Medicaid – Holland Elder Law

Miller Trusts Texas. What they are. How they work.

Michael L. Holland — Tue, 04 Feb 2025 16:50:35 +0000

In some states (Texas being one of them), when the income of an applicant for Medicaid exceeds the monthly limit, a special type of document is necessary to meet income eligibility rules. Known as “income cap” states, they cap monthly income to $2,901 (for 2025). In these states, if your income is more than the monthly amount Medicaid permits, special rules allow you to redirect your income to a Qualified Income Trust. Most folks know it as a “Miller Trust” (so named for the family that brought the court action that now makes the solution possible) and as a “QIT.” In Texas, this arrangement is commonly referred to as a Miller Trust Texas solution, helping applicants qualify for Medicaid despite exceeding income limits.

Why Miller Trust Texas Solutions are Needed

A Qualifying Income Trust is set up for one reason and one reason only. In it’s most basic form a person gains income eligibility by depositing specific income received into a checking account titled in the trust name.

It’s used to process the Medicaid applicant’s income so that it fits Medicaid’s income rules. The trust must follow special rules for managing the monthly income of the person seeking Medicaid’s help. The instructions contained within the document are what make up the trust. Only income may be deposited into these types of trusts. The trust bank account is prohibited from accepting anything other than income. That is why they are generically referred to as income trusts.

Regulations require depositing income into a Miller Trust checking account authorized by the trust. Rather than using an existing account, I recommend fresh bank accounts with a zero balance. You can use a current account, but it’s too risky. In my practice, I always help clients set up a new account, which is easier and safer.

Medicaid policy limits the monthly income people can receive and still get nursing home benefits. The Federal government adjusts this upper limit for inflation each year. If the applicant’s income exceeds the limit, special rules allow them to be put into a Miller Trust.

When deciding eligibility, the Medicaid agency ignores the income deposited into the Miller Trust bank account. Using this approach reduces countable income. The apparent income reduction helps the person in need of long term care meet the strict income rules.

How Income Flows Through the Trust

A qualified income trust in Texas helps people qualify for Medicaid but it doesn’t shelter income. Money deposited into trust bank account typically flows out of the trust to pay the nursing home. It’s designed to cover part of the care costs. The balance of the nursing home payment comes from Medicaid. If any money remains in the trust after death, the state keeps it to help defray their costs.

Here’s an example of how a QIT works in Texas

Let’s say your dad needs nursing home care. He gets a monthly Social Security payment of $2,950. His income exceeds the Medicaid eligibility limit of $2,901 but is not enough to pay for the care he needs. The rules say he won’t qualify for Medicaid, but the QIT provides a way.

The first step is to hire an attorney to create a Medicaid qualified income trust. You then deposit the Social Security check into the account. This drops the amount of income the state counts against his eligibility. His Social Security income will pay part of his care. Medicaid makes up the difference.

Expenses Allowed Using The Miller Trust Texas Solution.

The Medicaid agency figures out how much of the long-term care costs an individual must pay. They add up the amount of income received each month. From that, they allow payments for health insurance premiums. Examples include premiums for

Medicare Part B,
Prescription Drug plans (Medicare Part D),
Group retirement health insurance
Medicare Supplements
Vision insurance and
dental coverage.

Payment of medical expenses not otherwise covered by Medicare and Medicaid is also allowed through the trust. The trustee (the person managing the trust) cannot use trust funds for any other purpose than what Medicaid allows.

Your dad also gets to keep a $75 out of the $2,950 for his personal needs.

If an applicant has a spouse, the trust may be able to distribute part of the income to the spouse. This allotment is called the Minimum Monthly Maintenance Needs Allowance. The Spousal Income Protection rules determine the size of this monthly allowance. For 2025, the largest allocation in Texas is $3,948 per month.

Payback Provision

The trust will typically distribute all deposited funds each month to cover the items detailed above. There is little chance the balance will grow in the qualified income trust.

Typically, money flows into the trust and right back out each month. If a person dies with a balance in the Miller Trust bank account, the state can recover what it spent on the applicant’s care. After the state is repaid, the trustee can distribute the rest to beneficiaries named in the document.

Setting up and managing a Miller Trust is not a “do-it-yourself” project. The rules are too complicated.

If you set it up the wrong way, you face a real risk of losing thousands of dollars’ worth of benefits. Remember that once you lose those benefits, they are lost to you forever. If you have income that’s too high to qualify for Medicaid, a Qualifying Income Trust makes sense. But, you must execute each step the right way.

Find an experienced Miller Trust attorney to guide you. A skilled attorney will prepare the specific instructions needed for the trust. You’ll get advice on how the trust should be set up and how to fund it. It’s the best way to avoid the pitfalls and get all the benefits from qualified income trusts in Texas.

Make Sure You Get Medicaid—Call Me Today!

A Miller Trust can help you qualify for Medicaid in Texas, but setting it up the wrong way could cost you thousands in lost benefits. Don’t take that risk!

📞 Call me now at (713) 970-1300. Get your questions answered. The call is FREE!

As an elder law attorney, I will walk you through the process step by step, making sure everything is done right. Get the care you need—call today!

Texas Medicaid Nursing Home Benefits: Do You Need an Elder Care Attorney?

Michael L. Holland — Tue, 04 Feb 2025 16:50:35 +0000

Applying for Texas Medicaid nursing home benefits is complicated. Even small mistakes can lead to costly delays. Understanding income and asset limits, Medicaid rules, and how to protect your home requires careful planning.

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.

What Is a Miller Trust?

Michael L. Holland — Tue, 04 Feb 2025 15:35:01 +0000

A Miller Trust is a type of trust that allows a person to become eligible for Medicaid even if his or her income is over the qualifying limit. It’s also known as an income cap trust or Qualified Income Trust.

Definition and Purpose

A Qualified Income Trust (QIT) is a special legal setup that helps people get Medicaid benefits by managing their income. The main goal of a Miller Trust is to help people qualify for Medicaid by putting extra income into the trust. Doing so lowers their monthly income to meet Medicaid limits.

It’s an income only trust, necessary for applicants who earn more than the Medicaid income cap but still need long-term care services. By using a Miller Trust, people can make sure their income meets Medicaid rules, allowing them to get important healthcare services without losing all their money.

Benefits of a Miller Trust

A Miller Trust provides several important benefits for people trying to qualify for Medicaid. First, it helps them become eligible for Medicaid by moving extra income into the trust. This lowers their monthly income to meet Medicaid’s income limit.

Income eligibility must be met to get Medicaid benefits. The Medicaid program covers costly long-term care services like nursing home care.

Additionally, a Miller Trust can help protect a person’s assets, like their home and savings, from being used up to pay for these services.

How to Set Up a Miller Trust

Setting up a Miller Trust involves a few vital steps to make sure it follows the law so it helps the person who needs it. First, you should talk to an elder law attorney who knows about Medicaid planning. This expert help is important to set up the trust correctly.

Next, the attorney will create the trust document, explaining the rules, the trustee’s duties, and the beneficiary’s rights. After that, you need to open a separate bank account in the trust’s name to keep the income that goes into it.

The applicant’s income must be put into this trust bank account in monthly deposits. Lastly, you must choose a trustee to manage the trust and distribute the funds to the beneficiary according to the trust’s rules.

Funding a Miller Trust

The trust only allows income; it is not designed to protect assets. Only 25 states allow Miller trusts to meet Medicaid’s income requirements.

Funding a Miller Trust means putting different types of income into the trust account. Types of income include Social Security benefits, pension payments, retirement account distributions, annuity payments, and other income that pushes the patient over the Medicaid income limit.

The income must be put into the trust every month.

The designated trustee then, the person who manages the trust, handles this money and ensures all funds are used as the trust document says. Making sure the trust is funded correctly helps keep the person’s income at a level that lets them qualify for Medicaid benefits.

Eligibility Requirements

To be eligible for a Miller Trust, an individual must meet specific criteria.

They must be a Medicaid applicant or recipient with income above the Medicaid income limit.
They must require long-term care services, such as nursing home care or assisted living.
They must meet the specific eligibility requirements for the of Texas Medicaid program.

In Texas, when an individual wants financial assistance from Medicaid to pay for nursing home care or medical expenses, he or she must meet these criteria:

There must be a medical need
They must be in a Medicaid bed
Countable resources must be under $2,000, and
Gross Income must be less than $2,901/ month

For example, let’s say your father’s total monthly income is $2,995: a check of $1,100 from a pension and $1,895 from social security. Since his total income exceeds $2,901, he would not qualify financially for Medicaid even if he had no assets. A Miller Trust is the legal means around that problem. Without one, any Medicaid nursing home financial assistance application would be denied.

Using a Qualified Income Trust is an effective solution to the problem of “too much income”, but the solution is clumsy. To fix the situation in my example, an elder law attorney must draft the Miller Trust document. The state requires checks or checks that cause income to exceed the monthly limit to be deposited in a special trust bank account every month. In this case, the solution requires either the social security check of $1,895 or the Pension check of $1,100 to go into the Miller Trust.

Keep in mind that your particular financial picture may be more complicated. If you have multiple sources of income, how you deposit those funds into the trust is critical. Funding incorrectly could disqualify the trust, preventing you from being eligible for Medicaid.

After the trust is funded, the state determines how much of the nursing home bill will be paid by the state and how much will be paid by the patient. Texas follows guidelines established by the Federal government. From the patient’s total income, the following amounts may be deducted:

A “Personal Needs Allowance” for the patient ($75 in Texas for 2025)
Premiums for health insurance such as Medicare Part B, Medicare Part D (prescription drug plans), Medicare supplements, and private health plans.
If a spouse lives “in the community” (meaning not in a nursing home), an amount to raise his or her available monthly income to the Spousal Income Protected Allowance of $3,848.00

The balance is paid to the nursing home as the patient’s “share of cost” known in Texas as the “co-pay” or the “applied income amount”.

Let’s say your father is widowed but a single person pays a Medicare Part B premium of $174 and a premium of $215 per month for a Medicare Supplement. The co-pay calculation would be $2,995 per month less the Personal Needs Allowance of $75 less the Medicare Part B premium of $174, less the $215 Medicare Supplement premium for a total of $2,531.

If your father is married and his wife lives at home, she would be entitled to the greater of her monthly income or $3,948 of their combined income. Let’s say her gross income is $900 each month from Social Security. That brings their total family income to $3,895 (dad’s $2,995 and mom’s $900)

Since her income is less than $3,948, your father can direct the difference through the Miller Trust to her every month. This would reduce the applied income payable to the nursing home to about $1,631.

The Houston area’s nursing home room and board costs run about $7,500/month. Using a Miller Trust allows your Dad to become income-eligible and dramatically reduces his cost of care.

Upon the Medicaid recipient’s death, the state is named as the beneficiary of the Miller Trust and will receive the remaining funds.

You’re safer hiring an elder law attorney experienced in creating Qualified Income Trusts to guide you. Drafting and funding a Miller Trust is exact. I can help.

If you have a question about Miller Trusts, call me at 713-970-1300.

How to Find The Right Elder Law Attorney To Help You

Michael L. Holland — Sun, 02 Feb 2025 16:50:34 +0000

To find the right Houston Elder Law Attorney can feel overwhelming, especially when you’re dealing with Medicaid planning, rising nursing home costs, or protecting your family’s assets. The truth is that the wrong choice could lead to unnecessary stress, financial loss, and missed opportunities for securing care. That’s why it’s so important to find an attorney who truly understands your needs.

In this article, we’ll walk you through five key traits to look for, helping you find a trusted advocate who will guide you through this complex process with confidence and peace of mind.

When you find yourself in need of an Elder Law Attorney, you usually won’t have much time to make a decision. Maybe you just found out that Medicare only covers the first 100 days in a nursing home. Perhaps you’ve just been told you’re ineligible for Medicaid. Maybe the hospital just informed you they are discharging your loved one to a long-term care facility, and you’re frightened by the high cost of care.

There’s almost always some dire financial emergency looming in front of you and your family. The sooner you find a solution to your problem, the better.

However, you can’t allow a stressful situation to get in the way of finding the right Elder Law Attorney for you. After all, this person will be responsible for protecting your family’s financial well-being! To get the most out of your legal advice, it must come from someone you can confide in and trust.

5 Traits to Look for in a Houston Elder Law Attorney

Sounds like a pretty tall order, right? Here are five traits to look for to find the right Houston Elder Law Attorney:

1. Focused in Elder Law

It might seem obvious, but this should your ideal attorney’s first and most important trait: their law firm should focus on elder law.

Many folks will turn to general purpose attorneys for Elder Law-specific advice. Doing so can be a a huge mistake. The sheer volume of State-specific policies associated with elder care, and with Medicaid in particular, makes it extremely important to work with an attorney experienced in this area of the law.

Here’s a good rule of thumb: if less than 25% of your prospective attorney’s cases involve Elder Law, consider working with a more experienced attorney. The more experienced, the better – competent elder law advice will always pay for itself.

2. Eager to Help You

Elder Law tends to be time-sensitive, so it’s important that you find an attorney who’s going to help you identify an optimal solution quickly. If you find yourself facing down eminent monthly nursing home costs, for example, then an eager Elder Law Attorney will be the one who makes sure you get the maximum short-term and long-term health care coverage.

In addition, an eager attorney will be easy to get a hold of. It’s stressful to need immediate legal advice and be unable to get in touch your attorney. If you get the feeling that your prospective attorney is overbooked, or if they make you feel like “just one more client then find a Houston Elder Law Attorney who’s going to pay attention to your problems.

Which brings me nicely to the next trait…

3. Compassionate Toward Your Specific Needs

A good Elder Law Attorney is compassionate. In other words, he or she genuinely cares about your problems and wants to help you solve them. He or she treats you the same way they’d treat a close friend or loved one.

A compassionate Elder Law Attorney is always on your side, and makes it a point to help you and your family as much as possible. This is particularly important during Medicaid planning or application because of the many fine-print policies that can make an enormous difference in asset protection. A truly compassionate attorney will do everything in their power to maximize the coverage that Texas’s Medicaid program will provide for your loved one.

4. Offers Transparent Legal Advice

While it’s important for you to trust that your attorney is 100% on your side, it’s also important for your attorney to be completely upfront with you. When your life’s savings are at stake, you want to know exactly which incomes and assets are on the table. The better Elder Law Attorneys know one of the most important ways to help a family cope in times of a financial crisis is by setting realistic expectations.

Keep in mind that this transparency should also apply to your attorney’s fees. Ideally, your attorney makes their payment-structure intuitive and easy to understand. If you have a billing question, you want a straightforward, no-nonsense answer.

5. Official NAELA Member

There’s an organization for Elder Law Attorneys called the National Academy of Elder Law Attorneys. It’s a group dedicated to the improvement of legal services for the elderly and the disabled. Its members make a commitment to continued education in elder law. They also tend to support other organizations that help the people they serve.

In short, NAELA serves as a benchmark for quality Elder Law Attorneys, and its members are much more likely to demonstrate all of the traits listed in this post.

If you want trustworthy legal advice on anything from Medicare, Medicaid, long-term care insurance, estate planning, guardianship, social security, or anything related to elder law, look for the NAELA badge, just like the one at the bottom of this page.

In the end, remember that an Elder Law Attorney should be there to help you.

By following the traits outlined in this article, you’re much more likely to find that “perfect” Elder Law lawyer – the one who’ll make your life easier, secure your financial legacy, and ultimately provide your family with more freedom and peace of mind.

The Holland Elder Law team does its best to uphold these traits. If you have a question or legal issue, discover what a good Elder Law Attorney can do for you.

Take Action Now – Secure Your Family’s Future!

Figuring out Medicaid, nursing home costs, and asset protection can be confusing, but you don’t have to do it alone. Making the right choices now can save you money, time, and stress down the road.

📞 Call us today at (713) 970-1300 for a FREE consultation!

We’ll help you understand your options, make a solid plan, and protect your loved one’s care and finances. Don’t wait—call now and get the guidance you need!

7 Mistakes That Will Kill Your Miller Trust.

Michael L. Holland — Thu, 09 Jan 2025 22:02:39 +0000

One of the most persistent myths is that a Miller Trust in Texas can protect assets from Medicaid.

I don’t know why this misunderstanding persists, but it does.

The truth is simple: you cannot use a Miller Trust in Texas to shelter assets. If you try, you invalidate the trust and lose benefits. The consequences can be serious for families who don’t know the rules.

*Been told income is too high to get Medicaid? Use my 100% guaranteed Miller Trust. Put an end to high nursing home bills and sleepless nights. 713-970-1300

How a Qualified Income Trust Will Help You Get Medicaid in Texas

Federal and Texas law limit how much gross income you can have and still qualify for Medicaid nursing home benefits. The income limit is low, well below the average monthly cost of nursing home care. Years back, this restriction would keep patients from becoming Medicaid eligible.

The income cap for Medicaid nursing home care in Texas is a critical factor, as individuals with income above this cap may not qualify for Medicaid benefits.

In 1993, Congress established laws to address the problem by allowing applicants to set up a special purpose income trust, known as a qualified income trust, to determine Medicaid eligibility. The new rules allow applicants to set up a special purpose income trust – a Miller Trust.

Thankfully, they won.

The legal description for this type of document is a Qualifying Income Trust. The name spells out the only purpose of the trust. It’s designed to help someone become income-eligible for Medicaid benefits.

Miller Trusts Ensure Income Eligibility

A basic limitation of Qualified Income Trusts is that only the income of the person needing care can go into it. Medicaid’s income limit for 20245 is $2,901 per month. This limit changes each year. If a person has income over the threshold, the only way to become eligible is to set up a Texas Miller Trust. If you have too much income to qualify but too little to pay the large nursing home costs, a Miller Trust can help you qualify for Medicaid even if your income exceeds the Medicaid income limit.

Without a Miller Trust, you can’t.

That is why it’s so important to put one of these income cap trusts in place. But you must do it in the right way. Unless you’re using a Medicaid planning attorney in Texas skilled with these documents, you can get this wrong. Only the income of the person needing care can be deposited. Medicaid rules consider assets in the trust as “wrong money.” If the “wrong money” gets deposited into Texas Qualified Income Trusts Medicaid will deny the application.

Denials are costly mistakes. They ruin your chances of qualifying for Medicaid money to pay for high nursing home costs.

How Income Trusts Work for Medicaid Eligibility

The Miller trust document establishes a special checking account. Qualified income trusts, also known as Miller Trusts, are used to help individuals qualify for Medicaid long-term care services when their income exceeds the Medicaid income limit. The terms of the trust legally redirects monthly income away from the care recipient. Instead, the patient directs his or her income into a new checking account. When properly managed the character of the income changes under Texas Medicaid Income rules

Excess income no longer prevents eligibility. A Miller Trust does not shelter income; instead, it acts as a funnel. Rules restrict how the income deposited in the trust account can be used, and the funnel follows those rules to flow money from the patient to medical providers.

This approach works because the language of the trust recycles the money back out to help the patient pay nursing home and medical expenses. Income is no longer considered for eligibility purposes. It is considered, however, when the state calculates how much the patient pays for care.

Income deposits into the trust may also provide funds to a spouse if the patient is married. In Texas, Miller Trust funds can also be used to pay for health insurance and Medicare premiums. Medical costs not covered by Medicare and Medicaid can also be paid from the trust. Rules also allow a $75 personal needs allowance for the patient.

Misconceptions About Qualified Income Trusts

A frequent mistake families make is setting up the trust incorrectly. The benefits of a Miller Trust in Texas can be lost by not understanding the language required to establish the trust in the first place. The rules for Texas Miller Trusts are precise. The problem is most don’t understand the rules.

Another mistake I see has to do with the amount of money people put into the Medicaid trust. Sometimes they “round off” the amount. Sometimes they put only a part of a Social Security or retirement check into the trust. When the deposited amount differs from what the law requires, a Medicaid agency attorney can void the trust. Caseworkers may view an incorrect deposit as an attempt to protect the income.

This small change can mean losing thousands of dollars of financial help.

Another mistake is people try to put funds other than income into their trust account. Miller Trusts are income-only trusts. The monies that go in must only come from the patient’s income. Putting other money into the trust account is a big mistake. When you place other anything else in the trust you run the risk of voiding the entire trust. Examples of disqualifying income include income tax refunds, some annuity payments, vocational rehabilitation, or some financial help from the Veteran’s Administration. This simple mistake translated into losing Medicaid eligibility.

If you need a Texas Miller Trust, work with an elder law attorney who understands how Medicaid rules work with the income cap. A skilled elder law attorney will help you avoid small mistakes that lead to big problems. Something as simple as not depositing income by the last business day of the receipt month can cause problems. Some pension benefits are received on the last day of the month. If the deposit isn’t made during the same calendar receipt month, Medicaid policy requires the State to count the income. Eligibility can be lost.

Setting up and funding a Miller Trust account can be tricky. Simple missteps lead to losing thousands of dollars of benefit eligibility. ..money you can’t recover. There’s an easy way to avoid each of these serious blunders. If you need a Miller Trust to qualify for Texas Medicaid, hire an elder care attorney. Follow the advice of a lawyer with extensive Texas Miller Trust experience. You’ll be able to qualify faster, save money and reduce the emotional stress of the process.

5 Reasons to Hire a Houston Elder Law Attorney for Medicaid Planning

Michael L. Holland — Thu, 26 Oct 2023 10:50:34 +0000

There are many reasons you might be looking for an elder law attorney for medicaid planning in Houston, Texas. However, one of the most common reasons is that you or a loved one is facing the need for specialized long-term nursing home care.

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.

Medicaid Income Cap States in 2025

Michael L. Holland — Thu, 26 Oct 2023 10:50:31 +0000

Certain states impose strict Medicaid income limits, known as “Medicaid Income Cap States.” This article explains which states have these restrictions, how Medicaid eligibility is determined, and how a Miller Trust can help applicants qualify. Learn how an elder law attorney can guide you in navigating Medicaid rules to protect your assets and secure nursing home benefits.

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.