Texas Medicaid provides free and low-cost health care services to eligible low-income adults, children, seniors and people with disabilities who meet certain requirements.
Seniors aged 65 and older and adults with disabilities may qualify for Medicaid if they:
- Receive Supplemental Security Income
- Participate in the Medicaid Buy-In program, where seniors can pay for services if they work and live in an institutional setting
Medicaid benefits for seniors may include:
- Doctor and hospital visits
- Prescription drugs
- Vision, hearing and dental care
- Laboratory services
- Nursing home care or residence in a home for people with mental illness or intellectual disabilities
- Home health care
Seniors must meet certain financial criteria to qualify for Medicaid. Adults aged 65 and older or who are blind or disabled are entitled to receive Medicaid through the SSI program if they meet the following financial limits:
- Earn no more than $771 (individual) or $1,157 (married couple) in monthly income
- Have no more than $2,000 (individual) or $3,000 (married couple) in assets excluding a residence, primary vehicle, personal belongings and furnishings
Seniors who meet the financial requirements below and require a nursing home level of care are entitled to receive Medicaid benefits in a nursing facility:
- Earn no more than $2,313 (individual) or $4,626 (married couple) in monthly income
- Have no more than $2,000 (individual) or $3,000 (married couple) in assets, excluding a residence, primary vehicle, personal belongings and furnishings; if only one partner of a married couple applies, the non-applicant spouse may retain up to $126,000 in assets
To be eligible for long-term care, an adult must be at least aged 65 years old or have a disability lasting 12 months or longer, meet the above financial limits and require care for at least 30 consecutive days. Participants must first use their own money to pay for services, excluding a small monthly allowance, before receiving services for free.
STAR+PLUS Home and Community-Based Services Waiver Seniors seeking long-term care while living in an assisted living facility or community setting may be eligible for services through the
HCBS STAR+PLUS waiver. This program aims to help seniors aged 65 and older and people with disabilities reside outside of nursing homes.
Interested individuals must qualify for Medicaid and meet at least one of the following criteria to participate:
- Receive SSI and qualify for Medicaid based on low income
- Be eligible to receive STAR+PLUS HCBS and not receive SSI
- Receive Medicaid through the Medicaid for Breast and Cervical Cancer program or by living in a nursing home
Assigned regional health plans provide the benefits of STAR+PLUS, which include:
- Assisted living services
- Nursing care
- Personal assistance services
- Medical supplies
- Respite care
- Therapies
- Transitional assistance
Medicaid participants who qualify for the STAR+PLUS waiver receive an enrollment packet in the mail. They should select their preferred health plan and return the completed form within 15 days of receipt.
Sugar Land seniors can apply for Medicaid
online or by calling (877) 541-7905 and pressing “2” after selecting a language.