How to apply for Texas Medicaid for long-term care

Applying for Texas Medicaid to pay for long-term care is not hard because any single step is complicated. It is hard because there are several steps, each with its own paperwork, and a mistake in one can delay or derail the whole thing. This guide lays out the process in order, so you know what is coming and can prepare for it.

It is educational information, not legal advice. Medicaid rules are technical, and for anything involving income over the limit, a spouse still at home, or assets to protect, a Texas elder law attorney is worth talking to before you file. Our Texas Care Funding Playbook is the full workbook version of everything below.

Before you apply: confirm your parent qualifies

Texas long-term care Medicaid has three tests, and it helps to check them before you file.

• Income. In 2026, a single applicant needs countable monthly income under $2,982. If income is over that, do not stop. A Miller Trust fixes it.
• Assets. A single applicant can keep no more than $2,000 in countable assets. The home is usually exempt, and married couples keep much more under spousal impoverishment rules.
• Medical need. Your parent must need a nursing-facility level of care, which the state assesses separately.

If income or assets are over the limits, handle that before filing, not after. Moving money the wrong way can trigger the five-year look-back and a penalty. Our guide on how to pay for a nursing home in Texas explains how the three tests fit together.

Step 1: Gather the documents

This is the step that decides how smoothly everything else goes. Collect, for your parent:

• Proof of identity, and citizenship or immigration status.
• Social Security card and Medicare card.
• Five years of statements for every bank and investment account, since that is the look-back window.
• Proof of all income: Social Security, pension, annuities.
• Property records, the deed, and vehicle titles.
• Life insurance policies and any prepaid funeral contract.
• A list of any gifts or transfers made in the last five years, with dates and amounts.

Having these in one folder before you start turns a frustrating process into a manageable one.

Step 2: Handle income and assets first if needed

If your parent is over the income cap, set up and fund a Miller Trust before the application is decided. If there are excess countable assets, get advice on a proper spend-down or, for married couples, on protecting the community spouse's share. This is the stage where an elder law attorney saves families the most money, because the right moves here are legal and the wrong ones create penalties.

Step 3: Submit the application

You can apply for Texas Medicaid in a few ways:

• Online at YourTexasBenefits.com, the state's benefits portal.
• By phone by calling 2-1-1 (the Texas Health and Human Services helpline).
• By mail or in person through a local HHSC benefits office.

Many families also work with the nursing home's admissions staff or an elder law attorney, who file these regularly. Apply as soon as your parent needs care, because coverage generally starts from the month you apply.

Step 4: Complete the medical necessity assessment

Alongside the financial review, the state assesses whether your parent needs a nursing-facility level of care. The nursing home usually helps with this part, since they gather the medical information. Both the financial and the medical sides have to clear for approval.

Step 5: Respond quickly to requests, then wait for the decision

After you file, the state will almost always ask for additional documents, often a specific bank statement or an explanation of a past transfer. Respond fast, because the clock can pause while they wait on you, and missing a deadline can mean starting over. Texas is generally required to decide most applications within 45 days, and up to 90 days if a disability determination is needed. If your parent is approved, Medicaid begins paying the nursing home, your parent keeps a small monthly personal needs allowance, and most of their income goes toward the cost of care.

After approval: keep the coverage

Medicaid is not a one-time approval. Texas reviews eligibility at least once a year in a process called redetermination, and your parent has to stay under the asset limit and keep any Miller Trust funded every month. Report changes in income, assets, or living situation when they happen. A little bookkeeping keeps the coverage from lapsing over something avoidable, like an account that drifted above the limit.

What to do this week

1. Start the document folder today. Five years of financial statements takes the longest to collect, so begin there.
2. Check the income and asset numbers against the $2,982 and $2,000 limits, and get advice before moving any money.
3. Pick how you will apply, online at YourTexasBenefits.com or by calling 2-1-1, and file as soon as care is needed.
4. Choose the home carefully. Approval lets Medicaid pay, but you still choose where. Compare homes on the government's inspection records with our Texas nursing home report cards, and see how long savings last on our calculator.

The application rewards preparation. Families who gather the paperwork, fix any income or asset problem before filing, and respond quickly to the state's requests usually move through it in a month or two. The ones who guess, move money first, or file without the documents are the ones who face denials and delays. Do the steps in order, and get advice on the money before you file.