From The Law Office of Whitney L. Thompson, PLLC – Does Texas Have Spend Down Medicaid? breaks down the essential differences between Medicaid’s income spend-down rules and the income-cap system used for long-term care in Texas. This episode highlights how the Medically Needy Medicaid program in Texas allows pregnant women and children under 19 to qualify through spend-down, while adults needing long-term care must navigate income limits using tools like the Qualified Income Trust (Miller Trust).

Listeners will learn how the spend-down process works—similar to a monthly deductible—and what qualifies as a valid medical expense under Texas rules. We cover examples of unpaid bills that can help meet eligibility, including prenatal care, prescriptions, ultrasound tests, and lab work. The role of the Texas Medicaid and Healthcare Partnership (TMHP) Clearinghouse is also explained, along with tips on submitting bills using Form H1120 and maintaining thorough documentation.

For families exploring long-term-care Medicaid, we unpack Texas’s income-cap model, including the 2025 limit of $2,901 per month and the strict rules around countable versus exempt assets. You’ll hear how common assets like a primary residence, vehicle, and personal effects may be protected, while others like bank accounts, investments, and certain life insurance policies count toward the $2,000 limit. We also cover the five-year look-back period, its penalties, and what types of transfers may trigger ineligibility.

Finally, we offer actionable strategies for asset spend-down, such as paying off debt, investing in home modifications, purchasing medical devices, and setting up Medicaid-compliant funeral trusts or caregiver agreements. Host Whitney L. Thompson, a trusted Houston Medicaid planning attorney, brings clarity to this complex topic and shares how her firm supports families across Harris County. Whether you're planning for nursing home costs or seeking coverage for a child or pregnancy, this episode offers the guidance you need to move forward with confidence.

The Law Office of Whitney L. Thompson, PLLC

4201 Farm to Market 1960 Rd W Suite 360, Houston, TX 77068, United States

(281) 214-0173

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