Maximum gross income:
- Individual and individual with an ineligible spouse - $2,199.00
- Couple - $4,398.00
What counts as income?
- Social Security Benefits
- Federal Employee Annuities
- Certain Veterans Benefits
- Railroad Benefits
- Private Pensions
- State and Local Retirement Benefits
- Interest and Dividends
- Gifts and Contributions
- Earnings and Wages
Maximum countable resource limit:
- Individual - $2,000.00
- Couple - $3,000.00
What is a resource?
- Bank Accounts and CDs
- Stocks and Bonds
- Real Property
- Oil/Gas/Mineral Rights
- Life Insurance Policies
- Jewelry and Antiques
- Burial Funds
- Cars and Other Vehicles
- Boats and Recreational Vehicles
What can be excluded?
- Homestead where the individual intends to return.
- Life insurance if the face value is $1,500 or less.
- Separately identifiable burial funds of $1,500 (less any excluded life insurance) or more if Irrevocable.
- One vehicle is excluded, regardless of value.
Protected resources amount for a spouse in the community:
- $22,728.00 Minimum - $113,640.00 Maximum (excludes value of homestead, household goods, personal goods, one car, and burial funds)
Medical Need - must meet medical necessity criteria.
Risk Assessment - must meet nursing facility Risk Assessment criteria.
Residency - must be a resident of Texas and U.S. citizen or alien with approved status (e.g., legalized or permanent resident alien).
Living Arrangement - must be a patient in a Medicaid-contracted long term care facility for 30 consecutive days.
Individual - total gross income less $60 for personal needs.
Individual with a spouse in the community - Total gross couple income less $60 for personal needs, less $2,841.00 for community spouse less certain amount for dependents living with community spouse.
Couple - Total gross income less $120 for personal needs.
Certain incurred medical expenses are deducted if the Medicaid program does not cover direct payment for the services.