The Income and Asset Numbers That Actually Decide Texas Medicaid Long-Term Care Eligibility in 2026

By Dallas Senior Advisor Care Team · August 15, 2026

Why the income and asset numbers matter more than the waiver name

Families researching Texas Medicaid long-term care options for a parent in Dallas, Plano, or Arlington often start by learning the name STAR+PLUS and assume that's the whole picture. It isn't. STAR+PLUS is the delivery system — the managed-care program through which Texas provides Medicaid long-term services. Whether a specific person qualifies to use it comes down to two separate financial tests administered by the Texas Health and Human Services Commission: a monthly income limit and a countable asset limit, both evaluated against Supplemental Security Income (SSI)-related Medicaid rules for people who are 65 or older, blind, or disabled.

For 2026, the individual income limit for most Texas Medicaid long-term care pathways, including STAR+PLUS HCBS waiver services and nursing facility Medicaid, sits at 300% of the federal SSI benefit rate — a figure HHSC updates annually. The countable asset limit is $2,000 for a single applicant. Both numbers sound simple in isolation, but the details of what counts as 'income' and what counts as a 'countable asset' are where most Dallas-area families either qualify sooner than they expected or get tripped up by a number they didn't know was being counted.

What counts toward the income limit — and what doesn't

Countable income for Texas Medicaid long-term care includes Social Security retirement or disability benefits, pension payments, and most other regular income sources. It does not include the value of SNAP benefits, most home-energy assistance, or a small list of other excluded payments. For a single applicant whose Social Security and pension income exceeds the 300% SSI limit, Texas allows the use of a Qualified Income Trust — commonly called a Miller Trust — which redirects excess income into an irrevocable trust so the applicant can still qualify. This is a legal mechanism, not a workaround, and it's specifically built into Texas Medicaid rules for exactly this situation.

Married couples add another layer: when one spouse needs long-term care Medicaid and the other doesn't, only the applying spouse's income counts toward the limit under spousal impoverishment rules, and the non-applying spouse (the 'community spouse') is entitled to keep a Minimum Monthly Maintenance Needs Allowance drawn from the applicant's income if their own income is low. Families in Frisco, McKinney, or Garland navigating this for a parent should know the community spouse does not have to spend down to poverty to let the other spouse qualify.

What counts toward the $2,000 asset limit — and the big exemptions that trip people up

The $2,000 countable asset limit for a single applicant sounds tight, but a substantial list of assets is exempt and doesn't count against it: the primary home (up to a 2026 equity limit around $730,000, adjusted annually, as long as the applicant intends to return or a spouse/dependent still lives there), one vehicle, prepaid burial arrangements and a small burial fund, household goods and personal effects, and certain other categories. For a married couple, the non-applying spouse is also allowed to keep a larger share of the couple's combined countable assets under the Community Spouse Resource Allowance, which is recalculated annually and is meaningfully higher than $2,000.

Where Dallas-area families most often get surprised is with assets they didn't think of as countable: a second bank account opened for a grandchild's college fund but still titled in the applicant's name, an inherited property in another county, or cash value in a life insurance policy above a small exemption threshold. HHSC's eligibility workers count what's actually titled to the applicant on the application date, not what a family intends the money for — which is why an asset review well before an application is filed matters more than the headline number itself.

The five-year lookback and why timing an application matters

Texas Medicaid applies a five-year lookback period on asset transfers for long-term care eligibility. If an applicant gave away money or property, sold an asset for less than fair market value, or otherwise transferred resources within five years of applying, HHSC can impose a penalty period during which Medicaid won't pay for long-term care — calculated based on the value transferred divided by the average monthly cost of care in Texas. This is why last-minute asset transfers made after a health crisis, rather than as part of longer-term planning, are one of the most common reasons a Dallas-area application gets delayed rather than denied outright.

This is also why families managing a parent's move from a hospital discharge at UT Southwestern, Baylor University Medical Center, or Texas Health Presbyterian Dallas straight into a nursing facility or assisted living sometimes discover the Medicaid timeline doesn't match the care timeline — the facility placement can happen in days, but a clean Medicaid application with no lookback complications takes real documentation and, ideally, advance planning rather than a scramble.

Where to apply and get help in the Dallas–Fort Worth area

Applications go through YourTexasBenefits.com or by phone through the Texas Health and Human Services Commission's 2-1-1 line, which routes to local aging and disability resources. In the DFW area, the Dallas Area Agency on Aging (operated by The Senior Source) and the Area Agency on Aging of North Central Texas — covering Collin, Denton, and Rockwall counties — both provide benefits counseling that can walk a family through the income and asset review before an application is filed, at no cost. The Area Agency on Aging of Tarrant County serves families in Arlington and the rest of Tarrant County.

For veterans, it's worth checking VA Aid & Attendance eligibility alongside Medicaid, since the two programs use different financial tests and a Dallas-area veteran or surviving spouse who doesn't qualify for Medicaid on income grounds may still qualify for VA benefits that help cover the same care. The VA North Texas Health Care System, including the Dallas VA Medical Center, can connect veterans and families to accredited claims assistance for that separate application.

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