Short answer: Texas nursing home Medicaid has a financial test (for 2026, countable income no more than $2,982 per month and countable resources no more than $2,000 for a single person) and a medical test (the person must need nursing-facility-level care). Both have to be met, along with a review of gifts made in the prior 60 months.
Texas checks several things, and passing one does not satisfy the others:
- Income. For 2026, countable income must be no more than the special income limit of $2,982 per month for an individual (300% of the $994 SSI federal benefit rate). Income above that can be handled with a Qualified Income Trust.
- Resources. No more than $2,000 in countable resources for an individual ($3,000 for a couple who both apply). The home, one vehicle, household goods and some burial funds are excluded.
- Home equity. For 2026, home equity above $752,000 blocks Medicaid payment for nursing facility care unless a spouse or a qualifying child lives in the home.
- Transfers. Gifts and below-value transfers in the 60-month look-back can cause a penalty period.
- Medical necessity. The person’s condition must need licensed nursing supervision available only in an institution, determined from the nursing facility’s MDS assessment.
A married applicant gets added protections for the spouse at home. Eligibility is decided by Texas HHSC; an elder-law attorney should advise on planning.
Sources
Texas HHSC MEPD Handbook, Appendix XXXI, Budget Reference Chart (Revision 26-2)fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/appendix-xxxi-budget-reference-chart26 Tex. Admin. Code 554.2401, Medical necessity qualificationslaw.cornell.edu/regulations/texas/26-Tex-Admin-Code-SS-554-240142 U.S.C. 1396p (transfers, trusts, estate recovery, home equity)law.cornell.edu/uscode/text/42/1396pTexas HHSC MEPD Handbook F-3600fhb.hhs.texas.gov/handbooks/medicaid-elderly-people-disabilities-handbook/f-3600-substantial-home-equity