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Do you understand Texas Medicaid eligibility requirements?

Here's the one truth you can rely on regarding Medicaid coverage: It's not as easy to understand as you might hope for. Medicaid eligibility -- and applying for Medicaid -- is complex. While both states and federal governments have attempted to make the planning and application processes easier, Medicaid eligibility is based in part on income levels, which means you have to provide financial and other information when you apply.

It doesn't help that eligibility thresholds are listed as a percent of federal poverty level by the federal government, and the information published by federal Medicaid doesn't always appear to line up with information published by state programs. For example, the federal government lists the eligibility of Texas Medicaid for children of various ages; in the first year, a child is eligible if his or her household reports an income less than 198 percent of federal poverty level. The income requirement is lower for older children and parents of children, though pregnant women qualify at 198 percent as well.

Medicaid also comes into play in elder care situations, depending on someone's income level and other insurance requirements. Most older residents are also going to qualify for Medicare benefits, which means that Medicaid benefits might be used as the secondary coverage for someone with a qualifying income. This can help families find and pay for assisted living or nursing home care when needed.

Understanding how Medicaid works and whether or not you might qualify is only the first step in Medicaid planning. Even after you begin receiving benefits, you might need to work through the system to ensure those benefits remain in force. Seeking assistance with Medicaid planning alongside your estate planning services can be a helpful way to manage such a complex issue.

Source: Medicaid.gov, "Texas," accessed Dec. 11, 2015

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