Planning Ahead for Nursing Home Costs in Texas

 Posted on July 09, 2025 in Elder Law

Daily rates for nursing homes vary based on where you live and the chosen provider, as well as whether a private or semi-private room is chosen. The median national cost for a private nursing home room in 2025 is $361 per day, or $314 per day for a semi-private room. As you might imagine, staying in a nursing home for an extended period can become very expensive. Location can significantly influence the cost of a nursing home.

Texas, Missouri, Oklahoma, Arkansas, Kansas, and Missouri have some of the lowest costs, with Texas averaging about $185 per day for a semi-private room and $240 per day for a private room. Even so, the monthly rate is more than double the average Social Security benefit. This makes planning ahead essential.

Cost estimates, funding options, Medicaid planning, and other strategies to preserve your hard-earned assets are extremely important. An experienced Flower Mound, TX elder law attorney can help you get your affairs in order early on, preventing your loved ones from experiencing confusion, financial stress, and limited care choices down the road.

Medicare’s Limited Role in Nursing Home Care

Most people believe that Medicare covers nursing homes, but in reality, Medicare plays a very limited role in long-term care. When medically necessary, Medicare pays 100 percent of the cost of nursing home care for the first 20 days following a hospitalization. For days 21-100, Medicare pays only a small portion of the cost.   

What About Medicaid?

Medicaid currently pays 100 percent of nursing home costs for beneficiaries if the patient meets the limited income and asset criteria, which include assets valued at less than $2,000 and a monthly income of less than $2,901 per month in 2025.  A married couple, when both are applying for Medicaid nursing home care, can have a combined monthly income of $5,802 and a combined asset limit of $3,000. When a married couple has only one spouse applying, the applicant’s monthly income limit is $2,901.

The non-applicant spouse has a protected interest in the assets. Depending on the circumstances, under the Community Spouse Resource Allowance (CSRA), that could be as high as $157,920.  The nursing home applicant is entitled to a monthly personal needs allowance, with the majority of the remaining income going toward the nursing home costs. Medicaid will only pay for a shared room.   

What is Medicaid’s Look-back Rule?

Texas Medicaid has a five-year look-back period immediately preceding the application date. The state will scrutinize all asset transfers to ensure that no assets were gifted or sold at a price below fair market value during these five years.

Although the primary home is usually exempt from the asset limit, it is not exempt from Medicaid’s Estate Recovery Program, which occurs when the agency seeks reimbursement of care costs through any estate remaining for the decedent, which is often the home.

How Medicaid Planning Can Make a Difference

An experienced elder law attorney can help you engage in asset protection for Medicaid planning, but you need to start well before nursing home care is necessary. In some cases, irrevocable trusts can protect assets from being claimed by Medicaid by removing assets from the applicant’s ownership outside the look-back period. Other strategies include:

• Asset transfers to move assets out of the applicant’s name to reduce countable resources
• Gifting assets to family members or other beneficiaries
• Medicaid Compliant Annuities (MCAs) can be used during "crisis planning" (the five-year look-back period) to convert a lump sum of countable assets into a non-countable income stream.
• Asset spend-down, using excess assets to pay for permitted expenses to lower the total countable assets
• Maximizing the Community Spouse Resource Allowance
• Medicaid Asset Protection Trusts (MAPTs), which are irrevocable trusts designed to safeguard assets from Medicaid

Contact a Denton County, TX Elder Law Attorney

If you are ready to take control of your future needs, do not wait until a crisis occurs. A highly skilled Flower Mound, TX elder law attorney from Colbert Law Group PLLC can help you personalize your long-term care plan while protecting your legacy. Attorney Colbert has served as an administrative law judge and a tribal judge for the Chickasaw Indian Nation. Call 972-724-3338 to schedule your initial attorney appointment.