My Parents Need Medicaid. How Can I Apply for Medicaid in Texas on Their Behalf?

When your parents reach the point where they need long-term care, the financial reality can be overwhelming. In Texas, nursing home costs typically range from $5,600 to over $7,200 per month, depending on whether it is a semi-private or private room, with urban areas like Houston often on the higher end. Assisted living facilities average between $4,000 and $5,000 monthly.

For many Houston families, Medicaid is the only way to cover these expenses without draining life savings. But applying for Medicaid on behalf of your parents is not simple. Texas Medicaid has strict eligibility requirements, complex rules on income and assets, and a five-year look-back period that penalizes certain transfers.

If you are caring for aging parents and facing the possibility of financial devastation, it helps to understand what Texas law allows and what steps you can take now. In this blog, we will look at how to apply for Medicaid in Texas, what eligibility requires, and the planning options that can protect your parents’ well-being and preserve their assets.

The Medicaid Nursing Home Program in Texas

Texas Medicaid covers a range of long-term care services for low-income individuals who meet financial and medical criteria. These services are primarily delivered through two programs: Institutional Medicaid (for nursing homes) and Home and Community Based Services (HCBS) Waivers (for care outside of a facility). These services include:

• Nursing home care
• Assisted living facilities (typically covered under certain HCBS waiver programs)
• In-home medical assistance (through programs such as STAR+PLUS HCBS)
• Hospice care

Medicaid benefits are designed to provide medical assistance and daily support when aging individuals require long-term care. However, not every Medicaid applicant will qualify for nursing home or waiver benefits. The Texas Health and Human Services Commission (HHSC) applies complex rules to determine eligibility, making the application process difficult without legal strategies in place.

Determining Medicaid Eligibility

To qualify for Medicaid long-term care in Texas, your parents must meet strict income and asset limits.

• Income cap: As of 2025, an applicant’s monthly income cannot exceed $2,901 (300% of SSI for 2025) for nursing home coverage or HCBS waivers.
• Countable assets: An individual may have no more than $2,000 in countable assets. Countable assets include cash, bank accounts, investments, and some real property.

What assets are exempt (non-countable)? Not all assets count toward the $2,000 limit. Major exempt assets typically include:

• The applicant’s primary residence (up to a maximum equity limit of $730,000 in 2025, provided the applicant intends to return or a spouse lives there).
• One automobile, regardless of value.
• Household goods, personal effects, and furniture.
• Irrevocable burial trusts or specific burial funds.

Community Spouse Resource Allowance

If only one spouse requires nursing home care, the other spouse, called the “community spouse,” may keep a portion of the couple’s countable assets. In Texas, the CSRA is designed to prevent spousal impoverishment. This protection allows the healthy spouse to retain a portion of the couple’s assets ranging from a minimum of $31,584 up to a maximum of $157,920.

Income Caps and Qualified Income Trusts

What happens if your parent’s monthly income is above the Medicaid cap of $2,901? Texas, as an “income cap” state, requires the use of a Qualified Income Trust (QIT), also known as a Miller Trust. This legal document allows excess income to flow into the trust, where it can be applied toward the required patient co-payment for nursing home costs. Without this trust, even a few extra dollars of income can disqualify an applicant from Medicaid coverage.

The Look-Back Period and Asset Transfers

Texas applies a five-year look-back period when reviewing Medicaid applications. This means HHSC will examine all financial transactions made within the past 60 months. If they find transfers made for less than fair market value, the applicant may be penalized and temporarily denied benefits.

Examples of problematic transfers include:

• Gifting money to family members
• Transferring property to children without compensation
• Moving funds into an irrevocable trust during the look-back window

Because penalties can delay access to immediate care, asset transfers should only be considered with effective Medicaid planning strategies in place.

Preserving Medicaid Eligibility Through Planning

Applying for Medicaid during a crisis is possible, but it often leaves fewer options. Advanced planning allows families to protect assets, maintain eligibility, and avoid last-minute financial distress.

Some planning strategies may include:

• Using a Qualified Income Trust to address income caps.
• Converting countable assets into exempt assets, such as paying off debt, purchasing a new car, or making home improvements.
• Purchasing an Irrevocable Annuity to convert a countable lump sum of cash into a stream of income for the community spouse.
• Creating irrevocable trusts outside the five-year look-back period to preserve wealth for future generations.
• Purchasing long-term care insurance early can help offset costs before Medicaid eligibility is necessary.

Working with a Medicaid planning attorney can help families understand these legal strategies and make informed decisions before a crisis situation develops.

The Medicaid Application Process in Texas

Filing a Medicaid application for your parents involves several steps. Before you begin, make sure you have the legal authority to act on their behalf. In most cases, this requires a valid Durable Power of Attorney (POA) that grants authority over financial and public benefits matters. If your parent lacks capacity and no POA is in place, you may need to pursue guardianship or be designated as an authorized representative by the Texas Health and Human Services Commission (HHSC) before submitting the application.

1. Collect documentation such as birth certificates, Social Security numbers, marriage records, tax returns, and financial account statements.
2. Complete the official Medicaid application through HHSC, either online, by mail, or at a local office.
3. Submit medical information confirming that long-term care services are necessary (meeting the Nursing Facility Level of Care).
4. Provide proof of income and assets for both the applicant and, if married, the community spouse.
5. Respond to HHSC requests for additional information or clarification during the review process.

Because the application process is lengthy and mistakes can delay benefits, many families rely on elder law attorneys for Medicaid assistance.

Medicaid Appeals and Crisis Planning

If your parents are denied Medicaid, you have the right to appeal. The hearing process allows applicants to present additional evidence and challenge HHSC’s decision.

Crisis planning is often necessary when a parent suddenly requires nursing home care. In these situations, effective Medicaid planning can preserve a portion of assets, provide for the community spouse, and secure access to nursing home benefits more quickly.

Protecting Assets and Preserving Your Parents’ Well-Being

Long-term care often arrives sooner than families expect. Without advanced planning, the high cost of nursing home care can quickly consume hard-earned assets. Medicaid benefits offer critical support, but only if eligibility requirements are met and applications are handled correctly.

It is also important to understand that under the Medicaid Estate Recovery Program (MERP), the state may seek reimbursement for certain benefits paid after the recipient’s death, which makes early planning even more valuable.

By working with a Houston lawyer for Medicaid, you can protect your parents’ financial stability, preserve Medicaid eligibility, and take the right steps towards securing the long-term care they need.

Secure Your Parents’ Future with a Houston Medicaid Planning Lawyer

Applying for Medicaid in Texas is not just about filling out forms. It requires a deep understanding of complex rules, income caps, asset transfers, and the protections available to married couples. Because every family’s circumstances are different, the strategies that work best for your parents will depend on their unique financial and medical situation.

At Your Legacy Legal Care®, our elder law attorneys have extensive experience guiding Houston families through Medicaid planning and long-term care challenges. We provide comprehensive estate planning and effective Medicaid planning strategies to protect assets and preserve eligibility. Whether you are facing immediate care needs for your parents or want to plan ahead, our law office is here to support you.

Call [phone_number dsk_contact=’true’ strong=”false”/] or complete our confidential online form to schedule your Complimentary Strategy Session. While you wait, we invite you to check out our  podcast, “Life Happens!”, with estate planning and elder law attorney  Kim Hegwood.

We help Texas families create estate plans that protect their future, honor their wishes, and support their loved ones.

Copyright © 2025. Your Legacy Legal Care®. All rights reserved.

The information in this blog post (“post”) is provided for general informational purposes only and may not reflect the current law in your jurisdiction. No information in this post should be construed as legal advice from the individual author or the law firm, nor is it intended to be a substitute for legal counsel on any subject matter. No reader of this post should act or refrain from acting based on any information included in or accessible through this post without seeking the appropriate legal or other professional advice on the particular facts and circumstances at issue from a lawyer licensed in the recipient’s state, country, or other appropriate licensing jurisdiction.

Your Legacy Legal Care®
1150 Clear Lake City Blvd., Suite 100
Houston, Texas 77062
[phone_number dsk_contact=’true’ strong=”false”/]
https://www.yourlegacylegalcare.com/