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).