Medicaid Planning: Medicaid Eligibility

The laws regarding Medicaid eligibility are just as complex as any tax law and understanding the process of qualifying for Medicaid in Texas can be confusing for most people.

Medicaid laws, along with private health insurance laws, are constantly changing, so it is important to have experienced Medicaid legal advice for current Medicaid eligibility questions, issues or concerns.

Advice you may have been given in a previous year or even month, can sometimes be invalid for your future needs. It is wise to consult with an elder care attorney that will provide you with ongoing long term elder law advisory services, so you have the confidence and security knowing that your long term health care plans and estate plans are revised as laws change.

Medicaid uses the following four factors to determine you or your loved one's eligibility:

  1. Class Requirements:
    A person must be at least 65 years of age, blind or disabled, and be
    1. A U.S. citizen or resident alien and
    2. A resident of the State in which the Medicaid application is made.
  2. Medical Necessity:
    An applicant must meet the medical eligibility requirement for Medicaid. An applicant must be evaluated and certified to meet the medical requirements.
  3. Income Eligibility:
    The applicant may not receive direct income of more than $2022.00. (Effective, as of January 1, 2010). If the amount exceeds the cap, a Miller Trust can usually solve the problem. In some situations income can be allocated to a spouse who is still living at home.
  4. Asset Eligibility:
    The baseline amount for eligibility is $2,000.00 subject to many exceptions. Much can be done if the amounts of assets greatly exceed the $2,000.00 baseline. There are many techniques available for legally preserving assets that will usually enable transfer or use of assets without losing it all. The base amount for both spouses entering a nursing home and applying for Medicaid is $3,000.00, also subject to many exceptions.