Texas Medicaid Spend-Down and Long-Term Care: What to Know Before You Need Care

Learn how Texas Medicaid spend-down rules work so you can plan for long-term care before you need it. This page is general education, not legal or Medicaid-eligibility advice. Not affiliated with Medicaid or any government agency.

Why Planning Ahead Matters

Without planning, families can face difficult financial choices when long-term care is needed. Understanding Texas Medicaid rules early gives you more options, and time to work with an elder law attorney if needed.

Plan for Your Spouse

Learn the rules that help the spouse at home keep income and resources

Understand Spend-Down

Know what counts, what's exempt, and how the look-back works

Maintain Dignity

Explore ways to pay for quality care before savings run out

The Cost of Waiting

Average nursing home cost in Texas: about $5,500–$6,000 a month

Common Topics We Explain

Medicaid-Compliant Annuities (education)

Some married couples use a Medicaid-compliant annuity, under strict federal and Texas rules, to turn countable assets into an income stream for the spouse at home. Rules are complex; coordinate with an elder law attorney.

Spend-Down Basics

How countable resources are counted, which assets are generally exempt (such as a primary home within limits, one vehicle, and certain personal items), and permitted ways to spend down.

Spousal Rules

The Community Spouse Resource Allowance and income allowance that help the spouse at home.

Paying for Care Before Medicaid

How long-term care insurance and hybrid policies can pay for care with policy benefits, and how Texas Partnership-qualified policies may allow a dollar-for-dollar asset disregard.

Understanding Texas Medicaid Rules

Category	Individual	Married Couple	Notes
Asset Limits	$2,000 countable	Depends on whether one or both spouses need care; spouse at home may keep a Community Spouse Resource Allowance set yearly	Check Texas HHS for current figures
Income Limits	Set yearly by Texas HHS	Set yearly	Income over the limit may require a Qualified Income Trust
Look-Back Period	5 years	5 years	Transfers for less than fair value can cause a penalty period

Texas Long-Term Care Partnership policies only: If you own a Partnership-qualified long-term care insurance policy that pays benefits, and you later apply for Texas Medicaid long-term care, Texas can disregard countable assets equal to the benefits the policy paid, dollar for dollar, when deciding eligibility and at Medicaid estate recovery. This applies only to policies that meet Texas Partnership requirements. Most hybrid life and annuity products are not Partnership-qualified. Owning a Partnership policy does not guarantee Medicaid eligibility; you must meet all other Medicaid rules. Source: Texas HHS, Medicaid for the Elderly and People with Disabilities Handbook, P-1200.

Our Process

1
Assessment
Review of your savings, income, and care concerns
2
Education
Plain-English explanation of Texas rules that may apply to you
3
Options
Compare insurance options that can pay for care
4
Referral
Coordinate with an elder law attorney for legal and Medicaid-application work

Plan Before Care Is Needed

Long-term care planning is most effective when done before care is needed. Contact us for a confidential, no-obligation conversation.

Schedule Free Consultation Download Planning Guide

Educational only; not legal, tax, or Medicaid-eligibility advice. Not affiliated with Medicaid or any government agency. Benefits vary by product and carrier.