Medicaid Spend-Down in Texas

Texas is an "income-cap" state, meaning there's a hard monthly income ceiling for nursing home Medicaid rather than a medically-needy spend-down option for excess income. Asset rules follow the federal baseline most states use.

Income limit

The 2026 income limit for a single Nursing Home Medicaid applicant in Texas is $2,982/month; for married applicants where both spouses are applying, it's a combined $5,964/month. Because Texas is an income-cap state, income even slightly over this limit generally requires a Qualified Income Trust (Miller Trust) rather than a spend-down — there's no "spending the excess down" option here the way there is in medically-needy states. Nursing home residents on Medicaid keep a $75/month personal needs allowance; the rest of their income goes toward the cost of care.

Asset limit

The asset limit for a single applicant is $2,000 in countable assets — the federal baseline used by most states. For married applicants where both spouses are applying, the combined limit is $3,000.

Community Spouse Resource Allowance

When only one spouse is applying for nursing home Medicaid, the applicant spouse's asset limit stays at $2,000, but the non-applicant "community spouse" can typically retain up to $162,660 (2026) in assets, thanks to the Community Spouse Resource Allowance.

What to do if your parent is over the limit

If assets are over $2,000, asset spend-down is the standard path — see our guide on countable vs. exempt assets for what actually counts. If income is over $2,982/month, a Qualified Income Trust is typically the tool used instead of a spend-down. Our spend-down calculator can give a rough starting estimate using Texas's current asset limit, though a Texas elder law attorney should confirm any numbers before you act on them.