Houston Medicaid Planning Attorney Whitney L. Thompson Discusses Texas Medicaid Coverage and Nursing Homes

HOUSTON, TX - For families in Texas facing the difficult decisions that come with nursing home care, understanding what Medicaid covers and how to qualify can be overwhelming. At The Law Office of Whitney L. Thompson (https://www.wthompsonlaw.com/nursing-home-care-and-medicaid-eligibility/), Houston Medicaid Planning Attorney Whitney L. Thompson provides clear and practical legal support to clients seeking long-term care benefits through Texas Medicaid.

Medicaid does cover nursing home care in Texas, but only for individuals who meet strict financial and medical criteria. According to Houston Medicaid Planning Attorney Whitney L. Thompson, "It's not enough to simply need help with daily tasks. IT is needed to meet the state's medical necessity standard, which typically means requiring skilled nursing care regularly." Understanding this distinction is critical when planning for future care needs.

Applying for Medicaid nursing home benefits requires more than just demonstrating medical need. The process includes income caps, asset evaluations, and consideration for spousal protections. Houston Medicaid Planning Attorney Whitney L. Thompson explains that many families are caught off guard by these financial requirements, especially when a spouse remains at home and still needs access to essential resources. "Texas does offer allowances for community spouses, but the rules can be complicated without proper guidance," she notes.

One of the main financial tools that can make or break eligibility is the Qualified Income Trust, also known as a Miller Trust. If an applicant's monthly income exceeds the 2025 Medicaid limit of $2,901, they may be disqualified, even if they can't afford nursing home care. Attorney Whitney L. Thompson helps clients establish these trusts, which allow excess income to be legally redirected so applicants meet the income requirements. These trusts must be drafted and managed correctly to comply with Texas Medicaid law.

As Whitney L. Thompson emphasizes, "The five-year lookback period doesn't apply to properly structured Qualified Income Trusts, but it does apply to asset transfers. That's why getting legal help early in the process is key to avoiding penalties." Improper transfers during the five years before an application can result in delayed eligibility and financial stress during an already difficult time.

To qualify for nursing home Medicaid in Texas, applicants must first prove they need a nursing facility level of care. This involves an evaluation of both physical function and medical needs. Individuals who require help with basic activities, like dressing, toileting, or bathing, or who suffer from medical conditions that require skilled nursing, are typically eligible. Cognitive decline from conditions such as Alzheimer's disease or dementia can also be considered. Physician documentation from hospitals like Memorial Hermann or Houston Methodist can support the application.

Additionally, applicants must live in a nursing home for 30 consecutive days before applying for Medicaid. During that period, they are responsible for paying the costs themselves or relying on Medicare if eligible. Once this requirement is met and an application is approved, Medicaid can begin covering the majority of ongoing nursing home expenses.

Spousal protections are another major concern for married couples, especially when only one spouse requires institutional care. Medicaid counts a couple's assets and income jointly, but Texas law allows the "community spouse" to retain a portion of the couple's resources. For 2025, this includes up to $157,920 in countable assets and income up to $3,948 per month. Whitney L. Thompson regularly assists families in structuring their finances to meet these guidelines while maintaining stability for the spouse remaining at home.

Another often misunderstood rule involves homeownership. Although a primary residence is usually exempt if a spouse or dependent child still lives there, the home equity must be below $730,000 in 2025. After the applicant's death, Medicaid may attempt to recover costs through estate claims, including claims on the home, unless certain legal protections apply. Whitney L. Thompson helps families understand how to avoid unintended consequences during the estate recovery process.

Families may also consider community-based services or waiver programs like STAR+PLUS if their loved one does not yet require full-time nursing home care. These programs offer support such as personal assistance and respite care, but still come with their own application requirements and waiting lists.

Attorney Whitney L. Thompson has worked with families across Houston and Harris County to help them navigate this process, prepare the necessary documentation, and protect family assets. Her approach to Medicaid planning is grounded in ensuring long-term financial security for both the applicant and their loved ones.

Navigating Medicaid nursing home eligibility in Texas can be confusing, and small mistakes may result in costly delays or disqualification. With the guidance of Whitney L. Thompson, families can move forward with clarity and confidence. Whether it's creating a Qualified Income Trust, managing spousal protections, or understanding estate recovery, The Law Office of Whitney L. Thompson is committed to helping Texans secure the care they need without sacrificing their financial future.

Families who need help with Medicaid eligibility or planning for nursing home care are encouraged to consult with Houston Medicaid Planning Attorney Whitney L. Thompson. Understanding the state's requirements ahead of time can prevent costly missteps and ensure loved ones receive the care they need.

About The Law Office of Whitney L. Thompson:

The Law Office of Whitney L. Thompson serves clients in Houston, Harris County, and throughout Texas. The firm focuses on estate planning and elder law, helping families navigate complicated legal systems related to long-term care, Medicaid planning, and asset protection. Whitney L. Thompson works with clients to prepare for the future with legally sound strategies tailored to their specific needs.

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