Medicaid Planning Attorneys Helping People Qualify for Medicaid to Pay for Nursing Home Care

Ross & Shoalmire provides comprehensive Medicaid planning services for Texas and Arkansas families facing long-term care needs. Our experienced elder law attorneys help protect your assets from nursing home costs while ensuring you qualify for vital Medicaid benefits. Whether you need advance planning or crisis assistance, we guide families in Texarkana, Tyler, Paris, Longview, Magnolia, and throughout the region with compassionate, strategic legal counsel.

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What Is Medicaid Planning?

Medicaid planning is the process of legally organizing your finances and assets to qualify for Medicaid long-term care benefits while protecting your life savings from nursing home costs. Without proper planning, individuals facing nursing home care must spend down nearly all their assets before Medicaid will provide coverage.

Long-term care in Texas and Arkansas is expensive. Nursing homes can cost $5,000 to $8,000 per month or more, quickly depleting retirement savings and family assets. Medicaid covers nursing home care for those who meet strict income and asset requirements, but qualifying often means losing everything you've worked a lifetime to build.

That's where Medicaid planning makes the difference. Our attorneys help Texas and Arkansas families navigate complex eligibility rules, implement legal asset protection strategies, and preserve wealth for spouses and heirs while ensuring access to quality care. We serve families throughout Northeast Texas and Arkansas, including communities in Texarkana, Tyler, Paris, Longview, and Magnolia.

The Cost of Waiting

Many families wait until a crisis hits to seek help. While crisis planning is possible, advance planning provides significantly more options to protect your assets. Ideally, Medicaid planning should begin at least five years before care is needed.

Texas vs. Arkansas Medicaid Requirements

While federal law governs Medicaid, Texas and Arkansas each have unique requirements and procedures for long-term care benefits. Understanding these differences is essential for effective planning.

Texas Medicaid Eligibility

Texas Medicaid for nursing home care requires meeting strict financial criteria. As of 2025, individuals can generally keep only $2,000 in countable assets. Monthly income limits in Texas require a Qualified Income Trust (Miller Trust) if income exceeds approximately $2,829, even if that income isn't enough to pay for nursing home care.

Texas allows community spouses (the spouse not requiring care) to protect certain assets and income. The Community Spouse Resource Allowance (CSRA) in Texas permits the at-home spouse to retain approximately half of the couple's countable assets, up to $154,140 in 2025.

Arkansas Medicaid Eligibility

Arkansas has similar but distinct Medicaid rules. The asset limit for individuals is also $2,000, and Arkansas uses income caps requiring Miller Trusts when income is too high. Community spouse protections exist in Arkansas as well, with comparable resource allowances to Texas.

Both states exempt certain assets from Medicaid counting, including your primary residence (up to equity limits), one vehicle, personal belongings, household goods, and prepaid funeral arrangements. However, the application processes, documentation requirements, and regional practices differ between Texas and Arkansas.

Ross & Shoalmire attorneys are licensed in both Texas and Arkansas, giving us unique expertise in navigating the requirements in both states. This matters if you own property in both states or are considering moving across state lines for care.

Our Medicaid Planning Services

Our comprehensive Medicaid planning services protect families throughout Texas and Arkansas from the devastating financial impact of long-term care costs. We tailor strategies to your unique situation, family dynamics, and financial goals.

Medicaid Eligibility Planning

We analyze your complete financial picture to develop strategies that help you qualify for Medicaid benefits while protecting maximum assets. This includes reviewing all income sources, assets, property ownership, and family circumstances to create a personalized plan.

Our eligibility planning services include:

• Complete financial assessment and asset inventory
• Analysis of Medicaid eligibility under Texas or Arkansas rules
• Strategic planning to meet income and asset requirements
• Guidance on exempt vs. countable assets
• Documentation preparation for Medicaid applications
• Representation during the application process

Asset Protection Strategies

Protecting your assets while qualifying for Medicaid requires sophisticated legal strategies that comply with federal and state regulations. We implement proven techniques to shield your wealth from nursing home spend-down requirements.

Asset protection methods we use:

• Irrevocable Trusts: Properly structured trusts can protect assets from Medicaid counting while providing income and use rights
• Asset Transfers: Strategic gifting and transfers outside the five-year lookback period
• Exempt Asset Conversion: Converting countable assets into exempt assets like home improvements or vehicles
• Spousal Protections: Maximizing Community Spouse Resource Allowances and income protections
• Caregiver Child Exceptions: Special transfer rules for children who provided care
• Home Protection Strategies: Methods to preserve your home for your family

Long-Term Care Planning Integration

Medicaid planning works best as part of comprehensive long-term care planning. We coordinate Medicaid strategies with your overall estate plan, including wills, trusts, powers of attorney, and healthcare directives.

This integrated approach ensures all your legal documents work together to protect you during incapacity, preserve assets for your family, and provide for quality care throughout your lifetime.

Protecting Your Assets While Qualifying for Medicaid

The key to successful Medicaid planning is understanding which assets Medicaid counts and which are exempt, then using legal strategies to maximize your protected wealth.

Exempt Assets

Both Texas and Arkansas exclude certain assets from Medicaid eligibility calculations. Understanding exempt assets is crucial because you can keep these without affecting Medicaid qualification.

Commonly exempt assets include:

• Primary Residence: Your home is exempt in both states if you intend to return or if your spouse or certain dependent relatives live there, subject to equity limits (approximately $713,000 in 2025)
• One Vehicle: Any value if used for transportation for you or a household member
• Personal Property: Household goods, furniture, clothing, and personal effects
• Prepaid Funeral: Irrevocable prepaid funeral arrangements and burial plots
• Life Insurance: Policies with face value under $1,500
• Income-Producing Property: Property essential to self-support in some circumstances

Countable Assets

Countable assets must be spent down to $2,000 (for individuals) before Medicaid will pay for nursing home care. These typically include cash, bank accounts, stocks, bonds, additional properties, and most other investments.

Strategic Asset Conversion

One effective strategy is converting countable assets into exempt assets. For example, using savings to pay off your mortgage, make home improvements, purchase a newer vehicle, or prepay funeral expenses can reduce countable assets while improving your quality of life.

Spousal Protections

When one spouse needs nursing home care, Medicaid provides important protections for the community spouse (the spouse remaining at home). The at-home spouse doesn't have to become impoverished for the institutionalized spouse to qualify for benefits.

Key spousal protections in Texas and Arkansas:

• Community Spouse Resource Allowance (CSRA): The at-home spouse can keep approximately $30,828 to $154,140 in assets (2025 figures)
• Monthly Maintenance Needs Allowance: Income protection ensuring the community spouse has sufficient monthly income
• Home Protection: The home remains completely exempt if the community spouse lives there
• Personal Property: All personal belongings and household items remain with the community spouse

Our attorneys work to maximize spousal protections, often obtaining court orders or administrative approvals for enhanced resource allowances when the standard amounts are insufficient for the community spouse's needs.

Qualified Income Trusts (Miller Trusts)

Texas and Arkansas are "income cap" states, meaning individuals whose monthly income exceeds the limit (approximately $2,829 in 2025) cannot qualify for Medicaid nursing home benefits, regardless of their assets or expenses. This creates a significant problem for people who have too much income to qualify but not enough to afford nursing home care.

The solution is a Qualified Income Trust (QIT), also called a Miller Trust. This special trust allows you to qualify for Medicaid even when your income is above the limit.

How Miller Trusts Work

A Miller Trust is an irrevocable trust that receives your monthly income. The trustee (often a family member) then distributes funds from the trust according to strict Medicaid rules. These distributions go toward:

• Your personal needs allowance (currently $60-75 per month in Texas and Arkansas)
• Health insurance premiums not covered by Medicaid
• Community spouse income allowance (if applicable)
• Nursing home patient liability (your required contribution to care costs)

Any income remaining in the trust at month's end goes to the nursing home or Medicaid program. Upon your death, any funds left in the trust must be paid back to the state Medicaid program.

Critical Requirements for Miller Trusts

Miller Trusts must be established correctly with precise language meeting federal and state requirements. Errors in drafting or administration can result in Medicaid denial. Our attorneys create properly structured Qualified Income Trusts that satisfy all legal requirements in Texas and Arkansas.

Who Needs a Miller Trust?

You need a Qualified Income Trust if your gross monthly income from all sources (Social Security, pensions, annuities, interest, dividends, etc.) exceeds the Medicaid income limit and you require nursing home care covered by Medicaid.

Miller Trusts are required in both Texas and Arkansas for individuals over the income cap. We help determine whether you need this trust and guide you through proper establishment and administration.

Understanding the Five-Year Lookback Period

One of the most important concepts in Medicaid planning is the five-year lookback period. When you apply for Medicaid long-term care benefits in Texas or Arkansas, the state reviews all financial transactions for the previous 60 months.

Any gifts or transfers for less than fair market value during this lookback period can trigger a penalty period during which you're ineligible for Medicaid coverage, even if you otherwise qualify. This is why advance planning is so valuable.

How Lookback Penalties Work

If the state discovers improper transfers during the lookback period, they calculate a penalty period based on the total value transferred divided by the average monthly nursing home cost in your state (approximately $5,500-6,500 in Texas and Arkansas).

For example, if you gifted $65,000 to children three years before applying for Medicaid, and the average nursing home cost is $6,000 per month, you'd face approximately an 11-month penalty period ($65,000 ÷ $6,000 = 10.83 months) during which Medicaid won't pay, even though you meet all other requirements.

Allowable Transfers

Not all transfers trigger penalties. Certain transfers are exempt from the lookback rules, including:

• Transfers to your spouse: You can transfer any assets to your spouse without penalty
• Transfers of your home to: Your spouse, a child under 21, a blind or disabled child of any age, a sibling with equity interest who lived there at least one year, or a "caregiver child" who lived there at least two years
• Transfers for fair market value: Sales or exchanges where you receive equal value
• Transfers to certain trusts: Properly structured special needs trusts for disabled individuals

Planning Around the Lookback Period

The five-year lookback period makes advance planning essential. Ideally, Medicaid planning should begin at least five years before you anticipate needing nursing home care. This allows time for strategic transfers and trust funding to age out of the lookback period.

For those who haven't planned in advance, all is not lost. Even within the lookback period, there are legal strategies to protect some assets through spousal protections, exempt asset conversion, and other techniques. Our attorneys analyze your transfer history and develop strategies to minimize or eliminate penalty periods.

Be Honest About Past Transfers

Attempting to hide transfers from Medicaid is illegal and can result in criminal charges. Always disclose all transactions to your attorney. We can work within the rules to address past transfers legally and protect your interests.

Medicaid Crisis Planning

Sometimes long-term care needs arise suddenly. A stroke, fall, or rapid disease progression can mean immediate nursing home placement without time for advance planning. In these crisis situations, families face urgent decisions about protecting assets while securing Medicaid coverage.

Crisis planning is possible, but options are more limited than with advance planning. Even so, our experienced Medicaid attorneys can implement strategies to protect significant assets even when care is needed immediately.

Emergency Medicaid Planning Strategies

When facing an immediate need for nursing home care, several strategies can protect assets:

• Spousal Protections: Maximizing the Community Spouse Resource Allowance to protect assets for the at-home spouse
• Spend-Down Planning: Converting countable assets to exempt assets through strategic purchases
• Income Diversion: Structuring income to benefit the community spouse rather than being spent on care
• Medicaid-Compliant Annuities: Converting assets to income streams that comply with Medicaid rules
• Partial Asset Transfers: Strategic gifting coupled with private pay periods that may preserve more assets than spending everything
• Promissory Notes: Properly structured loans to family members that convert assets while preserving value

The Importance of Acting Quickly

In crisis situations, time is critical. Every day delay can mean thousands of dollars in unnecessary spending. If you or a loved one needs nursing home care and hasn't completed Medicaid planning, contact our office immediately. Our attorneys prioritize crisis planning cases and can often meet with families within 24-48 hours.

We serve families throughout Texas and Arkansas from our offices in Texarkana, Tyler, Paris, Longview, and Magnolia, and we understand the urgency of crisis planning situations.

Medicaid Estate Recovery in Texas and Arkansas

Many families don't realize that Medicaid benefits come with strings attached. Both Texas and Arkansas have estate recovery programs that attempt to recover costs paid for long-term care from your estate after death.

Medicaid estate recovery primarily targets your home. While your house is exempt during your lifetime (if you meet residence requirements), after your death, the state may place a claim against it to recover Medicaid benefits paid on your behalf.

How Estate Recovery Works

After a Medicaid recipient dies, Texas and Arkansas Medicaid programs review the estate for recoverable assets. The state files a claim for reimbursement of benefits paid. This claim must be satisfied before heirs receive any inheritance.

Estate recovery typically focuses on real property, especially the home, though the state can pursue other probate assets as well. The amount claimed equals the total Medicaid benefits paid for nursing home care and other long-term care services.

Protections From Estate Recovery

Federal and state law provides certain protections that can prevent or delay estate recovery:

• Surviving Spouse: No recovery while a surviving spouse is alive
• Minor or Disabled Children: Recovery is postponed if you have children under 21 or children of any age who are blind or permanently disabled
• Hardship Waivers: Recovery may be waived if it would cause undue hardship to heirs
• Sibling Exception: A sibling who lived in the home at least one year before nursing home admission and has equity interest may prevent recovery
• Caregiver Child Exception: An adult child who lived in the home at least two years and provided care delaying nursing home admission may be protected

Strategies to Avoid Estate Recovery

Proper Medicaid planning can minimize or eliminate estate recovery risk. Our attorneys implement strategies to protect your home for your heirs, including:

• Irrevocable trust planning before the five-year lookback period
• Strategic property transfers to qualifying family members
• Life estate deeds with retained use rights
• Proper titling and ownership structures

These strategies must be implemented correctly and with proper timing. Our experienced asset protection attorneys help Texas and Arkansas families preserve their homes for the next generation.

Medicaid Planning FAQs

What is Medicaid planning and why do I need it?

Medicaid planning is the legal process of organizing your finances and assets to qualify for Medicaid long-term care benefits while protecting your assets from nursing home costs. Without proper planning, you may be required to spend down nearly all your assets before Medicaid will cover nursing home care. Our experienced Medicaid planning attorneys help Texas and Arkansas families protect their life savings while ensuring access to quality long-term care.

How much can I keep and still qualify for Medicaid in Texas or Arkansas?

Medicaid eligibility limits vary between Texas and Arkansas, but both states have strict income and asset requirements. In Texas, individuals can generally keep up to $2,000 in countable assets, while married couples can protect more through spousal protections. Arkansas has similar limits. However, certain assets like your primary residence, one vehicle, personal belongings, and prepaid funeral arrangements are typically exempt. Our attorneys help you navigate these complex rules and use legal strategies to protect additional assets while maintaining eligibility.

What is the five-year lookback period for Medicaid?

Both Texas and Arkansas Medicaid programs review all asset transfers made within five years before applying for benefits. Any gifts or transfers for less than fair market value during this period can result in a penalty period during which you're ineligible for Medicaid coverage. This is why early planning is crucial. Our Medicaid planning attorneys help you understand the lookback rules and implement strategies that comply with federal and state regulations while protecting your assets.

What is a Qualified Income Trust (Miller Trust) and do I need one?

A Qualified Income Trust, also called a Miller Trust, is required in Texas for Medicaid applicants whose monthly income exceeds the income limit but who still cannot afford nursing home care. The trust holds your excess income and uses it for your medical expenses and nursing home costs. Arkansas has similar income trust requirements. If your income is above the limit, you'll need this special trust to qualify for Medicaid. Our attorneys create properly structured Qualified Income Trusts that meet all state and federal requirements.

Can I protect my home from nursing home costs?

Yes, your primary residence is generally an exempt asset for Medicaid eligibility in both Texas and Arkansas, up to certain equity limits. However, after your death, your state may attempt to recover Medicaid costs through estate recovery from your home. There are several legal strategies to protect your home, including spousal protections, irrevocable trusts, and proper titling. Our Medicaid planning attorneys help Texas and Arkansas families implement the right strategies to preserve their homes for their families.

What happens if I need nursing home care but haven't done Medicaid planning?

Even in crisis situations, there are legal strategies available to protect some of your assets. This is called Medicaid crisis planning. While advance planning is always preferable, our experienced attorneys can still help protect assets through emergency techniques like spend-down strategies, converting countable assets to exempt assets, and spousal protections. If you or a loved one needs nursing home care immediately, contact us right away. Time is critical in crisis planning situations.

Contact Our Medicaid Planning Attorneys

Don't let nursing home costs devastate your family's financial security. The experienced Medicaid planning attorneys at Ross & Shoalmire are ready to help you protect your assets while ensuring access to quality long-term care.

Serving Texas and Arkansas From Multiple Locations

Ross & Shoalmire serves families throughout Northeast Texas and Arkansas from convenient office locations. We're proud to serve families across Texas communities including Texarkana, Tyler, Paris, Longview, Marshall, Mount Pleasant, and beyond, as well as Arkansas communities including Magnolia, Hope, El Dorado, Camden, and throughout the region.

Our office locations:

• Texarkana Office (Main): 1820 Galleria Oaks Dr, Texarkana, TX 75503 | Phone: 903-223-5653
• Tyler Office: Serving Smith County and East Texas
• Paris Office: Serving Lamar County and Northeast Texas
• Longview Office: Serving Gregg County and the Ark-La-Tex region
• Magnolia Office: Serving Columbia County and Southern Arkansas

Schedule Your Free Consultation Today

Don't wait until it's too late. The best time to plan was five years ago. The second best time is today. Contact Ross & Shoalmire now to discuss your Medicaid planning needs. We'll review your situation, explain your options, and create a comprehensive strategy to protect your assets and provide for your future care.

You've worked hard for what you have. Let our experienced elder law attorneys help you protect it for yourself and your loved ones. Whether you need advance planning or crisis assistance, we're here to guide you through every step with dignity, compassion, and proven legal expertise.