Medicaid Planning

Paying a Family Caregiver Without Triggering a Texas Medicaid Penalty

Published on: September 22, 2026 | By McCulloch & Miller, PLLC

Paying a Family Caregiver Without Triggering a Texas Medicaid Penalty

Last updated September 22, 2026 · Reviewed by Thomas W. McCulloch

Texas Medicaid reviews five years of an applicant’s financial history before it pays for nursing facility care. Money paid to a relative who has been providing care is one of the places a family’s arrangement can come apart. A payment the family sees as fair wages can look to the state like a gift. When it does, Medicaid withholds payment for a stretch of time calculated from the amount.

Texas HHS counts payments to a family caregiver as compensation rather than a gift only under specific conditions. The payments must follow an agreement established on or before the transfer, made for purposes other than qualifying for Medicaid, for services actually provided and documented. Payment for ordinary household help that a family member would normally provide does not count at all. A personal care agreement for Texas Medicaid purposes has to be built around those rules from the start. McCulloch & Miller treats it as part of Medicaid crisis planning for Houston families, not a form to sign later.

How a Qualified Income Trust Opens Texas Medicaid Eligibility

Published on: July 16, 2026 | By McCulloch & Miller, PLLC

Last updated July 16, 2026 · Reviewed by Thomas W. McCulloch

Texas applies a hard income cap to Medicaid long-term care benefits, which separates it from most states. An applicant whose gross monthly income sits above the state’s special income limit is denied, even when that income covers a fraction of a Houston nursing home bill and nothing is left over. Families across Harris County usually learn this after a parent has already moved into a facility, and the denial notice rarely explains what comes next.

Federal law supplies the answer. Income routed each month into a trust that satisfies 42 U.S.C. § 1396p(d)(4)(B) is disregarded when Texas measures an applicant against the income limit, so the same person denied last month can qualify with the trust in place. The trust does not shelter savings or reduce what the facility is owed. It removes one specific barrier, the one that stops most applicants. Texas Medicaid crisis planning often begins and ends with getting this document right.

Protecting the Healthy Spouse When One Spouse Enters a Texas Nursing Home

Published on: July 11, 2026 | By McCulloch & Miller, PLLC

Last updated July 11, 2026 · Reviewed by Thomas W. McCulloch

Federal Medicaid law treats a married couple differently from a single applicant the moment one spouse enters a nursing facility. The governing provisions are the spousal impoverishment rules at 42 U.S.C. § 1396r-5, and they decide how much of a Houston couple’s savings and monthly income the spouse who stays at home may keep while the other qualifies for long-term care coverage. What is at stake is the financial survival of the spouse who remains at home.

Congress wrote those rules so that no family would have to be reduced to nothing to get a husband or wife into care. Section 1396r-5 splits the couple into an institutionalized spouse and a community spouse, protects a share of the couple’s countable resources for the community spouse, and allows part of the institutionalized spouse’s monthly income to be diverted to the community spouse when that spouse’s own income falls below a federal floor. Texas administers the calculation through its own eligibility rules, but the architecture is federal, which is why Medicaid crisis planning in Texas begins with those same two definitions.

Texas Medicaid Planning: Protecting Assets From Long-Term Care Costs

Published on: May 27, 2026 | By McCulloch & Miller, PLLC

Texas Medicaid planning is the process of legally structuring your income and assets so you can qualify for long-term care coverage without spending down everything you have saved. Nursing home care in Texas can cost thousands of dollars a month, and Medicaid is the primary program that helps families pay for it. With advance planning, many families are able to preserve significant assets while still meeting Medicaid’s strict financial limits.

McCulloch & Miller, PLLC helps families across Houston, Harris County, and the greater Houston metro area with Texas Medicaid crisis planning. Founding partner Thomas McCulloch is a member of the National Academy of Elder Law Attorneys, and his commitment to elder law grew from his own experience caring for his aging mother — perspective that shapes how the firm approaches these deeply personal decisions.

What Are the Medicaid Asset Limits in Texas?

To qualify for long-term care Medicaid in Texas, a single applicant generally must have no more than $2,000 in countable assets (as of 2026). Not everything counts, though: a primary home within the equity limit, one vehicle, personal belongings, and certain other resources are typically exempt. Because these figures are adjusted periodically, families should confirm the current limits with Texas Health and Human Services before relying on them.

How Medicaid Estate Recovery Affects Your Assets and How to Plan Ahead

Published on: March 24, 2025 | By Thomas W. McCulloch

Medicaid estate recovery is a scary process, and it can affect families across the country during already difficult times. How can you plan ahead and help guard against Medicaid estate recovery? This blog serves as a starting point, but remember that each person’s circumstances are different, and each person might benefit from a slightly different strategy when thinking through their own opportunities moving forward.

What is Medicaid Estate Recovery?

Medicaid estate recovery is the process through which the government seizes a decedent’s assets after he or she passes away. Typically, the government will initiate this process when the decedent benefited from Medicaid and when that person’s estate has assets that the government can use to recoup the money spent on his or her healthcare.

The government can legally seek reimbursement for any costs that the decedent used for a nursing home or long-term care facility, home services, prescriptions, and/or hospital services. The government is only allowed to seize the decedent’s assets that are part of their probate estate – so if you have an asset that is set up to bypass probate entirely, it will not be subject to the recovery process. Assets that are part of probate and would be subject to recovery can include (but are not limited to) a home, cash, and personal belongings.

What is Medicaid Crisis Planning?

Published on: July 30, 2024 | By David W. Miller

As we age, we need more health services to maintain our quality of life. Unfortunately, in this day and age, necessary services can cost a fortune. At McCulloch & Miller, one of our specialties is Medicaid crisis planning, which helps clients prepare for possible health needs in the future. If you have not yet begun your Medicaid crisis planning process, contact a Houston elder law attorney that can help you get started.

What Services Might I Need?

Government estimates indicate that up to 70 percent of older individuals require long-term care at some point. As you age, you might need to move into a facility such as a nursing home or residential center. If you decide to stay in your home, you might need a fulltime or parttime nurse to come check on you or to offer more substantive care. You might also opt for home therapy, wound care, fall prevention services, or other specialized services.

What Does Medicaid Crisis Planning Achieve?

Medicaid crisis planning helps you predict whether might qualify for Medicaid, which covers significant amounts of long-term care. To qualify, you must be characterized as “low income” or “very low income.” Of note, the government looks not only at applicants’ current financial status but also at their previous five years, so if you have only recently qualified as “low income,” you still might not qualify under the rules. To learn more about specific qualifications, click here for a chart of Texas Medicaid Facts for 2024.

When Should You Start Preparing to Apply for Medicaid in Texas?

Published on: April 7, 2024 | By David W. Miller

In Texas, the state provides Medicaid to those considered “low income” that meet certain threshold requirements. To qualify, you must be a low-income resident of Texas in need of heath care, and you must either be: pregnant, responsible for the care of a child, blind, disabled or caring for a person who is disabled, or 65 years or older. If you meet the requirements, you can submit your application, wait for the government to approve it, and eventually receive the state-sponsored benefit.

If you know that you will likely qualify for Medicaid at the age of 65, you can start to prepare for the process of submitting your application. This process will include filing out an online (or phone) form in which you answer questions about your household, your current income, and your assets. The government will be looking at your financial profile to ensure that you meet its requirements to receive Medicaid before it approves your application.

You might need several documents to supplement your application: these documents may include proof of your identity, a social security card, proof of citizenship, and documents proving where you live (many times, these documents end up overlapping with each other). You might also have expenses such as child support or loan payments that you will need to address. You should also be prepared to submit documents regarding your earnings, assets, medical expenses, housing expenses, and any current health insurance plan that you are using.

What is Medicaid Crisis Planning?

Published on: March 5, 2024 | By David W. Miller

It’s a universal truth that we all get older, and it’s also a universal truth that we can’t be sure what the future holds. For many individuals, aging means finding long-term care. Unfortunately, the cost of elderly care is incredibly expensive in this country, and it is difficult for many clients to piece together enough funds to cover their expenses. In order to avoid this crisis, we recommend that you begin your Medicaid crisis planning as soon as possible, which can help you avoid the need to panic down the road.

Medicaid crisis planning is the process of preparing today for your possible needs down the line. In the future, you might need a fulltime nurse, a nursing home, or other specialized care. By starting to plan now for how you might pay for these services, you can save yourself significant stress in the future.

Medicaid and Public Benefits

In Texas, you can apply for Medicaid, which will cover large portions of the cost of long-term care. Importantly, when deciding if an individual qualifies for Medicaid, the government will look at the past five years of the person’s financial history. Thus, if you have been financially stable but you’ve recently hit a tough spot, or if you are hoping to transfer assets to a loved one in hopes of qualifying for Medicaid, there is still a substantial likelihood that you will not meet the requirements.

Senior Public Benefits Planning in Texas

Published on: February 29, 2024 | By David W. Miller

As healthcare improves over time, the median age of adults in the U.S. also rises. While this is certainly a net positive for adults and their families, it also means that individuals have more planning to do regarding their elder years. Today, our blog reviews some important topics regarding senior public benefits planning in Texas that you might want to think through as you and your loved ones prepare for the future. As always, there is more to discuss than included in this post, and we recommend you reach out to a trusted estate planning attorney to learn more.

Medicaid Eligibility

Medicaid is a state-provided benefit that provides healthcare for individuals with limited resources. If you qualify for Medicaid, the State calculates a co-pay for you, which you then pay through Social Security or other sources of income. Then, when you go to a doctor’s office, the government pays the difference between your co-pay and the rate that the medical facility charges.

There are two main criteria you must meet to qualify for Medicaid: you must be both medically eligible and financially eligible. To be medically eligible, a doctor must sign off, confirming that you need a certain level of care. To be financially eligible, your assets and income cannot be higher than the government’s designated limit.

The Importance of a Houston Medicaid Planning Attorney

Published on: June 22, 2023 | By David W. Miller

By definition, Medicaid is a government benefit that is available to individuals with lower incomes that need to pay for long-term care. It was created in 1965 and provides coverage to millions of Americans, including pregnant women and older people who need health insurance. Despite its widespread availability, it can sometimes be difficult to access Medicaid, and Houston Medicaid planning attorneys can be incredibly helpful in making sure you receive the benefits you need when times are tough.

When You Might Consider Hiring a Medicaid Planning Attorney

If you or a loved one is considering long-term care, you might want to contact an attorney that can help you think through what benefits are available to you. Additionally, if you are currently undergoing a financial change in circumstances, it could be in your best interest to talk to an attorney to see if you qualify for Medicaid.

Working through a serious illness or planning for retirement might also be reasons to talk to a Medicaid attorney. This can be especially helpful when you feel as if your medical issues require enough attention that it is difficult to focus on taking the time to apply for Medicaid benefits on top of everything else you have going on.