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Texas residents have to meet an asset limit and an income limit in order to be financially eligible for Nursing Home Medicaid. For a single applicant in 2022, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash and any other assets that can be easily converted to cash. An applicant’s home does not always count as an asset , and there are other non-countable assets like funeral trusts and Medicaid-approved annuities. Almost all income is counted – IRA payments, pension payments, Social Security benefits, property income, alimony, wages, salary, stock dividends, etc. COVID-19 stimulus checks and Holocaust restitution payments are not considered income.
Click on the state name below to see that state’s complete Medicaid eligibility criteria. Non-Financial Eligibility Requirements – For Texas long term care Medicaid, an applicant’s functional need is considered. For nursing home Medicaid and Medicaid Waivers, a nursing facility level of care is required. Certain benefits may have additional eligibility requirements specific to the particular benefit. For example, in order for a Waiver to pay for home modifications, the inability to safely live at home without modifying the home might be necessary.
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To be eligible for Medicaid, you cannot have assets greater than a certain limit, and only those with a low income and limited financial resources will qualify for coverage. According to the American Council on Aging, when you apply for Medicaid long-term care coverage in Texas as a single person, your non-exempt assets in 2022 cannot exceed $2,523. To be able to get Texas’s Medicaid program to pay for long-term care in 2019, a single person’s monthly income cannot be higher than $2,313.
By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible, as well as to protect their home from Medicaid’s estate recovery program. While one’s home is usually exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s estate recovery program. Following a long-term care Medicaid beneficiary’s death, the Medicaid agency in Texas attempts reimbursement of care costs through whatever estate of the deceased still remains. Without proper planning strategies in place, the home will be used to reimburse Medicaid for providing care rather than going to family as inheritance. The minimum Community Spousal Protected Amount increased from $24,720 in 2018 to the new limit of $25,824. This does not mean that the spouse of a nursing home Medicaid applicant can automatically keep $25,824.
The Minimum Monthly Needs for a Spouse
For programs being tested using the special income limit of 300 percent of the SSI-FBR, use the following figures. Individual with a spouse in the community — Total gross couple income, less $60 for personal needs; less amount up to $3,435 for community spouse; less certain amount for dependents living with community spouse. 5) Texas Community Attendant Services – Provides non-medical personal care assistance, homemaker services, and transportation assistance to / from medical appointments.
HHS works with federally qualified health clinics, medical associations, community partners and local governments to help clients find the health care they need. Aging and Disability Resource Centers can help Texans find personal care, nursing care, help at home and other long-term care services. 1) STAR+PLUS Waiver – This is a limited enrollment, managed care program that covers assisted living, adult foster care, and many in-home supports to help beneficiaries avoid nursing home placement. Further complicating eligibility is that the criteria vary with marital status and that Texas offers multiple pathways towards eligibility. The second change is an increase in the Medicaid Applicant's gross monthly income limit. In 2018 a Medicaid applicant was only allowed to have $2,250 per month in gross monthly income (using the government’s definition of “income” which may be a little different from what most people consider to be “income”).
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For example, if you have $50,000 in resources, the spouse will keep $27,480 but the rest of your life savings would face the spend-down. The Federal Poverty Level is determined by the size of a family for the lower 48 states and the District of Columbia. One can learn more about this program on the STAR+PLUS website or by contacting your local Area Agency on Aging. To apply for this Waiver or Texas Medicaid , one should visit the Your Texas Benefits website. There are a number of ways to manage assets outside of the QIT that you can use along with the QIT. For example, a Ladybird deed, allows you to transfer ownership of real estate upon the death of the owners and protect this asset from Medicaid recovery efforts.
Your home, your car, personal belongings, or your savings for funeral expenses remain outside of countable assets. A house must be a principal residence and does not count as long as the nursing home resident or their spouse lives there or intends to return there. These facilities are professionally staffed businesses that provide different levels of care, depending on what you need. 2) Medicaid Planning – the majority of persons considering Medicaid are “over-income” or “over-asset” or both, but still cannot afford their cost of care. By working with a Medicaid planning professional, families can employ a variety of strategies to help them become Medicaid eligible.
How Do I Spend Down Assets For Medicaid
Home and Community Based Service Waivers will pay for goods and services that help Texas Medicaid recipients who require a Nursing Facility Level of Care remain living “in the community” instead of moving to a nursing home. Living “in the community” can mean living in their home, the home of a loved one, an adult foster care home or an assisted living residence. The goods and services provided by HCBS Waivers can be medical or non-medical .
At the time of writing , the nationwide average daily cost for a shared room is $260. A shared room is important because typically Medicaid will only pay for shared rooms, not private rooms. Besides income, your assets will be counted toward meeting eligibility requirements. Countable assets include checking and savings account balances, CDs, stocks, and bonds.
Texas Medicaid applicants are not allowed to give away their assets in order to get under the asset limit. To make sure they don’t, Texas Medicaid has a “look-back” period of five years. This means the state will look back into the previous five years of the applicant’s financial records to make sure they have not given away assets. This is especially problematic in situations where there is a healthy spouse whose husband or wife needs long-term care.
Most Medicaid plans in the state of Texas are provided by Managed Care Organizations . Texas managed Medicaid for the elderly and disabled is often called STAR+PLUS.
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