Medicaid is a joint federal-state safety net program that provides healthcare coverage to over 64 million Americans. For those who qualify, Medicaid offers benefits not typically covered (or minimally covered) by other insurers, most notably long-term care.

Since each state establishes their own eligibility standards and benefit packages under broad federal guidelines, we’ll discuss how Medicaid works in Texas for seniors.

Texas Medicaid Programs

Medicaid for the Elderly and People with Disabilities (MEPD)

This Medicaid program is designed for US citizens (or qualifying US legal residents) aged 65 or older who require 30 or more days of non-stop, long-term care. According to Texas Health & Human Services, MEPD covers health care services such as:

• Regular checkups at the doctor
• Medicine and vaccines
• Hospital care and services
• X-rays and lab tests
• Vision and hearing care
• Access to medical specialists and mental health care
• Treatment of special health needs and pre-existing conditions

MEPD also covers long-term services and supports, including:

• Home care and personal care, like having someone help monitor your health and help you with daily activities
• Having somebody take your child to their medical appointments
• Nursing home care
• A hospital for mental illnesses
• A place of care for people with intellectual disabilities

STAR+PLUS

STAR+PLUS is a Medicaid waiver that allows Texans 65 or older to receive care at home, in adult foster care, or in assisted living. STAR+PLUS delivers services through managed care organizations (MCO). There are designated MCOs in each county and participants can select their preferred provider. In addition to service coordination, the program helps pay for a broad range of medical and care services, including:

• Adaptive Aids
• Adult Day Care / Adult Day Health
• Adult Foster Care
• Assisted Living
• Delivered Meals
• Home Modifications
• Home Care
• Medical Care / Medical Supplies
• Nursing Services
• Personal Care
• Physical/Occupational/Speech Therapy
• Personal Emergency Response Service
• Respite Care
• Transitional Services

Qualifying for Medicaid in Texas

The following table covers eligibility requirements for Skilled Nursing Medicaid care in Texas. If your loved one has income and assets over these limits they may still become eligible for Medicaid in Texas. Medicaid Filing Connection can help your family convert financial assets in excess of the limit into exempt assets.

  • Individual Income Limit$2,349/mo
  • Combined Spousal Income Limit$4,698/mo
  • Individual Asset Limit$2,000
  • Spousal Asset Limit*$3,000
  • Community Spouse Asset (Resource) Allowance (CSRA)$25,728 - $128,640
  • Spouse Maintenance Allowance (MMMNA)$3,216/mo
  • Home Equity Limit$595,000
  • Daily Penalty Divisor$213.71

*Both husband and wife in a nursing home
Please contact us for a complimentary, complete Medicaid Eligibility & Asset Protection Guide

Take our quiz to find out if your loved one is eligible to receive Medicaid financial assistance