Medicaid is the federally mandated, state-administered health program that gives low-income children, seniors and adults with disabilities access to health services. By law every Medicaid plan must include essential benefits, such as:
- Primary physician care
- X-rays and basic diagnostic tests
- Emergency and acute hospital services
- Transportation to Medicaid-funded care
- In-home and nursing home care
Individual states also have the option to provide additional services and supports through special programs and waivers.
In
Texas, the Medicaid program is administered through Texas Health and Human Services. Medicaid services are delivered through select managed care organizations on a county-by-county basis, and there must be at least two Medicaid providers in each county.
Qualifying for Medicaid Seniors aged 65 and older must meet income and asset limits to qualify for long-term Medicaid services, including home and community-based waiver programs.
Medicaid applicants can earn up to $2,313 per month in income from wages, pensions, investments and most other sources when applying as an individual and up to $4,626 in joint income when applying as a married couple.
Asset limits are set at $2,000 per individual and $3,000 per couple. These limits include all cash, bank account balances and investments. Certain assets are exempt, such as one vehicle and a house, condo or mobile home assessed at $585,000 or less that the applicant and/or spouse live in.
If only one spouse in a married couple requires long-term Medicaid services, any income earned by the non-applicant spouse is disregarded, and that spouse can also keep up to half of the couple’s joint assets, worth up to $126,420, in addition to all Medicaid-exempt assets.
Minimum Monthly Maintenance Needs Allowance If the non-applicant spouse relies on income from the applicant to cover shelter costs, the applicant can provide up to $3,160.50 per month under the minimum monthly maintenance needs allowance rule. Money transferred under the MMMNA is deducted from the applicant’s income on their Medicaid application.
STAR+PLUS Medicaid Managed Care Program Seniors aged 65 and older who qualify for Medicaid and meet the clinical criteria for nursing home placement may be eligible for services through
STAR+PLUS.
This managed care program provides additional community-based services along with all the basic Medicaid benefits to let seniors remain in an assisted living setting.
Missouri City is located in the
STAR+PLUS Harris Service Area. Available medical plans include Amerigroup, Molina Healthcare of Texas and Superior HealthPlan. By law, each of these plans must provide:
- Adult day activity and health services
- Personal and attendant care
- Assisted living
- Disposable medical supplies
- Nursing care
- Respite care
- Occupational, physical and speech therapy
- Minor home modifications to improve safety and accessibility
- A personal medical alert system
- Transitional support for seniors moving into assisted living from a nursing facility
By law, all Medicaid enrollees who request long-term care services must complete an assessment to determine the most appropriate, least-intrusive placement.
For more information on Texas Medicaid and the STAR+PLUS program, contact the
Houston-Galveston Area Agency on Aging at (713) 993-2436 or
Fort Bend County Social Services, Missouri City Annex at (281) 403-8050.