What Are The Income Limits For Medicaid In Texas

Table of Content

• Talk to an Estate Planning attorney.
• Moving Into A Senior Living Community
• How Do I Spend Down Assets For Medicaid
• What Are The Income Limits For Medicaid In Texas
• Federal Requirements Specify That Each Nf Must Provide At Least:
• Determining Eligibility For Medicaid Long Term Care
• When A Nursing Home Is Medically Necessary

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.

If you are looking for long term care Medicaid, then you better know the current numbers. In most states, you can retain up to $2,000 as an individual and $3,000 for a married couple outside of your countable assets. There are specific rules for protecting Texas homesteads which are too complex to go into detail here. However, a Medicaid applicant’s residential homestead in Texas may be protected while they are alive if certain conditions are met, but what about the Medicaid Estate Recovery Program after the Medicaid applicant passes away? We can help you protect your home, both while you are alive as well as preserve its value for your heirs.

Talk to an Estate Planning attorney.

However, to be eligible for Medicaid nursing home care, the patient must have very limited income and very few financial assets . If your doctor prescribes home health services like nursing or therapy services in your plan of care for a particular medical condition, Medicaid will cover those. You do not need to meet the nursing home level of care to qualify for home health services. However, because these Medicaid-funded home health services are related to a doctor’s plan of care for a particular medical condition, they are generally offered on a short-term basis.

The individual must have limited financial resources and a documented need for care. Texas offers its residents several Medicaid programs, some of which are entitlements and others have limited enrollment. Nursing home care is an entitlement for all Texas residents that require it and meet the program’s financial criteria .

Moving Into A Senior Living Community

This allows a healthy spouse at home to increase their monthly income in some cases. We can do this by diverting an extra $70.00 per month from the nursing home spouse’s income to themselves. That is $840 per year, and in situations like these every little bit helps. The 2022 asset limit for long term care Medicaid in Texas is still $2,000.

However, if the policy’s face value is more than $1,500, the cash surrender value becomes a countable asset. Permanent or whole life insurance accumulates a cash value that the owner can access, so it can be counted as an asset. A wait-list for STAR+PLUS may exist or specifically for services provided at-home. Waiting times can be as long as a year and current nursing home Medicaid participants are prioritized over at-home applicants. If your loved one is in a Medicaid-funded nursing home on Medicaid and wants to return home or move to assisted living, you should contact a STAR+PLUS caseworker to discuss the options.

How Do I Spend Down Assets For Medicaid

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.

When persons receive Medicaid long-term care at home or “in the community” through a Medicaid Waiver, they still have expenses that must be paid. Rent, food, and utilities, as an example, are expenses that end when one is in a nursing home, but continue when one receives Medicaid at home. Therefore, Medicaid beneficiaries that receive assistance through a Medicaid HCBS waiver are permitted to keep their monthly income to pay those expenses. One’s home is often their most valuable asset, and if counted towards Texas Medicaid’s asset limit, it would likely cause them to be over the limit for eligibility.

2) Asset Spend Down – Persons who have assets over the Medicaid limit can still become asset eligible by “spending down” excess assets on ones that are non-countable. Examples include making home modifications, like the addition of wheelchair ramps or stair lifts, prepaying funeral and burial expenses, and paying off debt. Remember that assets cannot be gifted or sold under fair market value, as it violates Medicaid’s look back rule. When “spending down”, it is best to keep documentation of how assets were spent as evidence the look back period was not violated. Texas has a 5-year Medicaid Look-Back Period that immediately precedes one’s Medicaid application date.

4) Day Activity and Health Services – This is an adult day care program that helps families care for their loved ones outside of nursing homes. Daytime supervision and health services are provided at community facilities during normal working hours. The government increased it from the previous limit of $3,090.00 to $3,160.00 beginning January 1, 2019.

Prior to submitting an application for Medicaid benefits in Texas, it is imperative that seniors are certain that all eligibility requirements for the program in which they are applying are met. For married applicants with both spouses applying, the 2022 asset limit for Nursing Home Medicaid through Texas Medicaid is $3,000 combined between the two applicants/spouses and the income limit is $5,046 / month combined. For a married applicant with just one spouse applying, the 2022 asset limit is $2,000 for the applicant spouse and $137,400 for the non-applicant spouse, and the income limit is $2,523 / month for the applicant.

Beginning January 1, 2019, a nursing home resident will be allowed to have $2,313 per month in grossmonthly “income”. Medicaid coverage amounts may vary from state to state, depending on the demand for nursing home care coverage. For example, the average cost of nursing home care in the state of California is on the higher end at $304 a day, compared to Texas at $165. This greatly impacts the coverage and benefits you can receive from Medicaid to offset the costs of nursing home care. For qualifying individuals, Medicaid picks up most of the tab for nursing home care, paying an average of 45 percent to 65 percent.