Texas Medicaid Crisis Planning

Long-term care is incredibly expensive. The need for long-term care is also often unexpected. Unfortunately, Medicare doesn’t cover long-term care costs, and families are left with two choices when facing the sudden need for long-term care: apply for Medicaid or pay out-of-pocket. This can put families in a difficult financial situation. At the Houston estate planning law firm of McCulloch & Miller, PLLC, we have extensive experience helping families protect what they’ve worked so hard for as they approach retirement ago. Our Medicaid crisis planning attorneys will help you account for all contingencies, so you know that you and your family are protected, no matter what the future brings.

Recent government estimates suggest that as many as 70 percent of people 65 and older will require long-term care at some point in their lives. And the costs of long-term care are increasing at an alarming rate; in some cases, more than $150,000 per year. For example, according to the Genworth Cost of Care 2020 Survey, the average monthly cost of a Texas nursing home as of 2020 was $5,019 for a semi-private room or $6,388 for a private room.

Given the astronomical cost, most people cannot afford long-term care for an extended period of time. However, at the same time, individuals cannot qualify for Medicaid benefits unless they meet strict income and asset limits. For example, in 2021 to be eligible for Medicaid in Texas*, a single person must make less than $28,584 before taxes; and a couple must make less than $57,168 before taxes. Note that these figures regularly change. Additionally, Medicaid applicants cannot own more than a certain amount of countable assets to qualify for benefits, generally less than $2,000.

Click here for a chart of Texas Medicaid Facts for 2024.

Medicaid in Texas includes a complex set of rules and regulations that can be very difficult to navigate. Adding to the challenges of Medicaid crisis planning is the fact that Medicaid uses a five-year lookback period when reviewing an applicant’s financial transactions. When you apply for Medicaid, the government looks through the most recent five years of financial statements to determine whether you made any non-qualifying transfers. For example, applicants cannot transfer money to a friend or loved one in anticipation of filing for Medicaid benefits. If they do, an applicant will face a period of ineligibility based on the value of the transfer. This is especially problematic with the finances of the family have been mixed in some way.

Like anything else in life, those who plan ahead when it comes to Medicaid are likely to achieve the best results. There are many pitfalls and traps that can have a devastating effect on someones wealth or ability to fund the care that they need. But there are also options and strategies to take well in advance of a Medicaid application that will allow future applicants to legally and ethically decrease their countable assets. Working with an experienced elder law attorney can help you set aside assets to cover supplemental expenses that Medicaid will not cover and preserve some hard earned wealth for your family. Waiting to the last minute is tempting and common, as no one looks forward to discussing these issues with loved ones. However, the importance of having a Medicaid crisis plan in effect cannot be overstated.

And even if the need for long-term care is immediate, there are still steps you can take to protect your assets and ensure your loved ones continue to benefit from what you’ve worked so hard for. Medicaid planning is complex, and anyone with questions should reach out to a dedicated Houston elder law attorney.

If you are approaching retirement age and do not yet have a Medicaid crisis plan in effect, reach out to the knowledgeable Houston estate planning lawyers at McCulloch & Miller, PLLC. At McCulloch & Miller, PLLC, we have decades of experience working with families from all backgrounds, familiarizing them with their options and providing sound legal advice. Our attorneys stay up-to-date on all changing laws and regulations to ensure that our clients’ interests are protected well into the future. To learn more, and to schedule a consultation with a Houston Medicaid planning lawyer at McCulloch & Miller, PLLC, call (713) 333-8900 today., You can also reach us through our online contact form.

* Since these amounts (e.g., the "Community Spouse Resource Allowance," etc.) are adjusted annually, these numbers may vary slightly depending on when the most recent figures are released.

Click here for a chart of Texas Medicaid Facts for 2024.