The Medicaid program that provides free health care to low-income, low-resource Americans is a jointly funded initiative of the federal and state governments. Each state adapts and manages its own Medicaid program to best meet the needs of its residents within a framework of federal regulations.
The Texas Health and Human Services Commission administers the Medicaid program that provides health care for 4.5 million state residents, including pregnant women, children, disabled and blind people and the elderly. In Texas, Medicaid services are delivered through state-approved managed care providers.
Texas residents who meet Medicaid’s eligibility guidelines receive a number of vital health care services, including doctor and specialist visits, emergency, inpatient and outpatient hospital care, X-rays, labs and other diagnostic tests, prescriptions, nonemergency medical transportation, ambulance services and long-term care in a nursing home.
Qualifying for Medicaid
To qualify for Texas Medicaid for long-term care, Conroe residents must be U.S. citizens or legal residents and:
- Be aged 65 or older
- Be aged 64 or younger with a disability that persists for at least one year
- Have a monthly income of $2,313 or less and resources of $2,000 or less as an individual
- Have a monthly income of $4,626 or less and resources of $3,000 or less as a couple applying together
All sources of income count toward the Medicaid eligibility limits, but some resources are excluded, including personal belongings, household furnishings and effects, an irrevocable burial trust, one car and a primary home worth up to $585,000.
Seniors who meet the income and asset limits of the
Supplemental Security Income program automatically qualify for Texas Medicaid and are enrolled when they apply for SSI through the Social Security Administration.
When the spouse of an applicant doesn’t need coverage, their income is excluded. Based on Medicaid rules to avert
impoverishment of a community spouse, the non-applicant may also be awarded up to $3,160.50 of their spouse’s monthly income and 50% of jointly owned assets up to $126,420.
Conroe seniors who exceed the Medicaid income limits but meet all other qualification criteria can reduce their monthly earnings by establishing a
Qualified Income Trust. Excess income gets deposited into the trust each month, and it no longer counts toward the limit. Funds can only be withdrawn by the account’s designated trust agent and used to pay Medicaid-approved medical and care expenses.
Applying for Medicaid Seniors in Conroe can contact Your Texas Benefits helpline at (877) 541-7905 or
apply for Medicaid online.
STAR+PLUS Waiver Program Seniors who require long-term care but want to avoid nursing home admission can apply for the Texas Medicaid
STAR+PLUS waiver. Those approved for the program are enrolled in a managed care plan that provides comprehensive medical and long-term care services and supports. All the medical services offered through Texas Medicaid are included, along with care coordination and other services necessary to meet the enrollee’s care needs, which may include:
- Transition assistance to relocate from a nursing home
- Assisted living services, including personal care
- Nursing care
- Occupational, physical and speech therapy
- Medical supplies
- Adaptive aides
Applicants must be assessed to verify their need for a nursing-home level of care and enrolled in Medicaid with full benefits. Additional program-specific eligibility criteria must be met, including enrollment in Medicaid, receiving SSI benefits and residing in a nursing home.
Conroe residents can contact the
Houston-Galveston Area Agency on Aging at (713) 627-3200 to learn more about the STAR+PLUS program or apply.