Texas Medicaid
Income Qualifications
Only Texas residents may qualify for state Medicaid. The individual may be a citizen or qualified alien and must qualify with low income and low resources. Texas Medicaid follows or exceeds federal guidelines to provide needy families, children, pregnant women, elderly, disabled and other protected groups with necessary medical care.
Identifying Income
Income is anything received in cash or in kind convertible to food or shelter. Texas Medicaid counts income in the month of receipt. Income is earned or unearned, and cash or in-kind. Income may be fixed or variable and does not include taxes withheld from wages. Income becomes a resource in the month after receipt. Texas does not count social services and medical services as income.
Resources
Resources for Medicaid purposes must total no more than $2,000, but like SSI, not all resources count. A home and lot, car, burial plot and small burial insurance, household goods and furniture are some of the items not counted. Texas counts cash, stocks, bonds, bank accounts and assets of value as resources.
Automatic Qualification
Supplemental Security Income or SSI is a federal program run by Social Security. Individuals who receive SSI who otherwise qualify for Medicaid as Texas residents can qualify for Medicaid based on SS qualification. Temporary Aid to Needy Families recipients who are Texas residents can qualify for Texas Medicaid as well. Mothers receiving Medicaid at birth automatically receive 12 months of coverage for the child. These groups automatically qualify for Medicaid.
Nursing Home and Medicaid Buy-In
Actual income cannot exceed $2,022 a month for nursing home Medicaid approval. There is a Medicaid buy-in program that requires countable income to be less than $2,257 a month. This is 250 percent of the federal poverty level. Medicaid buy-in works for disabled individuals and requires premium payments based on unearned and earned income.
Pregnant Women and Children
Medicaid eligibility in Texas applies to pregnant women with income up to 185 percent of the federal poverty level. Texas also recognizes "medically needy" pregnant women and children whose income exceeds the Medicaid limits. This group becomes Medicaid eligible if medical expenses exceed the spend down limit, calculated by subtracting income from a medically needy income limit for family of that size. Minor children in foster care usually qualify for Medicaid as well.
Children's Medicaid
Maximum monthly income limits for children's Medicaid depend on the age of the child. For children ages 1 to 5, the family of four can earn $2,444 a month, but for children 6 to 18, the income maximum for a family of four is $1,838. Families whose income is too high for Medicaid often qualify for Children's Health Insurance Program or CHIP.
