Texas Medicaid for Senior Care
Complete guide to Medicaid eligibility, coverage, and application process for nursing homes, assisted living, and home care in Texas.
7.6 million Medicaid long-term care recipients nationwide
Texas Health and Human Services Commission (HHSC)
Processing Time
45-90 days standard, 30 days for nursing facility emergency applications
Texas Medicaid Eligibility Requirements (2026)
To qualify for Medicaid long-term care in Texas, applicants must meet both financial eligibility criteria (income and assets) and medical criteria (level of care needs). Texas follows federal Medicaid guidelines with some state-specific variations.
Income Limits
Individual Applicant
$2,982/month (nursing home)
Married Couple (One Applying)
$2,982/month per applicant
Income includes Social Security, pensions, annuities, interest, dividends, and rental income.
Asset Limits
Individual Applicant
$2,000
Community Spouse (At-Home Spouse)
$148,620 (community spouse)
Primary residence, one vehicle, personal belongings, and prepaid burial arrangements are exempt from asset limits.
5-Year Look-Back Period
Texas Medicaid reviews all financial transactions for the 60 months prior to application. Asset transfers or gifts during this period can result in a penalty period of Medicaid ineligibility. The penalty is calculated by dividing the transferred amount by $7,200/month average (the average monthly nursing home cost in Texas).
Medical Eligibility
Applicants must demonstrate need for nursing facility level of care through a state assessment. This typically requires assistance with 2-3 Activities of Daily Living (bathing, dressing, toileting, transferring, eating) or cognitive impairment requiring supervision.
Assessments are performed by state-designated evaluators (nurses or social workers) and typically take 45-90 minutes. The assessment can occur at home, in a hospital, or at the care facility.
What Medicaid Covers in Texas
Nursing Home Care
Medicaid pays 100% of nursing home costs in Texas once eligibility is established. The average monthly cost is $7,200/month average. Recipients contribute most of their monthly income toward care costs, keeping only $50-75 for personal needs.
Coverage includes room, board, 24-hour nursing care, meals, medications, therapy services, and all medical care provided at the facility.
Home and Community-Based Services (HCBS) Waivers
Texas offers 3 HCBS waiver programs that provide in-home care and community services as an alternative to nursing facility placement.
Community Based Alternatives (CBA)
Serves individuals age 21+ who are nursing facility eligible, providing in-home services including personal assistance, respite care, and minor home modifications.
Program Details →STAR+PLUS Waiver
Provides HCBS services through managed care organizations for individuals eligible for both Medicare and Medicaid.
Program Details →Home and Community-based Services (HCS) Waiver
Serves individuals with intellectual or developmental disabilities who need ICF/IID level of care.
Program Details →How to Apply for Medicaid in Texas
Texas Medicaid applications typically take 45-90 days standard, 30 days for nursing facility emergency applications. Starting the process early and submitting complete documentation helps avoid delays.
Application Methods
You can apply for Medicaid in Texas through:
- Online at YourTexasBenefits.com
- Mail to local HHSC office
- In-person at HHSC benefits office
- Fax application
Step 1: Gather Required Documents
Before starting your application, collect:
- •Birth certificate and Social Security card
- •Proof of citizenship (passport, naturalization)
- •5 years of bank statements
- •Investment and retirement account statements
- •Property deeds and mortgage statements
- •Life insurance policies
- •Social Security award letter
- •Pension benefit statements
- •Medicare card
- •Doctor's statement of care needs
Step 2: Submit Your Application
Complete and submit your application through one of the methods listed above. If applying online or by mail, keep copies of all submitted documents.
Step 3: Medical Assessment
A state assessor will evaluate level of care needs. This assessment typically takes 45-90 minutes and covers functional abilities, medical needs, cognitive status, and safety concerns.
Step 4: Financial Review
Medicaid staff review all financial documents and investigate any transfers or gifts made in the past 60 months. They may request additional documentation during this process.
Step 5: Receive Determination
You'll receive written notification of approval or denial. Approved applications include the effective date of coverage (often retroactive up to 3 months), patient responsibility amount, and covered services.
Get Free Application Help
Free Medicaid application assistance is available in Texas from:
- •Area Agency on Aging: Call 1-800-677-1116 (Eldercare Locator) to find your local office
- •SHIP counselors: Free Medicare/Medicaid counseling
- •Nursing facility social workers: In-facility application support
- •Elder law attorneys: Paid help for complex financial situations ($2,000-$5,000)
Texas-Specific Programs and Resources
Texas Long-Term Care Partnership Program
Long-term care insurance policies that protect assets from Medicaid spend-down requirements.
Learn MoreNeed Help with Texas Medicaid?
Contact Texas Health and Human Services Commission (HHSC) for specific questions about eligibility, application status, or covered services.
Main Office Phone
1-800-252-8263Application Helpline
1-800-252-8263