Texas Medicaid Income Limits 2026: Do You Qualify?

Texas Medicaid income limits depend on the coverage you need: for long-term care in 2026, an individual's monthly income cap is $2,982, with an asset limit of $2,000.1,2 For a working-age adult who isn't disabled, the answer is harder, because Texas is one of the ten states that never adopted Medicaid expansion, so income alone usually won't open the door.3 Which rule applies to you comes down to your age, whether you need nursing-home-level care, and whether you have a dependent child at home.

In This Guide

• Which Texas Medicaid Are You Asking About?
• Texas Medicaid Income Limits for Regular Adults
• Texas Medicaid Income Limits for Long-Term Care
• Turning 65: The Aged and Disabled Track
• The Asset Limit and the Five-Year Look-Back
• What a Nursing-Home Resident Keeps
• Protecting the Spouse Who Stays Home
• Frequently Asked Questions
• Learn More

Which Texas Medicaid Are You Asking About?

"Do I qualify for Texas Medicaid" doesn't have one answer, because Medicaid covers different groups under different rules, and the number that decides your case changes with the group. Before you look at any dollar figure, figure out which path fits your situation:

• Working-age adults under 65 are the group Texas treats differently from most of the country. Because the state never adopted Medicaid expansion, an adult who isn't pregnant, disabled, or caring for a dependent child usually has no income-based pathway to full Medicaid at all.3
• People who need long-term care, in a nursing facility or through a home-based waiver, face a specific monthly income cap and a strict asset limit, because long-term-care Medicaid runs on its own math.1,2
• Adults 65 and older, and people with disabilities are measured under Supplemental Security Income rules rather than a percent of the poverty level, and this track applies an asset test.4

The rest of this guide walks through each of these paths, starting with the one that surprises Texas families most.

Texas Medicaid Income Limits for Regular Adults

Here's the part that trips people up. In most states, a working-age adult can qualify for Medicaid up to 138 percent of the federal poverty level. Texas is not one of those states. It is one of the ten that did not adopt the Affordable Care Act Medicaid expansion, so the "new adult group" that carries that 138 percent limit simply doesn't exist here.3,4

To see what that costs a Texan, it helps to know what the number would have been. The new adult group covers adults under 65 with income at or below 133 percent of the federal poverty level, and because eligibility is figured under Modified Adjusted Gross Income (MAGI) rules, the tax-based method that adds a 5 percentage-point disregard, the effective ceiling lands at 138 percent.4 In 2026 the federal poverty level (FPL) is $15,960 a year for one person, which puts 138 percent at roughly $1,835 a month.5,4 That is the coverage a low-income adult in an expansion state would get, and the coverage a Texan in the same situation generally cannot.

The practical result is what's known as the coverage gap. In nine of the ten non-expansion states, Texas among them, adults with income below the poverty level can earn too much for Medicaid yet too little for Marketplace premium subsidies, leaving them with no affordable path in either direction.3 If that describes you, don't stop at this page. Check whether another door reaches you first, as a parent or caretaker relative, or on the basis of a disability, and price out a plan through the Health Insurance Marketplace at HealthCare.gov, where your income may qualify you for a subsidy even when Medicaid won't.

One thing this section is not saying: Texas does cover children, pregnant applicants, and some very-low-income parents through the MAGI pathway, and for those groups federal law bars any asset or resource test.4 If there's a child in the household, the family's options are broader than a single adult's, and applying is the only way to know.

Texas Medicaid Income Limits for Long-Term Care

Long-term-care Medicaid, the coverage that pays for a nursing facility or home- and community-based services, works on a completely different track, and here Texas is more generous than it is for regular adults. For 2026, an applicant's monthly income must be at or below a special income limit of $2,982, or $5,964 for a couple when both spouses are applying.1 That figure is set at 300 percent of the individual SSI benefit rate, and the test HHSC applies is countable monthly income, not simply every dollar that arrives: Social Security and pensions generally count, but certain Veterans Affairs benefits do not count toward Medicaid eligibility, so the first step is working out which of your income actually counts.1

Texas is an income-cap state, which changes what happens when you're over the line. In a state like this, countable income even a few dollars above the cap makes you income-ineligible for that month unless you take a specific step: routing the excess income through a Qualified Income Trust, also called a Miller Trust.1 The trust holds the income that exceeds the limit, and the Texas Health and Human Services Commission (HHSC), the state agency that runs Medicaid, no longer counts that income in deciding eligibility.1 It's a paperwork solution to an income problem, and it's worth setting up correctly, because a trust that isn't funded properly won't fix eligibility. One boundary to know: HHSC says a QIT can overcome the special income limit for institutional and home- and community-based waiver services, but it is not available to people in Community Attendant Services who are income ineligible.1

Meeting the income cap is only the financial half. A long-term-care applicant must also need a nursing-facility level of care, which is a clinical determination HHSC makes, and must fall within the asset limit covered further down.1 For home-based care, the same financial rules generally apply through waiver programs such as STAR+PLUS.

Turning 65: The Aged and Disabled Track

Turning 65 quietly changes which rules apply, and it catches Texas families every year. For an adult under 65 with a disability but not yet on Medicare, a MAGI pathway such as parent or caretaker relative can still apply.6 On the 65th birthday, the yardstick generally changes to the aged, blind, and disabled (ABD) track, which federal law measures under Supplemental Security Income (SSI) rules rather than a percent of the poverty level.4 The 2026 SSI federal benefit rate is $994 a month for an individual and $1,491 for a couple.1 Confirm the exact income standard for the program you need with HHSC before you rule yourself out.

Two things can shift at once when this track takes over. The income yardstick is lower than the working-age figures above, and an asset test appears where the MAGI groups had none, because federal law bars a resource test only for the MAGI pathways and expressly excepts the SSI-related track.4 It's worth being precise about why age matters here. Turning 65 doesn't automatically pull every applicant off the MAGI method; the federal exception is written by eligibility group, so it removes the MAGI method only for groups where age itself is a condition of eligibility.6 For most Texas seniors seeking coverage, though, the ABD track and its SSI-based standard are the ones that govern.

The Asset Limit and the Five-Year Look-Back

For long-term-care and ABD Medicaid, income is only half the test. Texas also applies an asset limit: $2,000 in countable resources for one individual, and $3,000 for a couple.2 Not everything counts. The home you live in (subject to a home-equity ceiling), one vehicle, household goods, and personal effects are generally excluded, so the countable figure usually comes down to bank accounts, investments, and similar assets.2

There's one more review to understand, and it's the rule families most wish they'd learned earlier. When you apply for long-term-care Medicaid, Texas looks back over the previous 60 months, five years, of your finances.7 If you gave away money or property, or sold something for less than it was worth, during that 60-month look-back window, the transfer can create a penalty period when Medicaid won't pay for care, calculated from the amount you moved.7 It sounds alarming, but it becomes manageable once you see the timeline: this look-back applies only to long-term-care Medicaid, not to children's or MAGI coverage, and the earlier you understand it, the more of your options you keep.

What a Nursing-Home Resident Keeps

When someone on Medicaid lives in a nursing facility, most of their monthly income goes toward the cost of care, but not all of it. Texas lets the resident keep a personal needs allowance (PNA), a small monthly amount for personal expenses like clothing, toiletries, and a haircut. In Texas the nursing-facility PNA is $75 a month.1 That's well above the federal floor, which sets the minimum any state may pay at $30 a month for an individual.8 Whatever income remains after the PNA and certain other deductions is applied to the facility bill as the resident's share of cost. Our guide to the Texas Medicaid personal needs allowance walks through how that math works.

Protecting the Spouse Who Stays Home

If one spouse needs long-term care and the other stays in the community, the $2,000 asset limit above is not the whole story, and this is where couples most often assume the worst without cause. Federal spousal impoverishment rules let the at-home spouse keep a protected share of the couple's savings, far above the applicant's limit. For 2026, that Community Spouse Resource Allowance runs between $32,532 and $162,660, with the state setting its figure inside that range.9 The at-home spouse is also entitled to a monthly income allowance: the Minimum Monthly Maintenance Needs Allowance is $2,705 a month effective July 2026, so if the community spouse's own income falls short of that floor, part of the applicant's income can be shifted to make up the difference.9 The full Texas figures and how they're calculated are in our Texas spousal impoverishment guide.

Learn More

Find personalized help checking your Texas Medicaid eligibility at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.