Medicaid Eligibility Guidelines for Nursing Homes in Texas

Medicaid laws require specific criteria for admission to a Texas nursing home.

Medicaid is a government health program for those who are ill or disabled and need financial assistance. In order to receive nursing home Medicaid in the state of Texas, the individual applying for assistance must meet requirements of age, disability, medical assistance and income.

Eligibility

Medicaid caps individual income at $1,809 for Texas nursing home residents.

Because Medicaid is a government assistance program for elderly or disabled people who cannot afford to pay for full-time nursing home care, a monthly income limit is imposed. In the state of Texas, individuals who are in a nursing home can earn no more than $1,809 a month. For spouses in a nursing home, their combined earnings per month cannot exceed $3,618. The government determines earnings by looking at earned wages, rental payments, pensions, Social Security income and veterans benefits.

Application Process

These are several ways to apply for Medicaid.

There are several ways to apply for Medicaid for use in a Texas nursing home:

1. If the person is hospitalized, a social worker at the hospital can help the patient apply.

2. If the individual knows which nursing home facility he will be living in, the administrator of that nursing home may provide the contact information of the caseworker for that nursing home.

3. The individual may contact the local Texas Health and Human Services Commission and ask for local nursing home contact information.

Denied Application

Medicaid may deny a claim for nursing home assistance.

If the individual's nursing home Medicaid is denied, the applicant can contact an attorney, request a hearing to contest the decision or appeal a previous hearing decision confirming the application denial.

References

• Texas Legal Services Center: Nursing Home Medicaid: Income/Resource Limits

Resources

• Texas Health and Human Services Commission