What is the highest income for Medicaid in Texas?

Texas Medicaid income limits depend entirely on your household size and category, with strict limits that vary significantly by group.

Income Limits by Category (2026 Monthly Estimates)

• Pregnant Individuals: Up to ~198% of the Federal Poverty Level (FPL) (approx. $2,570/month for a single person).
• Children (Ages 1–5): Up to ~144% FPL (approx. $1,870/month for a single person).
• Children (Ages 6–18): Up to ~133% FPL (approx. $1,725/month for a single person).
• CHIP (Children's Health Insurance Program): Up to ~201% FPL (approx. $2,610/month for a single person / $4,447 for a family of 3).
• Parents and Caretakers: Extremely low limits, capped around 18% FPL (approx. $235/month for a single parent, or $514 for a family of 3).
• Aged, Blind, and Disabled (Regular Medicaid / MEPD): $994/month for a single person and $1,491/month for couples.
• Nursing Home / Long-Term Care (Special Income Limit): $2,982/month per applicant.
• Medicaid Buy-In (Working Adults with Disabilities): Up to 250% FPL (approx. $3,325/month for a single person).

You can review complete, detailed category programs via Texas Health and Human Services or use the Texas Medicaid Eligibility Guide to check estimates. Non-disabled childless adults are generally not eligible for Medicaid in Texas regardless of income.

If you make too much money for Medicaid, you can explore alternative pathways like health insurance marketplaces, spend-down programs, or trusts depending on your situation.

Explore Health Insurance Marketplace Plans

• Check Subsidies: If your income is just above the Medicaid limit, you may qualify for heavily subsidized health insurance plans through HealthCare.gov.
• Adjust Taxable Income: Lower your Modified Adjusted Gross Income (MAGI) by contributing to pre-tax retirement accounts or health savings accounts (HSAs).

Use a Medicaid Spend-Down Program

• Deduct Medical Bills: Many states offer a "medically needy" or spend-down program. You can subtract your ongoing medical expenses from your income until it reaches the state's Medicaid eligibility limit.
• Submit Receipts: You pay for approved medical costs or care out-of-pocket until you hit the threshold, and Medicaid covers the rest during that budget period.

Set Up a Qualified Income Trust (Miller Trust)

• For Long-Term Care: If you need nursing home or home-based care and your income is over the limit for long-term care Medicaid, certain states let you put excess income into an irrevocable trust.
• Designate Funds: The money placed into the trust is used to help pay for your medical and care costs to maintain eligibility.

Look Into Other Specialized Programs

• Medicaid Buy-In: Many states let working individuals with disabilities buy into Medicaid through a monthly premium.
• Medicare Savings Programs: If you have Medicare alongside higher income, you might qualify for partial help with out-of-pocket costs.

In Texas, the amount of money you can have in the bank to qualify for Medicaid depends on your demographic and the type of coverage you need, but for seniors (65+) and people with disabilities, the individual countable asset limit is $2,000.

For low-income families, children, and pregnant women under Modified Adjusted Gross Income (MAGI) rules, there is no asset or bank account limit. Eligibility for those programs is based strictly on your monthly income.

Asset Limits for Seniors and People with Disabilities (Aged, Blind, or Disabled Medicaid)

If you are applying for Medicaid for the Elderly and People with Disabilities (MEPD), institutional care, or long-term care waivers, your total "countable resources"—which includes your checking accounts, savings accounts, cash, stocks, and bonds—must remain under specific caps:

Important Rules Regarding the Limit

• First of the Month Snapshot: The Texas Health and Human Services Commission calculates your resource value exactly as of 12:01 a.m. on the first day of the calendar month. If your bank accounts are over the limit at that exact moment, you are considered ineligible for that entire month.
• Outstanding Checks: If you write a check or have a legally obligated payment that has not yet cleared the bank before 12:01 a.m., those funds can be subtracted from your balance calculation so you are not penalized for unprocessed payments.
• The 5-Year Look-Back Rule: For long-term nursing home care or home-based waivers, Texas reviews your financial records for the past 60 months. Giving away money or transferring assets out of your bank accounts for less than fair market value during this window will trigger a penalty period of ineligibility.

What Assets Do Not Count?

Not everything you own counts toward the $2,000 limit. Texas Medicaid excludes specific exempt assets from your calculation, including:

• Your primary home (up to $730,000 in equity if you intend to return, or unlimited equity if a spouse or dependent lives there).
• One motor vehicle of any value.
• Personal belongings and household furnishings (clothing, furniture, appliances).
• Irrevocable burial trusts or prepaid funeral plots.

In 2026, the monthly income limit for Medicaid depends on your state, household size, and eligibility group (such as expansion adults, pregnant individuals, or long-term care).

Medicaid Expansion Limits (Adults Ages 19–64)

In states that have adopted Medicaid Expansion, the standard income limit is 138% of the Federal Poverty Level (FPL) (including the 5% FPL disregard):

• 1 person: About $1,836 per month ($22,025/year)
• 2 people: About $2,489 per month ($29,864/year)
• 3 people: About $3,142 per month ($37,702/year)
• 4 people: About $3,795 per month ($45,540/year)

(Note: 10 states have not adopted Medicaid expansion, meaning non-disabled adults without children may face much lower or non-existent income limits.)

Long-Term Care & Nursing Home Medicaid

For aged, blind, or disabled individuals applying for nursing home care or home- and community-based services (HCBS) waivers, the gross monthly income limit in most states is $2,982 per month per applicant.

Medicare Savings Programs (Dual Eligibility)

For individuals who qualify for Medicare and Medicaid assistance, individual monthly limits (outside Alaska and Hawaii) generally range from $1,350 to $1,816 per month, depending on the specific program tier (such as Qualified Medicare Beneficiary or Specified Low-Income Medicare Beneficiary).

In 2026, Texas Medicaid experienced major funding battles, federal policy shifts, and post-pandemic enrollment changes.

$12 Billion Hospital Funding Restored

• The Impasse and Resolution: Texas faced a severe near-year-long standoff with the federal government regarding hospital financing and tax calculation methods under programs like CHIRP. This briefly threatened Texas hospitals with a loss of $27 million a day.
• The Outcome: In September 2026, Gov. Greg Abbott announced that nearly $12 billion in Medicaid funding for Texas hospitals was officially restored after reaching an agreement with CMS and the federal administration.

Federal Eligibility and Immigrant Restrictions

• Immigrant Coverage Cuts: Under broader federal policy changes (such as H.R. 1 rules taking effect on October 1, 2026), most lawfully present immigrants—including refugees and asylum recipients—lost eligibility for Medicaid nationwide, excluding specific groups like green card holders.
• Work Requirements on the Horizon: Federal legislation ties future expansion-group adult requirements and state rules to upcoming work mandates, though Texas has traditionally opted out of ACA Medicaid expansion.

Post-Pandemic Enrollment and Backlogs

• Drops in Enrollment: Following the unwinding of pandemic-era continuous coverage rules, Texas removed more than 2 million people (many for procedural paperwork reasons rather than confirmed ineligibility).
• Managed Care Changes: Regional managed care programs continue to shift; for instance, some health plans like FirstCare and RightCare exited the STAR Medicaid program in specific regions, forcing members to transition to new plans via Texas Health and Human Services.