| Medicaid Eligibility
Nursing Facility Program |
Income
|
| |
Maximum gross income |
 |
| |
|
Individual - $2,022
individual with an ineligible
spouse - $2,022
Couple - $4,044
|
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What counts as income |
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Social Security Benefits
Certain Veterans Benefits
Private Pensions
Interest and Dividends
Royalty & Rental Payments
|
Federal Employee Annuities
Railroad Benefits
State & Local Retirement Benefits
Gifts and Contributions
Earnings and Wages
|
Resources
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Maximum countable resources |
| |
|
Individual - $2,000
Couple - $3,000
|
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What is a resource |
| |
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Bank Accounts & CDs
Real Property
Life Insurance Policies
Burial Funds
IRA
|
Stocks & Bonds
Oil/Gas/Mineral Rights
Jewelry & Antiques
Cars & Other Vehicles
Boats & Recreational Vehicles
|
| |
What can be excluded |
| |
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Homestead where the individual intends to return.
Life insurance if the face value is $1,500 or
less.
Separately identifiable burial funds of $1,500
(less any excluded life insurance or irrevocable
arrangement for burial).
Car
Burial spaces
|
| |
Protected resources amount for
a spouse in the community |
| |
|
$21,912 Minimum - $109,660 Maximum (Excludes
value of homestead, household goods, personal
goods, one car, and burial funds)
|
Other
|
| |
Medical Need - must meet medical
necessity criteria.
Risk Assessment - must meet nursing facility
Risk Assessment criteria
Residency - must be a resident of Texas and
U.S. citizen or alien with approved status (e.g.,
legalized or permanent resident alien).
Living Arrangement - must be a patient in
a Medicaid-contracted long term care facility for
30 consecutive days.
|
Personal Needs Allowance
|
| |
Individual - total gross income
less $60 for personal needs.
Individual with a spouse in the community
|
| |
|
Total gross couple income less $60
for personal needs, less $2,377.50 for community
spouse, less certain amount for dependents living
with community spouse. |
| |
Couple - total gross income,
less $90 for personal needs.
Certain incurred medical expenses are deducted
if the Medicaid program does not cover direct payment
for the services.
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