28 Feb
When a spouse requires long-term care, it’s only natural to be worried about the spouse that’s left behind. Long-term care can be expensive, and Medicaid in Texas has strict eligibility criteria for income and assets.
It’s easy to assume that the spouse left in their own home will be required to cover the costs of care from their income or assets. However, that’s not always the case. In this guide, you can learn more about how to protect spouses’ assets from Medicaid, how to qualify for Medicaid in Texas, how Spousal Impoverishment works, and more.
Who Pays for Long-Term Care in Texas?
Before answering questions such as ‘How do I qualify for Medicaid in Texas?’, it’s helpful to understand what a typical situation looks like when one spouse needs long-term care.
Private pay, also known as out-of-pocket, is a common way to pay for long-term care. Many people cover the costs of their care through their savings, retirement fund, or income from selling a house.
However, low-income individuals with less than $2,000 in countable resources often receive Medicaid coverage. Medicaid covers nursing home care or in-home, community-based services, if required.
If someone has a private long-term care insurance policy, it may cover the costs of non-medical, custodial care. If you’re a qualifying veteran or a spouse of one, VA aid may be available. To learn more about your options, discuss your unique situation with a trusted Medicaid lawyer.
How Do I Qualify for Medicaid in Texas?
If you or a spouse needs to enter a nursing home and you don’t believe you have the private funds to pay for it, you may be eligible for Medicaid. There are a number of eligibility requirements to meet in Texas, including:
- Monthly income limit of $2,982 (as of 2026)
- Medical necessity for nursing home level of care
- Texas resident
- U.S. citizen/eligible immigrant
- Aged 65+ or disabled
- Proof of income
- Social Security number
- Proof of citizenship
- Details on assets
What Are Spousal Protections?
In many situations, two spouses jointly own a home and share income. This can sometimes mean you’re not eligible for Medicaid because your monthly income and assets exceed the threshold. However, parting with this income or assets would leave the remaining spouse with too few resources and income.
That’s where spousal protections come into play. Under federal law and Texas Medicaid rules, spousal impoverishment rules help ensure that when one spouse enters long-term care, the other isn’t left with too little to get by on.
Under these impoverishment rules, the spouse who lives at home, called the community spouse, is allowed to keep more of their assets and income than they would normally be able to under Medicaid eligibility. The institutionalized spouse would also not need to contribute all of the couple’s income to the care home, leaving the community spouse without the essentials.
How to Protect Spouses’ Assets from Medicaid in Texas?
In Texas, specifically, community spouses may be afforded specific spousal protections. You may like to ask an experienced Medicaid planning lawyer for advice on the following:
Community Spouse Resource Allowance (CSRA)
Under the Community Spouse Resource Allowance (CSRA), half of a couple’s countable resources may be protected for the community spouse, with minimum and maximum limits.
In 2026, the minimum amount is $32,532, while the maximum is $162,660. This means a community spouse may keep no less than $32,532 and no more than $162,660 in countable resources.
Countable resources are resources that Medicaid counts toward eligibility, such as cash and bank accounts, investments, real estate excluding the primary residence, retirement accounts, life insurance, and trusts. Excluded are the primary residence, personal property, one vehicle, and burial funds.
When a spouse enters a Medicaid-covered nursing home, Texas evaluates the countable resources to ensure eligibility.
Minimum Monthly Maintenance Needs Allowance (MMMNA)
Having enough income to live on is a primary concern for older adults who have just watched their spouse go into long-term care. For peace of mind, speak to your lawyer about the Minimum Monthly Maintenance Needs Allowance (MMMNA)
MMMNA is designed to protect the community spouse’s income, such as a pension or Social Security, if it’s below a certain threshold. The institutionalized spouse’s income can be transferred to the community spouse until the threshold is reached. This ensures that they have enough monthly income to live on.
How Do Spousal Protections Work?
Spousal protections aren’t an instant process. Instead, eligibility has to be determined. In practice, this occurs through two processes: asset assessment and income allocation.
Asset Assessment
During an asset assessment, the Texas Health and Human Services takes a snapshot of all countable assets at the start of the 30-day continuous care period for a spouse in care. Once the total is obtained, the HHSC uses it to calculate the amount of protected resources for the community spouse.
Income Allocation
When Medicaid eligibility is determined, there’s a post-eligibility income determination. This is about calculating the income the institutionalized spouse must contribute toward their own care. A personal needs allowance and the MMMNA for the community spouse are deducted before contributions are needed.
Learn More About Spousal Protections from Livens & Reed Medicaid Planning Lawyers
Whether you aren’t sure if you qualify for Medicaid in Texas or you need help learning how to protect your assets, contact the knowledgeable legal team at Livens & Reed in Dallas-Fort Worth, Texas. We are proud to be trusted Medicaid and estate-planning attorneys, helping you achieve peace of mind when you need it most. Schedule a no-obligation consultation today.
