient for the cost of many Medicaid services including nursing home care. In several situations, however, the state will not file such a claim. If you think your loved one's estate should be exempt, consult an attorney or contact the Texas Department of Aging and Disability Services (DADS) at 1-800-458-9858.

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