Senior Information Services

Texas MEDICAID at a Glance

2008 Statistical Reference Guide

INCOME and RESOURCE LIMIT

For the Applicant :

Maximum Allowable Monthly Income (for an individual) …......… $1,911.00
Maximum Allowable Countable Resources .......………...….......... $2,000.00

For the Community Spouse :

Maximum Allowable Monthly Income ......................................… No Maximum

Protected Monthly Income for the Community Spouse is the greater of :
         a) 100% of the Community Spouse's personal income, or
         b) up to $2,610.00 of the couple's combined income

Maximum Allowable Countable Resources : .........................… P.R.A.

P.R.A. = Protected Resource Amount for the community spouse is One-Half of the couple's countable Resources with a
         Maximum of .............................… $104,440.00*, or
         Minimum of ..............................…$20,880.00

* This maximum amount can be increased in certain cases. Contact our office to see if you qualify for this increase.

The P.R.A. is based on the resources of the couple as of the first day of the month in which an applicant enters a hospital or nursing facility and begins a continuous, uninterrupted stay.

TRANSFER PENALTIES and LOOK BACK PERIODS

(significant changes to the Transfer Penalty and Look Back rules occured on February 8th, 2006)
Transfer Penalties are assessed for uncompensated transfers, i.e. gifts or sales of resources for less than market value. The period of ineligibility for certain Medicaid benefits for these types of transfers is calculated by a formula based on the amount of the transfer. The Look Back Period is the time frame that can be examined prior to the date of application for Medicaid benefits. This examination is to assess financial data to verify assets and income - and also to determine if there were any uncompensated transfers that should be considered. The current Look Back Period is 60 months.

Non-Financial Requirements

In addition to the financial requirement above, there are also a set of non-financial requirements for the applicant for benefits. Namely, the categorical requirements of an applicant being at least 65 years of age, blind or disabled, and be Texas resident and a U.S. citizen or a resident alien to name just a few.

Also, the applicant must meet the medical needs requirement for Medicaid. This evaluation is usually completed by TDHS on a Form 3652 or level of care form.

For more information, or answers to specific questions, please contact us.