Texas Medicaid Planning for Married Couples: What the Healthy Spouse Can Keep in 2026

Answer first: The spouse who remains at home does not have to spend down to $2,000. For 2026, that spouse may receive a protected share of the couple's countable resources ranging from $32,532 to $162,660, keep excluded assets such as the home and one vehicle, keep their own income, and sometimes receive part of the Medicaid applicant's income. The exact amount is calculated. The $162,660 ceiling is not an automatic allowance for every couple.

This guide uses "healthy spouse" because that is the phrase families commonly search. Texas Health and Human Services Commission (HHSC) materials use community spouse for the spouse who remains outside the institutional setting. The spouse seeking nursing-facility Medicaid or certain home and community-based waiver services is the applicant or institutionalized spouse. The rules below are specific to that married-couple setting. They do not apply in exactly the same way when both spouses apply, or when someone applies for a different Medicaid program. See the HHSC nursing-facility and waiver guide.

The 2026 Texas numbers at a glance

• Community Spouse Resource Allowance: $32,532 minimum to $162,660 maximum. HHSC calls this the Spousal Protected Resource Allowance (SPRA). The actual amount is usually one-half of the couple's combined countable resources, subject to the federal floor and ceiling.
• Applicant's countable-resource limit: $2,000 after the community spouse's protected share and excluded assets are addressed.
• Current minimum monthly maintenance needs allowance: $2,705, effective July 1, 2026. This is a needs standard used in the income calculation, not an automatic monthly check.
• Maximum monthly maintenance needs allowance: $4,066.50 in 2026. Documented shelter costs, a fair-hearing decision, or a support order can affect the actual allowance.
• Community spouse housing allowance: $811.50, effective July 1, 2026. HHSC uses shelter costs above this amount when calculating an excess shelter allowance.
• Applicant's special income limit: $2,982 per month in 2026. A Qualified Income Trust, commonly called a Miller Trust, may overcome this eligibility limit when the applicant's countable income is higher.

The resource and income figures come from the Centers for Medicare & Medicaid Services updated 2026 standards. Texas confirms the $2,000 applicant limit, $2,982 income limit, and $32,532 to $162,660 protected-resource range in its current HHSC program guide. These figures are indexed on different schedules, so a guide that was correct in January can have a stale income floor after July 1.

How HHSC calculates what the healthy spouse can keep

For nursing-facility Medicaid, HHSC takes a resource snapshot at 12:01 a.m. on the first day of the month in which the applicant's first continuous institutional period began. A hospital stay may count when the applicant moves directly from the hospital into the facility. Waiver applications use a different assessment-date rule. HHSC explains both dates in Handbook Section J-4300.

HHSC then combines the spouses' countable resources, even when accounts are titled separately, and divides the total by two. The community spouse's share is limited by the federal minimum and maximum. The home, one vehicle, household and personal goods, and qualifying burial arrangements are excluded before this calculation. HHSC summarizes that method in Appendix XXXIII.

A worked 2026 example

Assume a married couple owns $260,000 in countable resources after excluded property has been removed from the calculation.

1. One-half of $260,000 is $130,000.
2. $130,000 falls between the 2026 minimum of $32,532 and maximum of $162,660.
3. The community spouse's starting protected allowance is therefore $130,000.
4. The applicant may retain $2,000 in countable resources.
5. The remaining $128,000 must be spent, converted to excluded resources, or otherwise handled under a lawful plan before resource eligibility can be met.

If the couple instead had $400,000 in countable resources, one-half would be $200,000, but the 2026 ceiling would generally limit the protected share to $162,660. If the couple had modest resources, the $32,532 floor could control. A fair-hearing decision or support order may change the result in a particular case. The governing federal statute gives either spouse a fair-hearing right to challenge the spousal share, resource attribution, or allowance calculation. See 42 U.S.C. § 1396r-5.

The protected amount should then be transferred to or for the sole benefit of the community spouse as soon as practicable. Federal law permits that transfer without the ordinary transfer penalty up to the authorized allowance. HHSC also warns that the special exclusion ends at the first annual redetermination, when resources still left in the applicant's name are counted again. Account ownership and timing therefore matter.

Assets that sit outside the CSRA calculation

The CSRA is only the protected share of countable resources. It is not the complete list of what the healthy spouse can keep.

• The home: HHSC excludes the homestead when the community spouse lives there. The home exclusion during eligibility is separate from Medicaid estate recovery after death.
• One vehicle: Texas excludes one vehicle regardless of value. Additional vehicles are reviewed under separate rules.
• Household and personal goods: Ordinary household goods and personal property are excluded from the protected-resource calculation.
• Burial arrangements and limited life insurance: Certain burial spaces, separately identified burial funds, irrevocable arrangements, term insurance, and limited-face-value life insurance may be excluded. The terms and values matter, so these categories should not be treated as unlimited.

The HHSC program guide lists the current exclusions. Families should classify each account and asset before moving money. A transfer made for less than fair market value can create a penalty within the 60-month review period, as explained in our guide to the Texas Medicaid five-year look-back.

The income protection is separate from the CSRA

Resources and income use different rules. Federal law says the community spouse's income is not deemed available to the institutionalized spouse. Texas likewise states that a spouse's income is not considered when testing the applicant against the special income limit. In practical terms, the healthy spouse keeps income that belongs to them under the program's income-ownership rules.

The community spouse may also receive part of the applicant's income through the community spouse monthly income allowance. As of July 1, 2026, the base minimum monthly maintenance needs standard is $2,705. Excess shelter costs can raise the needs standard, but the 2026 maximum is $4,066.50. The actual transfer is generally the difference between the applicable needs standard and the community spouse's own available income, limited by income the applicant can make available after other permitted deductions.

For example, if the applicable needs standard is $2,705 and the community spouse has $1,900 of their own monthly income, the starting shortfall is $805. That does not guarantee an $805 payment. HHSC must still calculate the applicant's available income and allowed deductions. If documented shelter costs support a higher needs standard, the shortfall may be larger, subject to the $4,066.50 maximum.

Either spouse can challenge an income-allowance calculation through a fair hearing. Under 42 U.S.C. § 1396r-5(e), exceptional circumstances causing significant financial duress can support an allowance above the ordinary calculation. A court support order can also set a floor for the monthly allowance.

Where a Miller Trust fits, and where it does not

The 2026 Texas special income limit is $2,982 per month for the applicant. The healthy spouse's income is not added to the applicant's income for this test. If the applicant's countable income exceeds $2,982, a valid Qualified Income Trust (QIT), commonly called a Miller Trust, may overcome the income-limit problem for institutional or qualifying waiver Medicaid. Read our full guide to Texas Miller Trusts and Qualified Income Trusts.

A Miller Trust is not a savings shelter and does not increase the CSRA. HHSC requires the trust to be irrevocable, funded only with the applicant's income, and written with the state as residuary beneficiary up to Medicaid benefits paid. The selected income source generally must be deposited during the month it is received. Income in the trust still enters the post-eligibility co-payment calculation. HHSC's controlling requirements are in Handbook Section F-6800.

The clean distinction is:

• CSRA/SPRA: protects a calculated share of countable resources for the community spouse.
• Monthly income allowance: may redirect part of the applicant's income to the community spouse.
• Miller Trust: addresses the applicant's income eligibility test when countable income exceeds $2,982.

Confusing those three tools is a common way to solve the wrong problem.

Lady Bird deed boundaries for a married Medicaid plan

A Lady Bird deed is an enhanced life estate deed. HHSC defines it as a deed that transfers property to heirs while the owner retains a life estate and powers that include the right to sell during life. It can be useful, but its role is narrower than many online summaries suggest. See the HHSC MEPD Glossary.

What it can address

Texas describes Medicaid estate recovery as a claim filed in probate court against a deceased recipient's estate. A valid deed that leaves no home in the recipient's probate estate may therefore reduce probate-estate exposure. That is a planning inference from the probate-only recovery rule, not a promise that every deed defeats every claim. Our related guides explain protecting a Texas home from Medicaid recovery, how Texas MERP works, and Lady Bird deed mechanics.

What it does not do

• It does not create the home exclusion. The home is already excluded during eligibility when the community spouse lives there. HHSC says the retained full equity value remains a resource unless another exclusion, such as the homestead rule, applies.
• It does not replace the surviving-spouse MERP exemption. Texas rules state that a MERP claim is made only when there is no surviving spouse, subject to the rule's other terms. See 1 Texas Administrative Code § 373.207 and the HHSC MERP handbook section.
• It does not fix excess bank accounts, the applicant's $2,000 resource limit, the $2,982 income limit, or QIT administration. Those are separate eligibility issues.
• It is not automatically penalty-proof. HHSC directs staff to obtain regional-attorney review for enhanced life estate deeds. Its home-transfer policy specifically requires approval and an intent-to-return statement when an enhanced life estate or transfer-on-death deed moves the home to children, siblings, or others. See Handbook Section I-3100.

The deed must match the owners, current title, retained powers, intended beneficiaries, and the Medicaid plan. A downloaded form cannot answer those fact questions.

A safer order of operations

1. Fix the assessment date. Gather statements showing every account and resource on the correct snapshot date.
2. Classify before transferring. Separate countable resources from the home, vehicle, personal goods, and other exclusions.
3. Calculate the actual SPRA. Do not assume the healthy spouse automatically receives the $162,660 maximum.
4. Run the income calculation separately. Identify each spouse's income, the community spouse's shelter costs, and the applicant's available income.
5. Test the applicant against $2,982. If countable income is higher, determine whether a properly administered Miller Trust is needed.
6. Review the deed as a separate title and MERP decision. Do not use a Lady Bird deed as a substitute for the resource or income analysis.
7. Document transfers and keep proof. HHSC requires proof of ownership, value, and changes, and the protected share should be moved to the community spouse within the permitted time.

For a broader cost and process overview, see the 2026 Texas Medicaid planning cost guide and WG Law's Medicaid planning practice.

Primary sources reviewed

• CMS, Updated 2026 SSI and Spousal Impoverishment Standards, including the July 1, 2026 MMMNA and housing update.
• Texas HHSC Appendix XII, current nursing-facility and waiver income, resource, exclusion, and spouse-protection figures.
• Texas HHSC J-4300, assessment-date rules.
• Texas HHSC Appendix XXXIII, spousal-resource calculation and excluded-resource overview.
• Texas HHSC F-6800, Qualified Income Trust requirements.
• Texas HHSC I-3100 and the MEPD Glossary, enhanced life estate deed treatment.
• 1 Texas Administrative Code § 373.207 and Texas HHSC D-7800, surviving-spouse exemption and probate-claim context.
• 42 U.S.C. § 1396r-5, official U.S. Code text for spousal income, resource, transfer, notice, and fair-hearing protections.

Request a married-couple Medicaid planning consultation

The right calculation depends on the snapshot date, account ownership, transfer history, income sources, shelter costs, facility or waiver setting, and title to the home. WG Law can review those facts together and build a plan around the current Texas rules. Call 214-250-4407 or request a consultation. WG Law serves families from offices in McKinney and Southlake and throughout the Dallas-Fort Worth area.

This article is general information, not legal advice or a Medicaid eligibility determination. The figures are current as of August 12, 2026 and can change. HHSC applies the rules to the documents and facts in each case.