Qualifying for Medicaid in Texas & How to Apply

Most people on Medicare assume Medicaid is strictly for younger, low-income families, so they never check whether they'd qualify themselves. That assumption can be an expensive one. If you're 65 or older, or you have a qualifying disability, Texas Medicaid can cover things Medicare doesn't touch — and in some cases wipe out your Medicare premiums and out-of-pocket costs entirely. Here's how eligibility actually breaks down in Texas, and exactly what applying looks like.

Two Medicaid pathways worth knowing about

Texas hasn't expanded Medicaid under the Affordable Care Act, so adult eligibility stays limited to specific groups: seniors, people with qualifying disabilities, and a handful of other categories. If you're already on Medicare, two Medicaid pathways are the ones that usually matter:

• Regular Medicaid for the Elderly and People with Disabilities (MEPD) — health coverage that runs alongside Medicare, with income limits tied closely to the SSI federal benefit rate.
• Long-term care Medicaid — covers nursing facility care or home- and community-based waiver services, at a higher income limit but with its own separate rules.

Worth knowing about too: Medicare Savings Programs (QMB, SLMB, and QI). They're Medicaid-administered but narrower — they cover Medicare premiums, deductibles, or coinsurance rather than full Medicaid benefits. If your income runs a little high for regular Medicaid, one of these may still be within reach. See the full breakdown of Medicare Savings Programs & Extra Help →

2026 income and asset limits

These figures come from the Texas Health and Human Services Commission and are effective January 1, 2026. They change annually, so always confirm the current numbers before assuming where you fall.

• SSI Federal Benefit Rate: $994/month — the baseline used for regular MEPD Medicaid income limits.
• Long-term care / nursing facility income cap: $2,982/month for a single applicant (300% of the SSI Federal Benefit Rate).
• Asset limit: $2,000 for an individual, $3,000 for a married couple (countable resources — see below for what doesn't count).

Married couples applying for long-term care Medicaid have additional protections for the spouse who isn't applying, allowing that spouse to keep a larger share of income and assets so they aren't left without resources. These "spousal impoverishment" rules are worth a closer look if only one spouse needs nursing home or waiver-level care.

What actually counts toward those limits

Income typically includes Social Security, pensions, retirement account distributions, and most other regular payments coming in.

Countable assets typically include bank accounts, savings, investments, and property beyond your primary residence and one vehicle. What usually doesn't count: your primary home (as long as you or your spouse lives there), one vehicle, personal belongings and household furniture, and prepaid funeral arrangements.

Running slightly over the income limit for long-term care Medicaid doesn't necessarily end things — a Qualified Income Trust (sometimes called a "Miller Trust") can, in some cases, still get you there. It's a formal legal process, though, and one worth discussing with an elder law attorney rather than attempting solo.

Basic eligibility requirements

Beyond the income and asset tests, Texas Medicaid generally asks that you:

• Be a Texas resident
• Be a U.S. citizen or qualified immigrant (lawful permanent residents generally face a waiting period; refugees and asylees typically do not)
• Be 65 or older, or meet Social Security's definition of blind or disabled
• For long-term care Medicaid specifically, meet a medical necessity requirement for nursing facility or waiver-level care

How to apply for Medicaid in Texas

1. Apply online through YourTexasBenefits.com, the state's official portal for Medicaid, SNAP, and other assistance programs. The Your Texas Benefits mobile app covers the same ground if you'd rather apply from your phone.
2. Apply by phone, or just get a read on your eligibility first, by calling 2-1-1 and choosing the option for Texas Health and Human Services programs.
3. Apply in person or by mail at your local HHSC benefits office if paper forms or face-to-face help fits you better.
4. Have your documents ready before you start: proof of age and identity, Texas residency, income (Social Security award letters, pension statements), and asset statements (bank, investment, and life insurance accounts).
5. Then it's a waiting game. Timelines vary by program and how complete your application is — anywhere from a few weeks to a couple of months. Respond fast to any request for more documentation; that's usually what slows things down.

Denied, or think the numbers were figured wrong?

HHSC denials come with a right to request a fair hearing, generally within 90 days of the decision. And eligibility isn't static — a change in your income, assets, or health can be reason enough to reapply even after an earlier denial.

Already on Medicare and think Medicaid might apply to you too?

Qualifying for both programs — "dual eligible," in Medicare terms — opens up plan options built specifically around coordinating the two, plus Special Enrollment Periods that let you make plan changes outside the usual windows. Learn how D-SNPs coordinate Medicare and Medicaid benefits →