At Ishihara & Parker Law Firm in Longview, Texas, we stay informed about the latest Medicaid changes to help individuals and families navigate long-term care planning. In 2024, Texas Medicaid has updated its financial eligibility numbers, particularly for those seeking assistance with nursing home care. Below, we outline the key changes and what they mean for individuals and married couples.

Income Limits for Single Applicants

For single individuals applying for Medicaid to cover nursing home care, the income limit has been raised to $2,829 per month. This figure refers to gross income, meaning the amount before deductions. If an applicant earns less than this threshold, they pass the income test for Medicaid eligibility. However, individuals earning above this limit are not automatically disqualified. They can still qualify by setting up a Miller Trust (Qualified Income Trust) to redirect excess income, ensuring Medicaid eligibility.

Resource Limits for Single Applicants

Unlike income limits, the resource limit for a single individual remains unchanged at $2,000 in countable assets. Countable resources generally include cash, bank accounts, and investments but exclude exempt assets like a primary residence, one vehicle, and personal belongings.

Income and Resource Limits for Married Couples

For married couples where one spouse requires nursing home care, eligibility is determined differently. Texas Medicaid assesses the couple’s combined countable resources as of the snapshot date (the first day of the month in which one spouse enters a facility) and assigns a spousal resource allowance. The spouse at home, known as the community spouse, is entitled to keep a portion of the couple’s assets.

In 2024, the community spouse resource limits are:

• Minimum protected resource amount: $30,828
• Maximum protected resource amount: $154,140

If a couple's countable resources are below the minimum amount ($30,828), the community spouse may retain all assets without spending down. However, if their assets exceed the maximum amount ($154,140), Medicaid will require a spend-down before eligibility is granted.

Community Spouse Income Protections

To ensure the community spouse remains financially stable, Texas Medicaid allows them to retain their personal income. In cases where the community spouse’s income is below a set threshold, they may receive a portion of the institutionalized spouse’s income. In 2024, the minimum monthly maintenance needs allowance (MMMNA) is $3,853 per month.

This means if the community spouse's income is below $3,853, they can receive income from the institutionalized spouse to reach this amount. If their income is above this threshold, they keep it without affecting Medicaid eligibility.

The Five-Year Look-Back Period and Asset Transfers

Medicaid enforces a five-year look-back period, reviewing any transfers or gifts made within five years before applying. If assets were gifted or transferred below market value, Medicaid imposes a penalty period during which it will not cover long-term care costs.

The penalty divisor for 2024 is $242.13 per day, meaning Medicaid calculates the penalty period by dividing the total amount transferred by this daily rate. For example, gifting $100,000 would result in a 413-day penalty period (approximately 13.8 months) before Medicaid coverage begins.

Final Thoughts: Seek Professional Guidance

Navigating Medicaid eligibility and planning for long-term care is complex, and making uninformed financial decisions can result in significant penalties. If you or a loved one are considering Medicaid for nursing home care, consulting an experienced attorney is essential to developing a plan that protects assets while ensuring eligibility.

At Ishihara & Parker Law Firm, we specialize in Medicaid planning and elder law, helping families understand their options and make informed decisions. Contact us today for a consultation to discuss your specific situation and plan for the future with confidence.

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