Paying for care
5 Costly Medicaid Mistakes
The mistakes that cost Texas families the most, and how to avoid each one.
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Medicaid pays for most long-term nursing home care in Texas, but the rules are unforgiving and easy to get wrong. These five mistakes cost families the most money and the most time. Every one of them is avoidable if you know it is coming.
Giving the house or money to the children
It feels like the responsible move. It usually backfires. Gifts trigger the five-year look-back, and Texas divides the amount given away by $262.37 a day to set a penalty period during which Medicaid will not pay. The fix: talk to an elder law attorney first. A properly drafted Lady Bird deed usually protects the home with no penalty at all.
Assuming your parent is too wealthy to qualify
Families see the $2,000 asset limit and give up before they start. But the home (up to $752,000 in equity for a single applicant in 2026), one car, personal belongings, and a prepaid funeral do not count. The fix: separate countable assets from exempt ones before you assume anything. The gap is where honest planning happens.
Waiting too long to plan
The look-back reaches back a full five years, and the strongest protections take time to put in place. Families who wait until the week of a crisis have the fewest options. The fix: start planning as early as you can, ideally well before care is needed.
Believing Medicare covers the nursing home
Medicare pays only for a short rehabilitation stay, up to 100 days, and then it stops. It is not a long-term care program. The fix: understand that Medicaid, not Medicare, is the long-term payer in Texas, and plan for the handoff before day 100 arrives.
Doing the paperwork alone
Texas is an income-cap state with specific legal tools, like the Qualified Income Trust, that a family cannot improvise. A single error can delay approval for months while the nursing home bill keeps coming. The fix: use a Texas elder law attorney. The cost is small next to what a delay can cost.
Put this to work for your family
Look up any Texas nursing home on the government's own records, see how long care is affordable, or get the full funding playbook.
Educational information only, not legal, medical, or financial advice. Figures are current for 2026, drawn from Texas HHS, the American Council on Aging, and CMS Care Compare. Ellery Care accepts no payment from any facility.