This article explores whether you should hire an elder care attorney, how they can speed up the process, and why their guidance can help protect your assets and secure Medicaid approval faster.

Whether or not it’s advisable to hire a Houston Elder Law attorney to prepare and submit your application for Texas Medicaid nursing home benefits turns on several questions:

• How complicated is the applicant’s financial picture?
• How well-organized are you?
• How much time do you have available?
• How comfortable are you dealing with a government bureaucracy?
• Can you afford to lose a month or more of eligibility if you are denied eligibility because of an error?

Medicaid offers a variety of financial support programs. The application process for non-nursing home programs is relatively simple. Most people can apply without help.  Nursing home benefits are a different matter.

Nursing home Medicaid is a form of insurance for long-term care costs. Because the cost of nursing home care is so high (over $6,500 monthly in Texas), most middle-class families need this program to help cover the monthly fees.  The long-term nursing home coverage application process is complex and confusing to the inexperienced. Relying on the skills of an experienced Elder Law attorney is a near necessity.

Successfully applying for Medicaid requires meeting strict guidelines on income and assets. It also requires you to understand the terminology and definitions unique to the program. Like all government agencies, the Texas Department of Health and Human Services (which runs Medicaid in Texas) has its own definitions for the terms used in its regulations.

How they define “income,” for example, differs from the definition used by the Internal Revenue Service or the Veteran’s Administration. The agency counts some forms of income when determining income eligibility. It ignores other.

For example, the “aid and attendance” income portion of a Veteran’s enhanced pension is not “countable income.” Social security, pensions, interest, dividends and IRA distributions count.

If the applicant’s countable monthly income exceeds the limit, an Elder Care attorney can draft a special document called a Qualified Income Trust. But, drafting the document is only half the battle.

You’ll also need to attach a bank account to the trust. The bank account receives the income, but not necessarily all of it. The State also has rules regarding how and when money must be deposited into the trust and how it’s paid out.

Handled improperly, Medicaid can disqualify the trust, costing a family thousands of important Medicaid dollars.

Texas also limits the amount of assets a person can keep and still qualify for benefits. As with income, certain assets are not counted. Examples include the personal residence, prearranged funeral plans and one automobile.

Yet, to exclude these items Medicaid requires other rules to be met. The Medicaid caseworker is legally required to count these otherwise excludable resources when they fail to meet all the requirements for exclusion.

How Medicaid treats a personal residence is another complicating factor. Just because the house is not counted when determining eligibility doesn’t mean it’s protected. Medicaid considers the money provided by the agency like an advance.

It’s not a gift from the government.

That means the State has a legal right to recover the amounts they’ve spent once the person passes on. Since the home is typically the largest asset a person owns when they die, you face the very real possibility of the state forcing the sale of your home get repaid for the funds used to pay for your care.

A good Elder Care attorney plays a valuable role. Hiring a Houston Elder Care attorney has several advantages:

* Expert guidance on the best way to qualify for Texas nursing home Medicaid
* How to get benefits sooner
* How to keep your share of costs as low as possible
* Experience dealing with complications as they arise
* Serving as your advocate through a challenging application process
* Protecting the family home

A drawback to hiring an attorney is the fee you’ll incur. Given the high monthly cost of Texas Nursing home care, if an attorney can speed up eligibility by as little as a month or two, you’ll generally cover the fee and then some.

For some families the peace of mind that comes from knowing the application is in capable hands is enough to justify hiring an attorney. Also keep in mind the funds used to pay the attorney would have likely been paid to the nursing home anyway.

The health of my widowed 74-year-old mom is starting to decline.  My sister and I understand mom must have limited assets to qualify for Medicaid. She owns an annuity and bank accounts worth about $100,000. A coworker tells me she can give each of us $19,000 yearly without a Medicaid penalty. Is this right?

Answer:

Your coworker is confusing a rule dealing with income and gift tax rules with Medicaid rules – a common and financially dangerous mistake.

Your co-worker refers to an exemption under the Federal Internal Revenue Code. Under that code, the first $19,000 of gifts made in a given year to an individual are exempt from gift tax.  The exemption allows families to distribute wealth by reducing the size of their estate taxable at death. 

However, that exemption does not apply to situations when applying for Medicaid benefits. Families wrongly believe the annual gift tax exemption shields them from Medicaid’s transfer penalty if nursing home care is needed sometime in the future.

It doesn’t. In fact, the opposite is true.

When an application is filed, you must list all gifts and property transfers made in the five years preceding the application.  The gifts are then added to determine how long the penalty will last.  In Texas, for approximately each $7500 gifted, Medicaid delays eligibility for a month.  A gift of $100,000 could delay benefits for 13 months.   When gifts like these are made with the belief that the money is protected, the recipients spend rather than save it. If Medicaid imposes a penalty, where will the money come from to pay for your mom’s care during that time? The result can be a terrible hardship on the entire family.

Giving away assets can be an effective Medicaid asset protection strategy used properly. Even if you’ve already made such gifts, an Elder Law attorney experienced in Medicaid estate protection planning can guide you on the right steps to take now that protect assets and increase your chances of qualifying for Medicaid assistance.

Not-So-Obvious Planning Pot Holes Derail Savings

What most people don’t realize is the number of other laws that need to be considered along with the Medicaid rules. Medicaid asset protection collides with with laws related to gifting, taxes, protecting assets, business succession, insurance, capital gains and income taxation.  Most of the issues are not obvious. Which is why who you turn to for Medicaid asset protection advice needs to be well-experienced.

As America’s population ages, the number of so-called “Medicaid planners” increases.  Financial planners see Medicaid planning as fertile ground for profits.  The problem is too many of them don’t understand the complexities. Not understanding the complexities leads to denied applications, lost time, lost money, and benefits you can never recover. Perhaps more important than the financial losses are the additional emotional stresses you suffer that could have avoided.

Experience matters

Planning doesn’t occur in a vacuum. Medicaid planning is more than “spending down” assets.  Most of my clients want to preserve assets for a spouse or their children but want to do so while getting good care in a decent setting they can afford. When you hire someone to help with your Medicaid planning, experience counts. Make sure the person you choose knows more than one way to gain eligibility and has a track record to prove it. Look for a person with a depth of knowledge who can create an effective Medicaid asset protection plan.

You can read the Dallas Morning News article by clicking this link.

Unfortunately, many families unnecessarily lose tens of thousands of dollars by opting to privately cover the cost of long-term care. Usually, they’ve been told that they’re ineligible for Medicaid, or they’re just generally misinformed about their options.

Did you know that the average cost of nursing home care in the US is $8,000 per month?

For example, if your loved one has been sent directly from a hospital to an nursing home for thereapy, there’s a good chance nobody told you that Medicare only lasts 100 days. You might be facing an $8,000 nursing home bill with less than 30-day’s notice! Many families assume they’re on their own at this point, even though Medicaid is designed to help pay nursing home costs in situations like these.

No matter what specific circumstances are causing you or your loved one to seek long-term nursing home care, here are five really good reasons to see a competent elder law attorney

Reason 1 – Nursing Homes are NOT Non-Profit Organizations

You’d be surprised how many families automatically assume that nursing homes are either non-profit or government-funded organizations. Neither is true – nursing homes are a business like any other. Their goal is to sell their service (elder care) and make a profit. They’re not in business to provide accurate legal advice or to help your family understand their options. And they’re certainly not there to save you money!

Nursing homes often make more money from their privately-funded residents than their Medicaid-funded ones. This is because nursing homes can charge you or I much more per month than they can charge the government. Strictly from a business perspective, nursing homes actually want you to pay for their services on your own.

Of course, this isn’t to say that nursing homes and their staff are trying to steal your money. Some of the kindest and most true-hearted people I’ve ever met work in nursing homes. But, their job is to provide a safe environment with good care. It isn’t to save you money.

Reason 2 – Peace of Mind

Your peace of mind  is the most important benefit of hiring an elderly law attorney.  A competent attorney will answer all your questions accurately and provide a clear course of action for you and your family to take. He or she will tell you exactly what to expect throughout the process of Medicaid planning and qualification, which medical expenses you should plan to cover and for how long.

Reason 3 – Save Every Possible Penny

An elder law attorney’s chief goal is to help you preserve a financial legacy for your family. You don’t have to use everything in your bank account to help pay for nursing home costs. An elder law attorney will help you understand what’s protected and what’s not. This is the key to making the most of you and your loved one’s current income and assets.

Reason 4 – You’re Ineligible for Medicaid Coverage

Or so you might think…

If you need Medicaid to help pay for nursing home costs, but you looked at the income and asset guidelines and believe you’re ineligible, think again. The Texas Medicaid program is complex. Chances are that you can qualify for financial help sooner than you think. For example, a Miller Trust can help you protect certain types of income that would otherwise go directly to the nursing home.

Whatever income and assets you have available, an elder law attorney can help you make the most of your financial resources.

Reason 5. You Need Medicaid Coverage — Fast!

The faster you need financial assistance, the more important it is that you seek the services of an experienced elder law attorney for Medicaid planning. Most of my clients approach me needing immediate help with a Medicaid-related problem. Even if you have a family member in a nursing home now, it’s not too late to get help.  When it comes to Medicaid – the sooner you act the better.

Lawyers focused in elderly care law are the people who can reliably protect the maximum amount of income and assets in the shortest time possible.  These are just five reasons to consider talking to an elder law attorney.  This article is too short to cover  all the specific circumstances that warrant contacting an elder care law firm.

📞 Call Me Now for a Free Strategy Session – Let’s Protect Your Savings!

I know how overwhelming nursing home costs and Medicaid planning can be. If you’re worried about losing your savings or being denied benefits, I can help.

📞 Call me today at (713) 970-1300 for a FREE strategy session!

Together, we’ll find the best way to qualify for Medicaid, protect your assets, and secure the care you need. Don’t wait—call now and let’s get started!

Whether your spouse, your sibling or your parent is the one in need of long-term care, you CAN get help paying nursing home costs.

Finding a good Houston elder care attorney isn’t easy, especially if you don’t have much experience working with lawyers. Fortunately, you don’t have to be a legal expert to find the right elder law attorney for you. Separating the wheat from the chaff is as simple as a few straightforward elder law questions.

6 Questions to Help You Identify the Perfect Houston Elder Care Attorney

Question 1 – “What Area of Elder Law Do You Focus On”
This is one of the most important questions to ask an elder law attorney because it’s the best way to get a feel for their level of expertise.

You see, the entire field of elder law is massive, and there’s no way to be a true expert in everything. Here at Holland Elder Law, I focus on nursing home care, Medicaid and estate planning, and that’s what I’ll tell you upfront. However, if your potential Houston elder care attorney can’t tell you a specific area of expertise, or if their specialty isn’t what you need help with, you may wish to consult someone else.

After all, the reason you hire an attorney is for expert legal advice, right?

Question 2 – “Are You an Official NAELA Member?”
The National Academy of Elder Law Attorneys is an organization for legal professionals in the areas of elder and special needs, all of whom are dedicated to the continued improvement of their legal services. You can visit the NAELA website at  for an official state directory to help you choose a NAELA member in Houston.

Question 3. “How would you describe your typical client?”
Ideally, you’d like to work with an elder law attorney who works with clients similar to you or your loved one. As with Question 1, the goal of this question is to assess how much attention, enthusiasm and expertise your prospective lawyer will bring to your case.

Question 4. “How long have you been practicing in Texas?”
Especially for something like Medicaid planning, which involves a unique set of policies from state to state, it’s important to find a Houston elder care attorney or law firm who’s been practicing in Texas for several years. That way, you can rest assured that they know Texas state laws inside and out, ensuring that your legal issues will be resolved optimally.

Question 5. “What is your preferred method of communication?”
Setting clear communication expectations upfront will make your life much easier. Figure out how your attorney likes to communicate – email, in person or over the phone – and how often they like to do so. You want to find a lawyer who will do a good job of keeping you in the loop with a communication style that works for you … This question is how you figure that out.

Question 6. “What are your fees to solve my problem?”
This one is both obvious and self-explanatory, but it’s listed here because it’s important. Try to get a total project estimate. Shopping around on hourly costs alone won’t give you the full picture. Avoid simple price shopping. You are not buying a commodity. You want the best advice possible at a time like this. Paying for a lawyer you like and trust is a worthwhile investment. A quality elder law attorney will pay you back in peace of mind and saved nursing home care costs.

Time to Start Interviewing

That’s it! These six questions to ask an elder law attorney should make it easy to choose which of the lawyers in Houston you want to work with. As you’re making your decision, remember that expertise is worth paying for and that your personal preference matters.

If you have any more questions for me, I’d be happy to answer them. I offer a free consultation for all new clients. Give me a call (713) 970-1300 or shoot me an email and I’d be happy to chat. Finding a Houston elder care attorney you can trust doesn’t have to be daunting – just shop around, trust your gut, and don’t be afraid to ask questions!

What is a Durable Financial Power of Attorney? What about an advance healthcare directive? What about a living will?

When it comes to legal and financial planning, it’s easy to feel overwhelmed. Every specialized area of life has its own vocabulary. Estate planning and elder law have their own lingo, too. Without understanding these key terms, it’s easy to get frustrated trying to properly protect yourself and those you care about.

The shortest path to peace of mind when planning is knowledge. The simple act of understanding the words involved, will inoculate you from getting lost or overwhelmed. Continue reading to better understand three cornerstone estate planning documents:

• Powers of Attorney,
• Durable Powers of Attorney, and
• Living Wills

The Differences Between a Texas Durable Power of Attorney, Medical Power of Attorney and Living Will.

What is a Power of Attorney?

Before we can discuss the different types of Power of Attorney (POA), it’s important to understand exactly what a POA is supposed to do.

A Power Of Attorney is a legal document that gives one person (the attorney-in-fact) the right to act and/or make decisions on behalf of another person (the Principal). What specific actions or decisions can be made by the attorney-in-fact vary according to the specific contents of the written Power of Attorney.  A general or uniform Power of Attorney is what you’ll use when the Principal wishes the attorney-in-fact to have complete legal control over their affairs.

What is a Texas Durable Power of Attorney?

A Durable Power Of Attorney, short for Power Of Attorney with Durable Provisions, is required when the attorney-in-fact wishes to continue acting on behalf of the Principal even after the Principal suffers a disability or legal incapacity. For example, if your parent or loved one suffers from a cognitive or mental issue but has prepared a Durable Power Of Attorney, the person they designate can serve as that person’s surrogate decision-maker no matter how their illness progresses.

Without the additional durability language the authority in the document ends with the Principal’s loss of cognition.

Types of Power of Attorney

Now that you know the difference between a non-durable and Durable POA, let’s quickly run through the some unique Powers of Attorney forms you might request from your elder law attorney. Sometimes, a general POA isn’t the right solution, so these are some alternatives to consider:

Medical Power of Attorney: Otherwise known as a Health Care Power Of Attorney, this is a limited POA that explicitly provides the attorney-in-fact with the authority to handle medical and healthcare-related decisions in the event that you no longer can make those decisions for yourself.

Financial Durable Power of Attorney: Much like the Medical POA, this is a limited Durable Power Of Attorney that only gives the agent legal power to make decisions over the Principal’s financial affairs.

These are the two most common “limited” Powers of Attorney, but hopefully you are starting to understand how to decipher what each type might mean. Last but not least, we have a living will.

What is a Living Will?

A living will, which is not the same thing as a living trust, is what’s called an “advance healthcare directive”. In plain English, it’s a legal document that officially describes you or your loved one’s life-prolonging healthcare wishes. For example, if you have a debilitating stroke and don’t wish to be kept alive on life support, a living will is how you make that clear to your family and healthcare providers. A living will cannot become effective until the Principal has become incapacitated.

Putting the Pieces Together

The goal of this article is to make it easier to talk to your Houston Elder Law lawyer about proper estate planning. By knowing the difference between general and limited Powers of Attorney, making an informed decision with your parents or you and your spouse should be much easier.

If you have further questions about living wills, Durable Financial Powers of Attorney or anything else related to estate planning, call (713) 970-1300. I’d be happy to help you and your family plan ahead.

A number of states apply Medicaid income limits.  These states are referred to as “Income Cap States.  The legislature in each strictly limit the amount of income an applicant for Medicaid nursing home benefits can have and still qualify for benefits.

Medicaid Income Cap States In 2025

• Alabama
• Alaska
• Arizona
• Arkansas
• Colorado
• Delaware
• Florida
• Georgia
• Idaho
• Iowa
• Kentucky
• Louisiana
• Mississippi
• Nevada
• New Jersey
• New Mexico
• Oklahoma
• Oregon
• South Carolina
• South Dakota
• Tennessee
• Texas
• Wyoming

Important note:

Income qualification is still possible- even if the applicant has “excess income” – by using the services of an elder law attorney. When income exceeds the annual limit in Texas, you have a simple solution. It’s a special attorney-drafted agreement known as a Miller Trust.   Without a Miller Trust, state law requires the caseworker to deny the application.

Medicaid Income Limits

In most states for 2025, the income limit for a single person seeking nursing home assistance is $2,901 of “countable income”. Some states set the limit higher. In Texas, the legislature sets that limit to $2,901.

Texas Medicaid considers income as payments bestowing a benefit to a household. Medicaid rules count some income when deciding how much a person must pay for care. Policy can also exclude certain income from that calculation.  Factors specific to an income source determine if it’s countable.

Is Medicaid Eligibility Based on Income or Assets?

Medicaid uses both income and the value of a Medicaid applicants’ assets to decide eligibility.   You will hear attorneys, nursing home personnel and caseworker  also call them “resources”, “countable assets” and “countable resources.”

Medicaid rules offer a number of exceptions to what might be considered a “countable” resource subject to spending down. In Texas,  the applicant’s personal residence, an automobile, personal jewelry, clothing and furniture and fully paid funeral arrangements are not counted toward financial eligibility.

When a senior’s resources exceed the Medicaid eligibility limit, the applicant (and spouse, if married) must use part of those excess assets to pay for their expenses until their assets are reduced to the limit.

As long as one spouse is not seeking Medicaid help (called the “community spouse”), federal and state law allows married individuals to keep  more assets than a single person. For 2025, federal law guarantees a minimum protection level of $31,584.

Medicaid has rules that protect assets. Sadly, most people are unaware that state Medicaid policies allow them to protect more of their life savings—the uninformed end up spending more than the law requires.

Don’t let that happen to you.

Proper planning can save you and your family substantially more than the minimum spousal protection level. A person with resources that are greater than Medicaid’s limits may still be able to qualify for financial assistance.

Don’t overspend assets. Here’s a solution…

Find an elder law attorney experienced with Medicaid matters. The advice can prevent over spending for nursing home care. By using the laws, you can qualify faster and protect more assets and get eligibility.