Elder Law · Medicaid Cost Guide
How Much Does Medicaid Planning Cost in Texas?
The real cost question in elder law is not the legal fee — it is the $6,000–$8,000 a month a nursing home charges, and the savings a family loses when no one plans. Here is what care costs, what planning costs, and how the five-year look-back penalty actually works, with a worked 2026 example.
The Short Answer
Nursing home care in Texas commonly costs $6,000 to $8,000 a month, and Medicare does not cover long-term custodial care. Medicaid does — but only once a person qualifies, which means countable assets at or below $2,000 and income at or below $2,982/month (2026). Lawful Medicaid planning restructures assets in advance so a spouse and family are not left impoverished: the healthy spouse can keep up to $162,660, the homestead is protected with a Lady Bird deed, and income over the cap is handled with a Miller Trust. The catch is the five-year look-back — gifts made in the prior 60 months are penalized at $262.37 per day transferred — so planning early protects the most. WG Law quotes a flat fee up front after a consultation.
The Numbers That Decide Everything
Texas Medicaid Long-Term Care — 2026 Figures
These are public Texas HHSC and federal figures, not firm fees. Every Medicaid plan is built around them — and they update periodically, so the ones below are current for 2026.
Nursing home care
$6,000–$8,000+/mo
Typical Texas private-pay cost
Applicant asset limit
$2,000
Countable resources, single applicant
Income cap (300% SSI)
$2,982/mo
Above this, a Miller Trust (QIT) is required
Community spouse keeps
up to $162,660
2026 max CSRA — the healthy spouse's share
Look-back period
5 years
60 months of transfers are reviewed
Penalty divisor
$262.37/day
Texas HHSC, effective Sept. 1, 2025
Worked Example · The Costly Mistake
What Giving Money Away Really Costs
The most common — and most expensive — mistake is to give assets to the children to “spend down” before applying. Any transfer for less than fair market value in the five years before applying is added up and divided by the state penalty divisor ($262.37 per day as of September 1, 2025), producing a stretch of time when Medicaid will not pay for care.
$120,000 gifted to children inside the look-back
Total gifts in the prior 5 years
$120,000
Texas penalty divisor (per day)
$262.37
Penalty period ( $120,000 ÷ $262.37, rounded down )
457 days
That is approximately
~15 months
~15 months with no Medicaid coverage
At $6,000–$8,000 a month of private-pay care, that penalty costs the family well over $100,000 out of pocket — often more than the gift itself. A properly structured plan avoids the penalty entirely.
Worked Example · The Protected Path
How a Married Couple Keeps What They Worked For
Now the same crisis, planned correctly. One spouse needs a nursing home; the other stays home. The couple has $400,000 in countable savings, plus a paid-off house and a car. Instead of spending it all on care, the plan protects it — legally, with no penalty.
$400,000 countable + exempt home & car
Community (healthy) spouse keeps — CSRA
2026 Community Spouse Resource Allowance
up to $162,660
Homestead
Protected from estate recovery with a Lady Bird deed
Exempt
One vehicle
Not counted toward the limit
Exempt
Remaining countable savings
Restructured — not simply handed to the nursing home
≈ $237,340
The remaining savings are converted, not lost
Penalty-free moves turn countable dollars into exempt or income-producing ones: paying off debts, home repairs and modifications, a newer vehicle, an irrevocable prepaid funeral — and a Medicaid-compliant annuity that converts a lump sum into a guaranteed income stream for the healthy spouse (not a gift, so no penalty). The applicant spouse reaches the $2,000 limit, Medicaid pays for care, and the family keeps the home and a protected nest egg for the spouse who remains.
Figures are illustrative and use the 2026 Texas limits; the exact mix of tools depends on the family's assets, income, and timing. The point is the contrast: the same money that is forfeited in an unplanned spend-down is, with planning, largely kept.
What the Legal Fee Depends On
Six Things That Move the Planning Fee
Crisis planning vs. advance planning
The most expensive Medicaid planning is the kind done in a hospital hallway after a stroke. Crisis planning — restructuring assets when a nursing home is needed now — takes more work than planning done years ahead, and it has fewer tools available because the five-year look-back clock is already running. Advance planning is both cheaper and far more protective.
Married vs. single
A married couple has powerful protections a single person does not — the community spouse resource allowance (up to $162,660 in 2026), the spousal income allowance, and Medicaid-compliant annuities that convert countable savings into an income stream for the healthy spouse. Those tools take drafting, which is reflected in the fee, but they typically protect far more than they cost.
Whether income is over the cap
Texas caps the applicant's income at $2,982 a month (2026). If income is even a dollar over, the applicant needs a Qualified Income Trust — a Miller Trust — to qualify at all. Setting one up and administering it correctly is a distinct piece of the engagement.
The home and other real estate
Protecting the homestead from Medicaid estate recovery usually means a Lady Bird (enhanced life estate) deed — a short document with an outsized effect. Additional real estate, rental property, or a family farm adds analysis and drafting.
Prior gifts inside the look-back
If money or property was given away in the last five years — even ordinary generosity to children or grandchildren — it may trigger a penalty that has to be planned around or cured. Untangling and mitigating prior transfers is some of the most technical work in this area.
A business or complex assets
A closely held business, mineral interests, brokerage accounts, or assets in more than one state each add valuation and structuring work. The more moving pieces, the more the plan costs — and usually the more there is to protect.
The Comparison That Matters
The Five-Year Clock Rewards Planning Early
Every tool on this page works better with time. Transfers into a properly structured irrevocable trust, or a home protected years in advance, fall outside the five-year look-back and carry no penalty — while the same moves made in a crisis can trigger months of ineligibility. The legal fee for planning is modest next to a single month of private-pay care, and tiny next to a spend-down that forfeits a lifetime of savings.
Compare this to what probate costs in Texas and the cost of an estate plan, or read more about Texas Medicaid planning and elder law.
Who Builds Your Plan
Elder Law Led by a Five-Time Author
Medicaid and long-term-care planning at WG Law is led by Taylor Willingham, author of five books on estate planning and elder law, counsel to more than 10,000 clients, and a Super Lawyers Rising Star (2019–2022). This is the planning that protects the home, the healthy spouse, and the savings a family spent a lifetime building.
We quote a flat fee up front after a consultation — no hourly surprises — and we build the plan around your family's actual numbers. Trusted by 350+ five-star clients across North Texas.
Common Questions
Medicaid Planning Cost — FAQ
How much does nursing home care cost in Texas?
How much does Medicaid planning cost with an attorney?
How is the 5-year look-back penalty calculated in Texas?
Can I just give my money and house to my children to qualify for Medicaid?
How does Medicaid protect the healthy spouse in Texas?
What is a Miller Trust / Qualified Income Trust, and do I need one?
Does WG Law charge for a Medicaid planning consultation?
Protect What You Built
Start Before the Five-Year Clock Runs Out
Tell us about your family's situation, and Taylor Willingham's team will explain what can be protected and quote a flat fee for the plan you need. An intake specialist responds within one business day.