Medicaid Planning Assistance
medicaidplanningassistance.org › medicaid-eligibility-texas
Texas Medicaid Eligibility: 2026 Income & Assets Limits
Simplified Eligibility Criteria: Single Nursing Home Applicant In 2026, a single Medicaid Nursing Home applicant in Texas must meet the following criteria: 1) Income under $2,982 / month 2) Assets under $2,000 3) Require a Nursing Home Level of Care. The table below provides a quick reference ...
Texas Health and Human Services
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Medicaid for the Elderly and People with Disabilities | Texas Health and Human Services
Seniors, adults with disabilities and some children with disabilities who don't have health insurance might be able to get health coverage through the Medicaid for the Elderly and People with Disabilities program.
Who is eligible for Medicaid in Texas?
In addition to those with low incomes who are aged, blind, or disabled (receiving SSI benefits), the following populations are eligible for Medicaid in Texas:[efn_note]”Medicaid, Children’s Health Insurance Program, & Basic Health Program Eligibility Levels” Medicaid.gov. Accessed Feb. 4, 2025[/efn_note]
- Children aged 0-1: 198% of the federal poverty level (FPL)
- Children aged 1-5: 144% of FPL
- Children age 6-18: 133% of FPL
- Pregnant women: 198% of FPL
- Adults caregivers of children or adult relatives: 12% of FPL
- Children are eligible for either Medicaid or CHIP if their household incomes are up to 201% of poverty
Texas has not expanded Medicaid under the ACA, so adults under 65 who aren’t disabled or raising a child are ineligible for Medicaid regardless of how low their income is.
healthinsurance.org
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Medicaid eligibility and enrollment in Texas
How can I enroll in Texas Medicaid?
If you believe you may be eligible to enroll in Medicaid in Texas:
- You can start the process through HealthCare.gov, either online or by phone at 1-800-318-2596. (Use this option if you’re under 65 and don’t have Medicare; you will be directed to the Texas Medicaid agency if HealthCare.gov believes you’re eligible for that coverage.)
- You can enroll through the Medicaid website maintained by the Texas Health and Human Services Commission.
- You can also download and print a paper application, or request that one be mailed to you, by using this page on the Texas Medicaid website.
healthinsurance.org
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Medicaid eligibility and enrollment in Texas
How does Medicaid provide financial assistance to Medicare beneficiaries in Texas?
Many Medicare beneficiaries receive Medicaid’s help with paying for Medicare premiums, affording prescription drug costs, and covering expenses not reimbursed by Medicare – such as long-term care. Our guide to financial assistance for Medicare enrollees in Texas includes overviews of these benefits, including Medicare Savings Programs, long-term care coverage, and eligibility guidelines for assistance.
healthinsurance.org
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Medicaid eligibility and enrollment in Texas
Videos
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Texas Health and Human Services
hhs.texas.gov › home › handbooks › medicaid for the elderly and people with disabilities handbook › appendix xxxiii, medicaid for the elderly and people with disabilities information
Appendix XXXIII, Medicaid for the Elderly and People with Disabilities Information | Texas Health and Human Services
Depending on your income, you will file an application with either the Social Security Administration for Supplemental Security Income (SSI) or with the Texas Health and Human Services Commission (HHSC). If the Social Security Administration determines you are eligible for SSI, you will also be eligible for Medicaid without having to file a separate application with HHSC.
Medicaid
medicaid.gov › state-overviews › stateprofile.html
Texas | Medicaid
5. Reflects Medicaid state plan coverage of the eligibility group for parents and other caretaker relatives. Parents and caretaker relatives with income over the income standard for coverage under this group may be eligible for coverage in the adult group in states that have expanded to cover the adult group.
Elderoptionsoftexas
elderoptionsoftexas.com › medicaid-for-texas-seniors.htm
Medicaid for Texas Seniors and Disabled | Elder Options of Texas
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.
Rossandshoalmire
rossandshoalmire.com › library › texas-medicaid-for-the-elderly-and-people-with-disabilities.cfm
How Texas Medicaid for the Elderly and People with Disabilities (MEPD) Helps Pay for Long-Term Care
Enrollment is only open to qualifying adults residing in their home or with a family member. The Program of All-Inclusive Care for the Elderly, or PACE, provides additional services to “people who are frail [or] elderly” and qualify for ...
HealthInsurance.org
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Medicaid eligibility and enrollment in Texas
November 26, 2025 - Children are eligible for either Medicaid or CHIP if their household incomes are up to 201% of poverty · Texas has not expanded Medicaid under the ACA, so adults under 65 who aren’t disabled or raising a child are ineligible for Medicaid regardless of how low their income is.
Aaact
aaact.org › home › medicaid
Medicaid * Area Agency on Aging of Central Texas
February 27, 2019 - 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.
Texas Health and Human Services
hhs.texas.gov › home › search services › health › medicaid and chip
Medicaid and CHIP | Texas Health and Human Services
Medicaid and the Children's Health Insurance Program (CHIP) provide health coverage for low-income children, families, seniors and people with disabilities.
Seniorplanning
seniorplanning.com › state › Texas › medicaid-eligibility
Medicaid Eligibility in Texas for Seniors | Senior Planning
Regular Medicaid/Medicaid for the Elderly and People with Disabilities (MEPD): This is an entitlement program that provides eligible individuals with long-term care benefits, such as personal care assistance. Medicaid in Texas is funded by both the state and the federal government, although it is run by Texas Health and Human Services (HHS). For seniors and individuals with disabilities, the primary program is called STAR+PLUS or STAR+PLUS HCBS (Home and Community-Based Services), which provides care at home.
Call 1-866-790-1662
Address 100 Blvd of the Americas, 08701, Lakewood
Benefit Karma
benefitkarma.com › learn › how-to-qualify-for-medicaid-in-texas
How to Qualify for Medicaid in Texas: 2025 Eligibility, Income Limits & Application Guide - Benefit Karma
In Texas, eligibility for Medicaid depends on several criteria: your income, household size, age, medical condition, and family circumstances. Unlike many other states, Texas has not expanded Medicaid to cover all low-income adults.
MARCA
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Medicaid Texas Eligibility: Who is currently eligible for Medicaid in Texas? | Marca
February 3, 2024 - Eligibility for Texas Medicaid is primarily based on income, family size, age, disability status, and other qualifying factors, but in general, low-income individuals and families, pregnant women, children, seniors (65+), and individuals with ...
CaregiverList
caregiverlist.com › texas › medicaid.aspx
Texas Medicaid Eligibility Requirements For Seniors - Caregiverlist.com
No, Medicaid will pay for long-term care in a nursing home for as long as a senior qualifies for needing the care, even if this means multiple years of care until death. Texas Health and Human Services Commission Texas Medicaid Services (800) 252-8263
Seniorplanning
seniorplanning.com › state › texas
Medicaid For Seniors In Texas | Senior Planning Services
To meet standards for Texas Medicaid nursing home eligibility, you must: • Be a legal U.S. citizen or qualified alien • Be a resident of Texas • Meet income and asset requirements • Be 65 years of age, blind, or permanently disabled · A ...
Call 1-866-790-1662
Address 100 Blvd of the Americas, 08701, Lakewood
Every Texan
everytexan.org › home › our work › policy areas › health care › health insurance coverage › medicaid
Medicaid - Every Texan
February 23, 2024 - Very few parents can access Texas Medicaid; left out of Texas Medicaid are parents with incomes between 18% and 100% of the federal poverty income. Adults with serious, chronic, or mental illness. Disability-related Medicaid only becomes available when a person is no longer able to work at ...
Elderoptionsoftexas
elderoptionsoftexas.com › texas-medicaid-eligibility-requirements-for-seniors.htm
Texas Medicaid Eligibility Requirements - Qualifying for Nursing Home Care | Elder Options of Texas
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. The table below provides a quick reference to allow seniors to determine if they might be immediately eligible for long term care from a Texas Medicaid program.
SingleCare
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Guide to Medicaid in Texas | SingleCare
October 25, 2024 - Adults with disabilities may have the option to get Medicaid, even if they work; they can “buy in” through the Medicaid Buy-In for Adults program. Texas residency is a requirement for eligibility in both Medicaid and CHIP in Texas.
Senior Planning
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Texas | Medicaid Long Term Care Eligibility 2025
January 10, 2025 - Age/Disability: Applicants must be 65 years or older, blind, or disabled. They must also meet medical requirements consistent with the level of care requested and require care for thirty (30) consecutive days.
Trajector Disability
trajectordisability.com › medicaid-eligibility-texas
Understanding Medicaid Eligibility In Texas - Trajector Disability
March 20, 2023 - If you receive supplemental security income (SSI), you will also qualify for Medicaid. The Texas Medicaid website has a calculator to determine that number. You must also be: ... Simply put, low-income adults with disabilities or who have a child with a disability will qualify.
Wellpoint
wellpoint.com › tx › medicaid › eligibility-and-enrollment
Texas Medicaid Eligibility and Enrollment | Wellpoint
Medicaid and CHIP programs help qualified Texas residents get access to affordable health care benefits. Review the requirements to find out if you may be eligible for one of these plans.