How To Apply For Medicaid In Texas For Seniors Who Need Home Care

If you are an older adult in Texas—or you help care for one—Medicaid can be a crucial way to pay for in‑home care so seniors can stay safely at home rather than moving to a nursing facility. Texas Medicaid offers special programs for seniors and people with disabilities that can cover home health aides, personal care, and other supports in the home, if certain income, asset, and medical criteria are met.

1. How Texas Medicaid Helps Seniors At Home

For seniors, Medicaid is not just basic health insurance. It can also help pay for:

• In‑home personal care (help with bathing, dressing, eating, toileting, and mobility)

• Home health services (nursing visits, therapies ordered by a doctor)

• Adult day care or respite for caregivers (in some programs)

• Equipment and supplies needed for safe care at home

These services usually come through “long‑term care” Medicaid programs, including waiver programs that are designed to keep people at home or in the community instead of a nursing home.​

2. Check If The Senior Might Qualify

Eligibility for senior and long‑term care Medicaid in Texas depends on three main areas:

• Age or disability: Usually age 65+ or meeting Social Security disability standards.

• Level of care: The person must need help with daily activities or have medical needs similar to what a nursing facility provides.

• Financial situation: Monthly income and countable assets must fall below state limits, which change from year to year and are different for single and married applicants.

For example, Texas sets specific monthly income limits and caps on countable assets like cash, bank accounts, and some investments; a spouse who is not applying may be allowed to keep a portion of income and assets to prevent hardship. Because these rules are complex, families often talk with a benefits counselor or elder law attorney, especially if the senior owns a home or has savings.​

3. Gather Documents Before You Apply

Having paperwork ready will make the application for senior Medicaid and home care smoother and reduce delays. You may need:

• Social Security number and photo ID for the senior

• Proof of age (driver’s license, birth certificate)

• Medicare card and any other insurance cards

• Proof of income (Social Security award letter, pension statement, pay stubs, annuity statements)

• Bank statements and information on other assets (retirement accounts, life insurance with cash value, property other than the primary home)

• Proof of Texas residency (lease, property tax bill, utility bill)

• Medical records or doctor’s statements describing the senior’s functional and health needs

If a family member is helping, it can be useful to have a signed authorization or power of attorney so they can speak to Medicaid on the senior’s behalf.​

4. Ways To Apply For Senior Medicaid In Texas

You can start the Medicaid application using the same channels as other applicants, but you will indicate that the senior needs long‑term services and supports or help at home.

Common ways to apply:

• Online: Through the Your Texas Benefits website or app, creating an account and starting a new application.

• By phone: Calling 2‑1‑1 (or the number listed for Texas Health and Human Services) to apply or request an application.

• By mail: Completing a paper application and mailing it to the address provided.

• In person: Visiting a local Health and Human Services benefits office or a community partner that helps with applications.

When the application asks about “long‑term services and supports” or “help with activities of daily living,” make sure to answer those questions carefully and describe the help the senior needs to remain safely at home.​

5. Be Detailed About Care Needs

For seniors seeking home care, it is especially important to clearly describe daily needs on the application and during any follow‑up assessments.

Carefully note whether the senior:

• Needs hands‑on help with bathing, dressing, toileting, eating, or walking

• Has memory problems, confusion, or dementia that affect safety

• Needs frequent monitoring due to medical conditions (for example, falls, diabetes, breathing issues)

• Needs help managing medications or using medical equipment

Texas may schedule a nurse or social worker to visit the home and complete an assessment to decide if the senior meets the medical “nursing facility level of care” needed to qualify for certain home‑based Medicaid programs.

6. What Happens After You Apply

After submitting the application and documents, the state reviews both the financial and medical eligibility. For long‑term care and home‑and‑community‑based services, this can take several weeks or more, depending on program and workload.

During this time:

• Watch the mail closely for letters asking for more information.

• Respond quickly if Texas Health and Human Services requests additional bank statements, medical records, or forms.

• Check the application status through Your Texas Benefits or by calling 2‑1‑1.

If approved, the senior will receive a notice explaining which Medicaid program they qualify for and when coverage starts.​

7. Getting Home Care Services Started

Once Medicaid approval is in place for long‑term care or a home‑based waiver, the next steps usually include:

• A service planning meeting to discuss the senior’s needs and goals.

• Creating a care plan that lists what services will be provided (for example, number of hours per week of in‑home personal care, respite, or therapies).

• Choosing an agency or provider for home care services, based on options available in the senior’s area.

Depending on the program, the family may be able to choose from different home care agencies, and in some cases, a relative (other than a spouse) may be paid as a caregiver through certain consumer‑directed options.​

8. Role Of Family Members And Caregivers

Family members and caregivers play a key role in the Medicaid process for seniors, especially when the senior has memory issues or complex medical needs. They can:

• Help organize documents and fill out forms

• Speak with Medicaid caseworkers (with permission or legal authority)

• Be present for assessments and clearly describe daily care needs and safety concerns

• Help monitor whether the services provided are meeting the senior’s needs

Keeping notes on the senior’s daily challenges, falls, and hospital or ER visits can help show why in‑home support is medically necessary.​

9. Renewals And Changes To Report

Senior Medicaid and home care services must be renewed periodically, and eligibility is rechecked. To avoid gaps in services:

• Look for renewal notices and complete them by the deadline.

• Report changes in income, assets, address, or household members.

• Let Medicaid know if the senior moves, goes into a hospital or rehab, or enters a nursing home.

Failing to report changes can lead to overpayments or interruptions in coverage, which can disrupt home care services.​

10. Where Seniors And Families Can Get Help

You do not have to figure this out alone. There are organizations that specialize in helping seniors and caregivers navigate Texas Medicaid and long‑term care:

• Local Texas Health and Human Services benefits offices

• Area Agencies on Aging (for benefits counseling and care coordination)

• Community‑based nonprofits and legal aid organizations

• Independent Medicaid planning or elder law professionals

They can answer questions, help you understand program options, and assist with complex financial and medical eligibility issues related to home care.

If and when you are ready for in-home care, you can contact CareChoice at 800.795.7770 and we are happy to help you through the process.