Eligibility Guidelines
To be eligible for the PHC Program, Texas residents must be 21+ years old and require assistance to perform at least one of the activities of daily living, such as bathing, grooming, eating, or toileting. Their functional limitation must result from a medical condition and must be documented by a medical professional. The financial eligibility criteria for PHC are the same as for regular Texas Medicaid. In 2020, a single aged (65 and over) person applying must have income below $783 per month and the value of their assets cannot be greater than $2,000. Some assets, however, are considered exempt. For instance, if the applicant owns a home, the asset limit does not include any home equity that they might have in their primary residence. However, if they do not live in their home and it is clear they will not be returning for medical reasons and they do not have a spouse that lives in the home, then the home is valued in their assets. An additional exception to the exempt home rule is when the value of their home equity exceeds $595,000. It is worth noting that although the home is exempted from consideration during eligibility, it is still possible that the state will place a lien on the home to recover part of the value of the services paid during the Medicaid recipient’s lifetime. If two individuals, a married couple, are both seeking Medicaid simultaneously, their combined monthly income cannot be greater than $1,175. Countable resources are limited to a value of $3,000. Qualifying for Medicaid When Over the Limits
It is possible to qualify for Medicaid in Texas when one exceeds the financial limits by re-allocation of income and assets into trusts and exempt resources. To do this, it is recommended that a Medicaid planning professional provide guidance as these processes can be complicated and carry financial risks. Benefits and Services
Participants in the PHC Program can be approved for up to 50 hours / week of assistance. Services can include assistance with any of the following:
Personal care assistance with bathing, grooming, dressing, eating, medication administration and transferring
Assistance with the instrumental activities of daily living such as shopping, housekeeping, laundry and meal preparation
Assistance with transportation for medical appointments