Nursing Home Medicaid Eligibility

Nursing Home Medicaid Eligibility

With the right legal guidance, you can qualify for Nursing Home Medicaid, protect your family’s assets, and gain peace of mind knowing everything is handled properly.

Why Most Families Struggle With Medicaid Eligibility

Nursing Home Medicaid isn’t simple. It involves strict financial rules, hidden pitfalls, and endless paperwork. Without experienced help, families often find themselves denied — even when they technically qualify.

Here are the 3 main reasons most people get stuck:

income icon

Income Eligibility

If your loved one receives more than $2,724 per month, their application will be denied. But there are legal solutions — such as the Miller Trust — that can help overcome this limit.

asset icon

Asset Eligibility

You must have less than $2,000 in countable resources to qualify. But not everything is “countable.” Many assets, like certain life insurance or retirement accounts, are handled differently.

transfer icon

Transfer Penalties

Medicaid reviews the last 5 years of your financial history. Gifts or transfers made during that time can trigger penalties and delays in eligibility. Even innocent financial moves can backfire without proper planning.

We Take the Fear Out of the Medicaid Process

At Shea Law, we’ve helped hundreds of families qualify for Nursing Home Medicaid — even when they were told it wasn’t possible.
 We don’t just fill out paperwork. We create strategies that protect your assets and ensure your loved one receives care without unnecessary financial loss.

We Can Help You:

  • Fix income issues through legal planning tools like the Miller Trust
  • Protect assets and structure them correctly before applying
  • Minimize penalties caused by past gifts or transfers
  • Handle the full application process so you don’t have to navigate it alone

Here’s What People Think About Working With Us

google

Mr. Shea was an answer to so many prayers! I live out of state and was needing legal assistance for my elderly parent located in Houston. I was concerned that navigating this process from afar would be difficult, but Mr. Shea’s communication was timely, thorough, and always reassuring. He was patient in answering my many questions and never made me feel like a burden or irritation. He kept me informed throughout the entire process and never left me wondering what was happening or why. He clearly is an expert in the field and knows from experience exactly how to handle the manipulative tactics of Medicaid. We would have most certainly given up our pursuit (and a significant sum of money we were rightfully entitled to) if we had tried to navigate Medicaid qualification on our own. My only regret is that we didn’t find him sooner. His cost was very fair, and I appreciate that it was all-encompassing with no hidden fees. Overall, Mr. Shea was an absolute dream to work with—a complete 180 from the nightmare experience we had previously with another elder law attorney in Spring. I am already recommending Mr. Shea to friends and give him my strongest endorsement!!

Stephanie D.
June 20, 2025
google

Mr. Shea was wonderful from the very first call. He helped me sort out what I needed for my mom and how to go about getting everything! He explains it all so that you can understand! I would highly recommend him if you are in need of a lawyer. Thank you so much!!!

Tina P.
May 22, 2025
google

Richard is the best. He has kept me informed and up to date on all matters concerning the process.

Michael W.
March 6, 2025
google

The Richard Shea Law Firm is the best. Mr. Shea takes care of business in a fast manner. He keeps you promptly informed on every aspect of your case Need more people like him and his firm.

Raymond H.
February 21, 2025
google

Before I even retained Shea Lawfirms services Richard responded to my emails regarding situations I was dealing with just to be helpful. His attentiveness and quick responses helped me able to address those situations. As a direct result when needing to update our wills and end of life directives he was the first one I called. He's been amazing to work with, very patient, very detailed and accommodating. He continues to go above and beyond!!

Steffanie J.
January 24, 2025
google

What can I say about the Shea Law Firm, there is so much, I will start with my older brother who got sick, and I didn't know anything on how to prepare to get him set for Medicaid, or for the long-term care he will be needing. Mr. Shea was very informative on options, that were out there to help get him set on Medicaid. Mr. Shea was always there to answer your questions, he listens to you like you are a family member, are a close friend. As I stated, I can go on about how Mr. Shea handled my situation, but I'm just going to let you know, when the time comes, and you need an attorney, to handle Probate, Medicaid, or any other family law issues I would definitely go to Shea Law Firm, and talk to Mr. Shea, an attorney who listens to you, and works to find the best outcome. Again, thank you Mr. Shea for all you have done.

R W.
November 29, 2024
puzzle image

Are You Under The Asset Limit?

In order for your loved one to win their case on the issue of resources, they must not have more than $2,000 in counted resources. It is important to keep in mind that this limit only applies to “counted resources.” There are many assets that are exempt from Medicaid while others that many people think are exempt are in fact counted. A popular example is cash value life insurance that is intended to pay for funeral expenses or many kinds of retirement accounts.

Married Couples and Asset Limits

When a married couple with one spouse applying for Medicaid enters the picture, special rules apply to their asset limits. In this case, the applicant has an asset limit of $2,000, however the healthy spouse at home may have a slightly different asset limit. The rule of thumb for the healthy spouse’s asset limit is 50% of the combined asset value, which has a minimum and maximum set by law. The floor on this value is currently $29,724 in 2023 and a maximum of $148,620.

This does not mean you can keep $150,620 ($148,620 + $2,000). For example, if you have $75,000 in counted resources, under the default rules you will only be able to keep approximately $37,500. The rest will go to the nursing home.

Do You Have Any Gift or Transfer Penalties?

A penalty is imposed for every transfer of assets by an applicant or his or her spouse in the last five years.

If your loved one has a penalizing transfer or event in the last five years (even those gifts the IRS does not tax each year) then they will not have nursing home medicaid eligibility until the penalty period expires. If this applies in your case, doing nothing about it until the money runs out is one of the worst things you can do.

Speak to me today about how we can minimize the damage from previous gifts and transfers — call or text (832) 856-4526.

Medicaid Eligibility Doesn’t Just Happen

We Make it Happen

  • If your parent or spouse is over the income limit, I can fix that.
  • If your parent or spouse is over the asset limit, I can protect their assets and get them under the limit.
  • If your parent or spouse has made gifts and may have a Medicaid penalty, I can minimize the damage and get them Medicaid as soon as possible.
  • If you need help getting through the application, I can walk you through the entire process.

Frequently Asked Questions

This is a very common belief and one belief that I am happy to say is 100% myth. Most of the families we work with are after someone has already entered a nursing home. Married or un-married, a nursing home admission does not make protecting your life savings impossible.

Unfortunately no. For eligibility purposes the HHSC views a married couple as one unit. Everything either spouse owns is evaluated as part of the Medicaid application process through the process called “deeming.”

IRAs, 401(k)s, and other types of retirement accounts are not automatically protected from a Medicaid spend-down. In some cases they are while in other cases they are not. We can show you the path to protect those retirement accounts.

No. Many nursing homes are a mix of Medicaid beds and private pay beds. This means a patient on Medicaid receives is in the same facility and receiving the same care that the person paying $8,000 or more a month receives. The nurses are not checking each patient’s file to see who is paying the bill, I assure you.

No. You can choose any nursing home that accepts Medicaid. Medicaid has a network of participating providers like every other commercially available health insurance. Many nursing homes accept Medicaid and private pay residents because very few patients can pay the private pay nursing home cost their entire life.

No, it is half of everything either of you own combined. The $148,620 figure is the maximum amount for the healthy spouse AFTER dividing all the assets in half. That means in order to keep $148,620 under the default rules you need $297,240 ($148,620 * 2) and you would still lose all the assets exceeding $148,620.

Medicaid covers the room and board of the nursing home (the largest expense) and all medically necessary expenses with a few exclusions. If you have co-pays from doctor visits or prescriptions Medicaid will pick those up once you are approved as long as you use Medicaid participating providers and vendors.