Texas medicaid application for elderly and disabled

Q: Do you automatically qualify for Medicaid with disability?

If you get SSI Disability and dont have Medicaid In many states, SSI recipients automatically qualify for Medicaid and dont have to fill out a Medicaid application. In other states, your SSI guarantees you Medicaid eligibility, but you have to sign up for it.

Table of Contents Show

Do you automatically qualify for Medicaid with disability in Texas?
Do you automatically qualify for Medicaid with disability?
How do adults qualify for Medicaid in Texas?
What is the income limit for Medicaid in Texas for adults?

Medicare, Medicaid, State Health Insurance Assistance Program (SHIP)

The maze of government benefit programs can be difficult to navigate, but it is the key to older adults receiving the benefits to which they are entitled. The Benefits Counseling program provides one‑on‑one, free counseling and assistance by a trained, certified Benefits Counselor to individuals eligible for Medicare benefits.

Benefits Counselors provide information and answer questions to ensure that individuals are receiving the benefits to which they are entitled. Benefits Counselors screen for eligibility and assist with the application process for benefit programs including the Medicare Savings Program (MSP) and Low-Income Subsidy (LIS or extra help). Unbiased information about Medicare Advantage plans, Medicare supplement or Medigap plans, Medicare Part D prescription drug plans can be provided as well as assistance with enrollment into a plan of the individual’s choice.

Texas Medicaid

A person who is 65 years or older, or a person who has a disability, may receive Medicaid assistance if he or she meets income and resource limits set by the program.

The amount of resources that a person owns is considered when deciding if he or she can receive Medicaid. Resources can include bank accounts, certificates of deposit, property, cash value of most life insurance, stocks and bonds.

Resources do not usually include the value of a person’s home, vehicle, limited burial fund or personal belongings.

To find out if your income and resources are within the limits of this program, you can fill out a self-screening questionnaire at www.YourTexasBenefits.com.

You can also meet with an HHSC staff person at an office near you. To find an office near you, call 2-1-1 and an operator will give you the address to the closest office.

Medicaid for Long-Term Care

A person who needs 30 or more days of continuous, long-term care may be able to receive Medicaid if income and resource limits set for the program are met. Medicaid may also pay for medical services that were received three months before the person applied for assistance.

A person who receives Medicaid for long-term care must pay a portion of the cost by using all of his or her income, except for a small monthly allowance for personal needs and certain deductions such as health insurance premiums.

Long-term care services can be provided through community programs while the person is living at home or while the person is living in a long-term care facility, such as a nursing facility, institution for mental diseases or facility for the mentally retarded.

The benefit period for long-term Medicaid services is usually one year. Before the end of the benefit period, a renewal application will be sent to that person, or his or her authorized representative.

Medicaid for People Receiving SSI

A person who receives Supplemental Security Income (SSI) automatically receives Medicaid. HHSC sends information about Medicaid services to people receiving Supplemental Security Income.

If a person receiving Supplemental Security Income needs help paying for medical services that were received three months before applying for Supplemental Security Income, he or she must complete a Medicaid application to request this help. Income and resource limits set by this program must be met.

To learn more about how to apply for Supplemental Security Income, visit the U.S. Social Security Administration’s website or call the toll-free number, 1-800-772-1213.

The info you entered on this page will not be saved if you change languages now.

To keep working on this page without changing languages, click Stay On Page.

To change languages and start over on this page, click Change Language.

Texas long-term care is expensive whether in a nursing home, assisted living facility, or home health care. Medicare coverage for long-term care is very limited, private health insurance policies generally do not cover long-term care, and few people have purchased private long-term care insurance policies.

For Texans needing long-term care, Medicaid is the most common source of funding. Medicaid is funded by both federal and state funds, and it provides health insurance to about 14% of Texans.

Medicaid Planning Specialists help clients structure their financial resources and prepare documentation to ensure the best possibility of being accepted into the Medicaid program. They create trusts, manage asset transfers, and convert countable assets into exempt assets to ensure eligibility and preserve a family's resources.

Medicaid provides health coverage to 7.2 million low-income seniors who are also enrolled in Medicare. According to the Federal government guidelines, a low-income senior is defined as any individual who has attained the age of 60 and has an income of less than $30,000 a year, which equates to about $2,450 a month, or about $80 a day. Medicaid also provides coverage to 4.8 million people with disabilities who are enrolled in Medicare.

Income & Asset Limits for Qualifying

How much in assets can you have and still qualify for Medicaid?

In order to be eligible for Medicaid, applicants must have no more than $2,000 in "countable" assets (the dollar figure may be slightly more, depending on the state). In addition, Medicaid also has strict asset transfer rules.

There are several different Medicaid long-term care programs for which elderly Texans may be eligible. These programs have slightly different eligibility requirements and benefits. Further complicating eligibility are the facts that the criteria vary with marital status and that Texas offers multiple pathways towards eligibility.

1) Institutional / Nursing Home Medicaid � is an entitlement (anyone who is eligible will receive assistance) & is provided only in nursing homes.

2) Medicaid Waivers / Home and Community Based Services � Limited number of participants. Provided at home, adult day care, adult foster care home, or in assisted living. More about Medicaid waivers.

3) Regular Medicaid / Aged Blind and Disabled � is an entitlement (persons who meet the eligibility requirements are guaranteed program benefits) and is provided at home or adult day care.

How do I protect my spouses assets from Medicaid?

Create a Funeral Trust � Certain irrevocable funeral trusts created for the Medicaid candidate and / or their spouse can enable a couple to reduce their countable assets by up to $30,000 (depending on their state of residence).

Can one spouse get Medicaid and the other not?

Medicaid assumes that both spouses of a married couple are financially responsible for one another. As a result, when Medicaid determines a spouse's eligibility for benefits, the assets of the husband or wife who isn't applying � known as �the community spouse� � are expected to contribute to the care of the other.

Related Articles:

Medicaid Guidelines When Moving Out of State
Medicaid Spousal Impoverishment Act
Medicaid Spend Down / Look Back Period
Types of Trusts Allowed Under Medicaid Rules

Disclaimer: Elder Options of Texas is not rendering any legal or professional advice. If legal advice is necessary the reader should consult an experienced elder law atttorney.

DISCLAIMER: Links to other websites or references to products, services or publications do not imply the endorsement or approval of such websites, products, services or publications by Elder Options of Texas. The determination of the need for senior care services and the choice of a facility is an extremely important decision. Please make your own independent investigation.

Do you automatically qualify for Medicaid with disability in Texas?

In Texas, people on SSI can automatically get Medicaid. They "buy-in" to Medicaid through the Medicaid Buy-In for Adults or Medicaid Buy-In for Children programs. They could be or have been placed in a nursing facility or care facility for people with intellectual disabilities.

Do you automatically qualify for Medicaid with disability?

If you get SSI Disability and don't have Medicaid In many states, SSI recipients automatically qualify for Medicaid and don't have to fill out a Medicaid application. In other states, your SSI guarantees you Medicaid eligibility, but you have to sign up for it.

How do adults qualify for Medicaid in Texas?

To be eligible for Texas Medicaid, you must be a resident of the state of Texas, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.

What is the income limit for Medicaid in Texas for adults?

In 2022, the MMMNA in TX is $3,435 / month. If a non-applicant spouse has monthly income under this amount, income can be transferred from the applicant spouse to the non-applicant spouse to bring their income up to this level.