Long Term Living Costs

MEDICAID INFORMATION

Eligibility for the Nursing Home Program

Maximum Gross Income:

  • Individual: $2,313 per month

  • Couple: $4,626 per month


What Counts as Income:

  • Social Security Benefits

  • Veteran Benefits

  • Private Pension Benefits

  • Interest or Dividends

  • Royalty and Rental Payments

  • Earnings and Wages

  • Civil Service Annuities

  • Railroad Benefits

  • State or Local Retirement Benefits

  • Gifts or Contributions

Resources

Maximum countable resources on the last day of the month:

  • Individual: $2,000

  • Couple: $3,000


What counts as a resource:

  • Bank Account and CDs

  • Real Property

  • Life Insurance Policies

  • Burial Plots and Funds

  • Stocks and Bonds

  • Oil/Gas/Mineral Rights

  • Jewelry and Antiques

  • Cars and Other Vehicles


What can be excluded:

  • Homestead where the individual intends to return (up to $585,000)

  • Life insurance if the face value is $1,500 or less

  • Burial funds of $1,500 (less an excluded life insurance)

  • One vehicle regardless of value

  • Burial spaces for the individual, spouse, and close relatives


Protected resources amount for a spouse in the community:

  • $25,284 minimum and $126,420 maximum (excludes value of homestead, household goods, personal goods, one car, and burial funds of $1,500 or less per person)

Other

Medical Need: Resident must meet medical necessity criteria or ICF-MR level of care criteria

Residency: Must be a resident of Texas and US citizen or alien with approved status (e.g., legalized or permanent resident alien)

Living Arrangement: Must be a patient in a Medicaid contracted long-term care facility for 30 consecutive days

Applied Income

Your patient liability to the nursing home each month:

Individual: Total gross income less $60 for personal needs

Individual with a Spouse in the Community: Total gross income less $60 for personal needs, less up to $3,160.50 for a community spouse

Additional Information

Please visit the Texas Medicaid website to learn more.

 

You can call the Texas Medicaid hotline toll-free at:

1-800-252-8263

 

TDD users can call:
512-424-6597

 

E-mail inquiries should be sent to:
medicaid@hhsc.state.tx.us

More information is available with the Aging and Disability Resource Center (ADRC) of Deep East/Southeast Texas