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Understanding Medicare v. Medicaid in Texas

Medicare and Medicaid are two government benefits with very different purposes and very similar names. Because clients often come to us feeling understandably confused between the two, today’s blog post will cover the fundamental differences. This blog can serve as a touchpoint for the future when you want to apply for either benefit.

What is Medicare?

Medicare is health insurance from the federal government. The government provides Medicare for anyone 65 or older, as well as some people under the age of 65 who have certain qualifying disabilities. When you reach the age of 65, though, regardless of your health, you automatically qualify for Medicare.

To receive Medicare under the “qualifying disabilities” standard, individuals must have received Social Security Disability benefits for 24 months. As an alternative, individuals could have one of two conditions: (1) End Stage Renal Disease (ESRD) or (2) Amyotropic Lateral Sclerosis (ALS). Frustratingly, individuals with one of these diseases can only receive Medicare five months after their diagnosis. In general, it can take a long time for the government to process Medicare paperwork, so we recommend applying as soon as you know that you might qualify under one of these conditions.

What is Medicaid?

Medicaid, by contrast, is health insurance from a joint federal and state government program. The government provides Medicaid for certain individuals with limited income and assets. To receive Medicaid in Texas, you also must be a resident of Texas and have status with the U.S. government.

The income and asset limits change every year for Medicaid, and there are different kinds of Medicaid (and for each different kind of Medicaid, there are different income and asset limits). In 2024, the income limit for “regular Medicaid” is $943 per month and the asset limit is $2,000. For a married couple, the income limit increases to $1,415 per month, with the asset limit increasing to $3,000. For an updated list of income and asset limits in Texas, click here.

Similarly, Medicaid paperwork can take a long time for the government to process, and it is important to be ready for a several-month waiting period. Apply as soon as possible, and plan accordingly.

Do You or a Family Member Need Help with Estate Planning or Government Benefits Planning?

At McCulloch & Miller, we offer individualized special needs planning, estate planning, and legal advice regarding government benefits in Houston. If you are looking for a Houston estate planning attorney that can help walk you through your options and figure out the next steps, we are the firm for you. Our team offers empathetic, thorough representation, and we are proud to have been serving our Houston community with high quality legal services for over three decades. For a consultation with a Houston estate planning attorney from our firm, give us a call today at 713-903-7879. You can also fill out our online form with your contact information to have an attorney get back in touch with you as soon as possible about your legal needs. We cover estate planning, trust planning, and elder law issues at our firm.

 

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