McAllen Senior AdvisorBy McAllen Senior Advisor Care Team · October 23, 2026
In 2026, Texas Medicaid nursing home eligibility uses a $2,982 monthly income cap and a $2,000 asset limit for one person. A resident keeps $75 a month; most remaining income goes to the home as applied income. A spouse at home keeps assets and income under federal 2026 standards.
The 2026 limits
Texas Medicaid pays for long-term nursing home care for residents who meet nursing facility medical necessity and the financial rules. For 2026, the key numbers are:
| Standard (2026) | Amount |
|---|---|
| Monthly income cap (special income limit) | $2,982 |
| Countable assets, one person | $2,000 |
| Personal needs allowance, individual | $75 a month |
| Personal needs allowance, couple | $150 a month |
| Community spouse resource allowance (federal range) | $32,532 to $162,660 |
| Monthly maintenance needs allowance (federal range) | $2,705 to $4,066.50 |
The income cap is three times the 2026 SSI federal benefit rate of $994. The spousal figures come from CMS's April 2026 bulletin; Texas applies its own calculation within them.
How applied income works
A Medicaid nursing home resident does not keep their monthly income. After a $75 personal needs allowance, health insurance premiums and any allowance for a spouse at home, the rest goes to the nursing home as applied income. Medicaid pays the difference between that amount and the home's Medicaid daily rate.
Texas raised the personal needs allowance from $60 to $75 effective January 1, 2024, through a state plan amendment approved by CMS. The allowance covers clothing, haircuts, phone and personal items, and the home may hold it in a trust account with monthly statements.
Which Valley homes take Medicaid
In CMS's data, 22 of Hidalgo County's 23 licensed nursing homes are certified for Medicaid. The exception is the medical center at John Knox Village in Weslaco, which is state-licensed but not certified.
Certification does not guarantee an open Medicaid bed on a given day. Ask whether a resident who enters for Medicare rehab can convert to Medicaid in the same room, and how long the business office expects private payment before an application.
Protecting a spouse at home
When one spouse enters a nursing home, Medicaid counts the couple's countable assets together, then lets the spouse at home keep a community spouse resource allowance. If the spouse at home has little income, part of the resident's income can be diverted to them, up to the monthly maintenance needs allowance.
The home is generally excluded while a spouse lives there. Texas's estate recovery program defers any claim while a surviving spouse is living. Transfers made within the five-year look-back can delay eligibility, so get advice before moving money or changing a deed.
Common mistakes to avoid
The most common mistakes are giving money to children or grandchildren within the five-year look-back, letting assets sit just over the $2,000 limit for months, and missing a request for documents from HHSC. Each can delay coverage while the nursing home bill keeps growing.
Spending on the resident's own needs is generally allowed: paying the nursing home, buying clothing or a hearing aid, paying debts, prepaying a funeral. Ask before spending anything large.
After approval
Once approved, HHSC sends a notice showing the applied income amount. The resident or family pays that amount to the nursing home each month. Medicaid eligibility is reviewed periodically, so keep bank statements and respond to renewal notices promptly.
What Medicaid does not cover in a nursing home
Medicaid pays for a semi-private room, meals, nursing care and most supplies. It does not pay for a private room unless it is medically necessary, and it does not pay for personal items beyond what the $75 allowance covers. Ask the business office for its list of charges that are billed to the resident, such as beauty shop services or a personal phone line.
Getting the application started
Apply at YourTexasBenefits.com or through a local HHSC office; the nursing home's business office usually helps start the paperwork. Gather five years of bank statements, income letters, insurance policies, deeds and vehicle titles.
The legal assistance program at the Area Agency on Aging of the Lower Rio Grande Valley ((956) 682-3481) can advise people 60 and older, and an elder law attorney can help when a couple owns more than a home, a car and a modest account.
These figures change every year. The income cap and spousal standards are updated each January and July, so check the current numbers with HHSC or an elder law attorney before relying on them in a plan. Our nursing home pages show which Hidalgo County homes are certified for Medicaid, along with each home's CMS ratings, staffing and latest inspection.
Frequently asked questions
What is the Texas Medicaid personal needs allowance in 2026?
$75 a month for an individual and $150 for a couple, in effect since January 1, 2024.
What is the 2026 income limit for Texas Medicaid nursing home care?
$2,982 a month, three times the $994 SSI federal benefit rate.
Do most Hidalgo County nursing homes accept Medicaid?
Yes. All of the county's certified nursing homes are certified for Medicaid; one state-licensed medical center is not certified.
How long does a Texas Medicaid application take?
It varies with how complete the paperwork is; applications with missing documents take longest, so gather five years of statements and respond quickly to any request from HHSC.
