Texas Medicaid Nursing Home Coverage
Texas Medicaid (STAR+PLUS) pays for nursing home care for income-eligible Texas seniors. This guide covers eligibility rules, income and asset limits, the application process, required documents, and important rules families need to understand before applying.
Eligibility at a Glance
Income Limit
$2,742/mo
300% of SSI · Individual
Asset Limit
$2,000
Countable assets · Individual
Look-Back Period
5 Years
Asset transfer review
Spousal Assets Protected
$154,140
Community Spouse Resource Allowance
Spousal Income Protected
$3,853/mo
Min. Monthly Maintenance Allowance
Avg. Nursing Home Cost
$6,800/mo
Medicaid rate: ~$195/day
Texas Nursing Home Medicaid Income Limit
300% of SSI Federal Benefit Rate ($914/month in 2026). For individuals in a nursing home, the income standard is 300% of the SSI FBR. Income above this amount may be contributed to cost of care — nursing homes may accept residents above this limit with a medical needs assessment and HHSC approval.
Texas Nursing Home Medicaid Asset Limit
Countable assets limit is $2,000 for an individual. Exempt assets include: primary residence (if spouse or dependent lives there), one vehicle, burial funds up to $1,500, and personal property. Texas does not count the home if the applicant states intent to return or a spouse/dependent lives there.
Texas 5-Year Look-Back Rule
Texas Medicaid reviews all asset transfers made within 5 years (60 months) of the application date. Transfers for less than fair market value during this period may result in a penalty period during which Medicaid will not pay for nursing home care. Consult a Texas elder law attorney before transferring any assets.
Important Texas Nursing Home Medicaid Rules
Medicaid Estate Recovery
Texas participates in the Medicaid Estate Recovery Program (MERP). After the death of a Medicaid nursing home recipient, Texas HHSC may file a claim against the estate for the cost of care paid by Medicaid. MERP applies to assets in the probate estate. A surviving spouse, minor child, or disabled child living in the home can delay recovery. Families should consult an elder law attorney about MERP implications before applying.
Personal Needs Allowance
Texas Medicaid allows nursing home residents to keep $60/month of their income as a Personal Needs Allowance (PNA) for personal expenses such as clothing, haircuts, and toiletries. All other income above this amount must be paid to the nursing home toward the cost of care (Patient Pay Amount or PPA).
Spousal Impoverishment Protection
If one spouse enters a nursing home while the other remains in the community, the Community Spouse Resource Allowance (CSRA) protects up to $154,140 in assets (2026) for the community spouse. The community spouse can also retain income up to the Minimum Monthly Maintenance Needs Allowance (MMMNA) of $3,853/month (2026). A Texas elder law attorney can help optimize income and assets before applying.
5-Year Asset Transfer Look-Back
Texas Medicaid enforces a 60-month (5-year) look-back period for asset transfers. If assets were transferred for less than fair market value within 5 years of applying for Medicaid nursing home coverage, HHSC may impose a penalty period during which Medicaid will not pay for nursing home care. Exceptions exist for transfers to a spouse, blind/disabled child, or caregiver child.
How to Apply for Texas Nursing Home Medicaid
Texas Health and Human Services Commission (HHSC)
Phone: 211 · Website: hhs.texas.gov
- 1Complete a Medicaid nursing facility application through Texas HHSC — apply online at YourTexasBenefits.com or call 211
- 2A Minimum Data Set (MDS) assessment must be completed by the nursing home's care team to establish medical necessity
- 3Provide documentation of income (all sources), assets (bank statements, property records), and identification
- 4Texas HHSC reviews the application and issues a determination; processing typically takes 45–90 days
- 5While the application is pending, many nursing homes accept residents as 'Medicaid pending' — confirm this policy with each facility
- 6If approved, Medicaid coverage typically backdates to the application date or nursing home admission date
Documents Required for Texas Nursing Home Medicaid
Gather these documents before starting your application. Missing documents are the #1 cause of application delays.
- Social Security card and proof of number
- Birth certificate or proof of age
- Medicare card (if applicable)
- Proof of all income: Social Security award letter, pension statements, investment income
- Bank statements — 5 years (60 months) of all accounts
- Life insurance policy statements
- Property records for any real estate other than primary residence
- Marriage certificate (if married)
- Prenuptial agreement or trusts (if applicable)
- Disability documentation (if under 65 and applying based on disability)
* Gather 5 full years (60 months) of bank statements for ALL accounts. This is the single most common documentation gap in Medicaid nursing home applications.
Texas Nursing Home Medicaid by the Numbers
1,224
Licensed Nursing Homes
88,000
Medicaid Beds
67%
Medicaid Bed %
$6,800
Avg Monthly Cost
Sources: CMS, Texas Health and Human Services Commission (HHSC), 2026 data.
Is There a Waitlist for Texas Nursing Home Medicaid?
Texas does not have a statewide waitlist for nursing home Medicaid — nursing homes accept Medicaid residents on a space-available basis. However, many popular facilities have limited Medicaid bed availability and operate waitlists informally.
Find Medicaid-Accepting Nursing Homes in Texas
Our care advisors can identify nursing homes in Texas with open Medicaid beds and help you start the application process — no phone call required.
Texas Nursing Home Medicaid FAQs
Does Texas Medicaid pay for nursing home care?▾
Yes — Texas Medicaid (STAR+PLUS) covers skilled nursing facility care for income and asset-eligible seniors. The income limit is $2,742/month (300% of SSI) and the asset limit is $2,000 for individuals. Unlike assisted living, Medicaid does cover nursing home room, board, and all medically necessary services in Texas.
How do I apply for Medicaid nursing home coverage in Texas?▾
Apply online at YourTexasBenefits.com, call 211, or visit your local HHSC benefits office. You will need to provide 5 years of bank statements, proof of all income, asset documentation, and identification. The nursing home must complete a medical necessity assessment (MDS). Processing typically takes 45–90 days.
Can a nursing home in Texas accept a resident while Medicaid is pending?▾
Many Texas nursing homes accept residents as 'Medicaid pending' while the application is reviewed — meaning the resident moves in and the application is processed simultaneously. Confirm this policy before admission; not all facilities do this, and those that do may have limited Medicaid-pending bed availability.
What is the average cost of nursing home care in Texas?▾
The average cost of nursing home care in Texas is approximately $6,800/month ($224/day) for a semi-private room in 2026. Texas is slightly below the national average of $7,400/month. Medicaid pays facilities a daily rate of approximately $195/day in Texas. Private pay daily rates range from $180 to $350+ per day depending on location and facility quality.
What happens to a nursing home resident's home in Texas under Medicaid?▾
A nursing home resident's primary home is exempt from Medicaid asset counting while the resident is alive and states intent to return or a spouse/dependent lives there. After the resident's death, Texas MERP (Medicaid Estate Recovery Program) may file a claim against the estate for care costs paid by Medicaid. A surviving spouse's presence in the home typically delays — but does not eliminate — MERP recovery.
Can I transfer assets to my children to qualify for Texas Medicaid?▾
Transferring assets to children (or others) for less than fair market value within 5 years of applying for Medicaid nursing home coverage will trigger a penalty period under Texas's look-back rules. The penalty period is calculated by dividing the transferred amount by Texas's average daily private-pay nursing home rate. Consult a Texas elder law attorney before making any transfers.
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