The following is intended as a brief overview of basic qualifying standards and includes recent changes to and/or interpretations of those regulations.
For those that are single, widowed, or divorced, Medicaid qualification and planning methods are fairly simple. For those who are married, Medicaid qualifications and planning methods are somewhat more complex.
Medicaid views a couple as a single unit and considers all of the couple's assets, whether those assets are community or separate property, as being available to both partners when applying the asset test for qualification. Due to the Medicare Catastrophic Coverage Act of 1988, substantial asset and income protections are available to the community spouse.
To qualify for Medicaid, the "applicant" may not have more than $2000 of non-exempt or countable assets. HOWEVER, legal planning methods exist that can often preserve as much as 70% of assets for single, widowed, or divorced persons and up to 100% of assets for married individuals.
Year 2021 - TDHS' Guidelines for Income and Resources
- Maximum allowable monthly income is $2,382 (If income exceeds maximum, Miller Trust/Qualified Income Trust is needed)
- Maximum Countable Assets is $2,000
- Maximum monthly income.........No Maximum!
- Protected monthly income for the community spouse is the greater of:
- Up to $3,259.50 of the couples combined income or
- 100% of the community spouses' income
- Maximum Protected Resource Amount (PRA) / assets is 100% of the countable assets up to $26,076 or 50% of the assets up to $130,080.