Texas Nursing Home Medicaid

Quick answer: To qualify for Texas nursing home Medicaid, an applicant must be 65 or older or disabled, meet medical necessity, and live in a Medicaid-contracted facility for at least 30 consecutive days. The 2026 income limit is $2,982 a month; above that, a Qualified Income Trust is typically needed.

Getting into Texas nursing-facility Medicaid requires clearing both a medical gate and a financial one. HHSC's published criteria call for the applicant to be 65 or older, or to meet the Social Security definition of disability; to meet medical-necessity standards; to be a Texas resident and either a U.S. citizen or a qualified alien; and to have resided in a Medicaid-contracted long-term-care facility for at least 30 consecutive days. The financial side of eligibility is assessed separately from all of that (HHSC Appendix XII).

For 2026, the institutional special income limit sits at $2,982 a month for a single applicant. Anyone whose countable income lands above that figure typically needs a compliant Qualified Income Trust rather than relying on an income spend-down, which isn't available in Texas (HHSC Appendix XXXVI).