{"id":13072,"date":"2025-03-02T06:00:38","date_gmt":"2025-03-02T12:00:38","guid":{"rendered":"https:\/\/legaltalktexas.hammerle.com\/?p=13072"},"modified":"2025-06-18T12:00:57","modified_gmt":"2025-06-18T17:00:57","slug":"couples-medicaid-planning-basics","status":"publish","type":"post","link":"https:\/\/hammerle.com\/legaltalk\/estate-planning\/couples-medicaid-planning-basics\/","title":{"rendered":"Couples\u2019 Medicaid Planning Basics: Should You Sell Your Assets to Pay for the Nursing Home?"},"content":{"rendered":"

Couples are living longer, and that is both a good thing and a bad thing.\u00a0<\/span><\/p>\n

Good because who doesn\u2019t want another day together basking in sunshine and eating ice cream?<\/span><\/p>\n

Bad because it increases the chances that your spouse will need a nursing home that you can\u2019t pay for.\u00a0\u00a0\u00a0<\/span><\/p>\n

Enter Medicaid.\u00a0\u00a0<\/span><\/p>\n

Understanding Texas Medicaid Programs<\/span><\/h2>\n

Texas has 42 individual Medicaid programs, but we will focus on only one: Nursing Home Medicaid. It covers most medical and support needs for a person who needs nursing facility care.\u00a0\u00a0<\/span><\/p>\n

Let\u2019s assume you are married to Bob, and he needs <\/span>nursing home<\/span><\/a> care. You know that 90% of nursing home residents exhaust their personal financial resources in 36 weeks or less, so you want to qualify Bob for Medicaid to avoid impoverishment.\u00a0\u00a0<\/span><\/p>\n

Nursing Home Medicaid Requirements<\/span><\/h2>\n

Is Bob eligible for Nursing Home Medicaid? Let\u2019s see.\u00a0<\/span><\/p>\n

1. Age and Residency\u00a0<\/span><\/h3>\n

He must be a US citizen or a qualified alien. He must be a resident of Texas. He must be either 65 or over, blind, or disabled.\u00a0<\/span><\/p>\n

2. Medical Necessity<\/span><\/h3>\n

Bob must meet a medical necessity requirement for a nursing home case. Generally, that means he has a medical disorder or disease requiring attention by registered or licensed vocational nurses on a regular basis.<\/span><\/p>\n

3. Income and Resource Limit<\/span><\/h3>\n

He must fall within an income and resource limit. [<\/span>Warning: numbers ahead<\/span><\/i>]<\/span><\/p>\n

Bob\u2019s income must be limited to $2,901 per month. If he makes more than that, then he can set up a Qualified Income Trust, known as a \u201cMiller Trust,\u201d to receive his income. Where does that leave you? If your monthly income is below $3,948, then you may be able to keep a portion of Bob\u2019s income to meet your living expenses.\u00a0<\/span><\/p>\n

Bob also has a resource limit for his countable assets. Because you are married, Bob\u2019s resource limit is half of your combined resources, but as a spouse, you can set aside a maximum amount of $157,920 as protected.\u00a0<\/span><\/p>\n

However, you need to focus on the phrase \u201ccountable assets.\u201d These exclude assets that Texas has deemed will not be counted against the limit. Happily, it is a long list that includes a <\/span>home<\/span><\/a>, a car, business property, some livestock, most household items, <\/span>burial plots<\/span><\/a>, and pre-paid funeral arrangements.\u00a0<\/span><\/p>\n

4. Occupying a \u201cMedicaid Bed\u201d<\/span><\/h3>\n

Finally, to be Medicaid-eligible, Bob needs to be occupying a \u201cMedicaid bed\u201d in an eligible facility.\u00a0\u00a0\u00a0<\/span><\/p>\n

The foregoing recitation is just a broad overview.\u00a0 There are multiple rules with additional exceptions, requirements, and generally confusing language.\u00a0<\/span><\/p>\n

Medicaid Requirements to Remember<\/span>\u00a0<\/span><\/h2>\n

As you begin your research, here are a few things to keep in mind.\u00a0<\/span><\/p>\n