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Texas Medicaid Eligibility Requirements

Medicaid's Eligibility Rules - STAR+PLUS

Texas Medicaid Eligibility Requirements

The eligibility rules for Medicaid's old-age and nursing home coverage can affect the validity of some asset transfers, impoverishing you or your loved ones. Even though elderly clients and those with disabilities are only 23 percent of  Texas Medicaid population, they account for almost 60 percent of the expenditures. Not everyone meets the Texas Medicaid Eligibility Requirements.texas medicaid nursing home eligibility

Texas Medicaid Planning Consultants

As the baby boom generation ages, the number of people needing long term services and support will increase. While Texas general population will increase about 50 percent by the year 2020, the elderly population will almost double from 1.9 million to 3.8 million. Paying for long term care is always an issue.

What is Medicaid?

Medicaid is a jointly funded, Federal-State health care program for persons who are financially eligible. Medicaid provides care for acute medical needs, rehabilitation, and long-term care at home and in nursing homes. There are also numerous community-based programs, including adult day care, and assistance with local transportation.

In Texas, it's referred to as STAR+PLUS - STAR+PLUS is a Texas Medicaid managed care program for people who have disabilities or are age 65 or older. 

Does Medicaid Pay for Long-term Care?

Yes, Medicaid pays for long-term care in a nursing home. In a few states it also pays for long-term senior care in the home. Medicare, on the other hand, does not pay for long-term care.

If I Give Away My House and All My Money Will I Qualify?

Not anymore. There is a 5-year look-back law now. Uncle Sam can find your money and make you pay. You should consult an Elder-law attorney to understand the acceptable ways to "spend-down" assets to qualify for Medicaid as a low-income senior.

Also See: Medicaid: Transferring of Assets & Look-Back Period

You can gift some assets, within limits, to a beneficiary, but you should remember that these assets will no longer be in your control. Also, remember that the leading type of elder abuse is financial, many times by a family member. Spousal poverty protection laws have been passed to allow the spouse of a senior who needs long-term nursing home care to maintain usually up to 50% of the couple’s assets.

How do I apply?

Applications are available through your state Medicaid program.

How soon will coverage start?

Coverage can possibly begin from 3-months prior to the application’s approval. Applications sometimes take longer than expected. You should ask about the usual approval timeframe when you submit your initial application for Medicaid coverage.

What is the minimum asset requirement to qualify?

Asset requirements are usually limited at $2,000.00.

Does Medicaid long-term care have a limit?

No, Medicaid will pay for long-term care in a nursing home for as long as a senior qualifies for needing the care, even if this means multiple years of care until death.

Source: Medicaid Services
Texas Health and Human Services Commission
Texas Medicaid Services
(800) 252-8263

 

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