Qualifying for Nursing Home Care

For the “Aged, Blind or Disabled” an applicant must:

  • Be a US citizen or lawfully admitted alien and be a resident of Texas.
  • Meet a health assessment that establishes need for daily attention of professional nursing staff.
  • Must have a Medicare Part A entitlement.
  • Be free of any penalties imposed by Medicaid for gifts made within 60 months prior to filing.
  • Meet Income and Resource guidelines.
  • An application cannot be submitted until the applicant has been in a nursing home Medicaid qualified bed for 30 days.

An applicant must:

  • Be a US citizen or lawfully admitted alien and be a resident of Texas.
  • Meet a health assessment that establishes need for daily attention of professional nursing staff.
  • Be entitled to Medicare Part A.
  • Be free of any penalties imposed by Medicaid for gifts/transfers made within 60 months prior to filing.
  • Meet Income and Resource criteria.
  • An application cannot be submitted until the applicant has been in a nursing home with Medicaid qualified beds for 30 days.

Income

  • Single Applicants: Gross income cannot exceed $2,313.00 per month. If income exceeds the limit, seek legal counsel about a Qualifying Income Trust (Miller).
  • Applicants with a Spouse at home: There is no income limit for the spouse at home. To satisfy Anti-spousal impoverishment laws, Medicaid has set a minimum income standard of $3,160.50 for the at-home spouse and income from the applicant will be diverted to the at-home spouse up to $3,160.50.

Resources
Applicants with no spouse can own:

  • Home (up to $585,000.00 in equity)
  • Irrevocable Burial provisions
  • Auto (currently no value restriction)
  • Personal property (with limits)
  • $2,000.00 in cash, savings, countable resources.

Applicants with an at-home spouse can also own additional resources to avoid impoverishment up to $126,420.00. If the at-home Spouse’s monthly income is under $3,160.50 after diversion of income, the applicant may be able to establish an expansion of the $126,420.00 cap so the at-home spouse can generate more investment income.