How Do I Qualify for Medicaid in Texas?

Applying for Medicaid to help cover the cost of nursing home care in Texas can feel overwhelming—but it doesn’t have to be. To qualify for Nursing Home Medicaid in Texas you must pass a three-part test: medical necessity, income, and countable resources. Here’s what you need to know about each part of the eligibility process, and how the right legal planning can make all the difference.

1. Medical Necessity

The first requirement is medical necessity. This type of Medicaid is only available to individuals who need full-time care in a nursing facility. To meet this requirement, a licensed medical professional must certify that the applicant: requires skilled nursing care on a daily basis, has a medical condition that is expected to last at least 30 days, and needs a level of care that can only be provided in a nursing facility. This is determined through a formal assessment called the Medical Necessity Determination (MND).

2. Income Test

Texas is an income-cap state, which means there’s a strict limit on how much income an applicant can receive each month. As of 2025, the income limit is $2,901 per month (gross) for an individual applicant. If your income exceeds this limit—even by one penny—you won’t qualify unless you use a legal tool called a Miller Trust (also known as a Qualified Income Trust).

3. Countable Resources Test

The third part of the test looks at your assets—also called resources. To qualify for Medicaid, an individual applicant may have no more than $2,000 in countable resources. The key is that not all assets are countable. Some common exempt (non-countable) assets include:

·         Your homestead

·         One vehicle

·         Personal belongings and household goods

·         A burial plot and limited prepaid funeral arrangements

·         Sometimes your retirement account

Everything else such as money in bank accounts, investments, and additional real estate may be counted against the limit unless legally protected through strategic planning. If you are married, your spouse (the “community spouse”) can keep a much higher amount—up to $157,920 in 2025—plus exempt assets. There are legal ways to protect even more, depending on your circumstances.

What If You Don’t Meet One of the Tests?

That’s where we come in. Medicaid has rules. We have strategies. Medicaid eligibility isn’t all or nothing—you can plan and become eligible, even if you don’t qualify today. A Certified Elder Law Attorney can help you create and operate a Qualified Income Trust, structure your estate to protect assets and maximize your public benefits, and a design an estate plan that works in concert with those goals.