By Penny Jones • October 15, 2026
TL;DR: Children's Medicaid in Texas covers doctor visits, therapies, prescriptions, and equipment for children who qualify by family income or by disability. For a child with special needs, the coverage is often irreplaceable, and it can be lost through an unplanned inheritance or gift. Supplemental needs trusts and ABLE accounts keep benefits safe.
Medicare vs Medicaid for Long-Term Care: What's the Difference for Texas Seniors?
By Penny Jones • September 17, 2026
Medicare pays for rehab. Medicaid pays for the nursing home. A Houston elder law attorney explains the difference and the planning gap between them.
By Penny Jones • August 31, 2026
TL;DR: Texas families pay for long-term care in seven main ways: personal savings, long-term care insurance, hybrid life insurance policies, VA Aid and Attendance, home equity, family caregiving agreements, and Medicaid long-term care benefits. Most families end up combining two or three, and Medicaid planning protects the rest. Every week, a family sits in my office and asks the same question: how are we supposed to pay for this? A parent needs care, the numbers feel impossible, and nobody planned for it. Here is the honest answer, option by option, so you can see the full menu before you spend down a lifetime of savings. 1. Personal Savings and Retirement Income The default plan for most families, and the fastest to run out Nursing home care in the Houston area commonly runs $6,000 to $9,000 per month Works best as a bridge while you set up the smarter options below Home care can cost much more! 2. Long-Term Care Insurance Excellent if purchased in your 50s or early 60s; expensive or unavailable after health changes Check existing policies for elimination periods, daily benefit caps, and inflation riders Already own a policy? Bring it to your planning meeting; it changes the whole strategy 3. Hybrid Life Insurance With Care Riders Life insurance policies that let you spend the death benefit on care while living Popular because unused benefits still pass to your family Underwriting is easier than traditional long-term care insurance 4. VA Aid and Attendance A pension enhancement for wartime veterans and surviving spouses who need help with daily living Often missed: many Houston families never learn their parent qualifies Can stack with other strategies on this list 5. Home Equity Reverse mortgages and sale proceeds can fund care, with real tradeoffs In Texas, your homestead receives special protection in Medicaid planning; selling it at the wrong time can create problems Talk to an elder law attorney before touching home equity for care costs 6. Family Caregiving Agreements A written, paid caregiver contract with an adult child keeps money in the family Done correctly, payments are legitimate and Medicaid compliant Done informally, the same payments can look like gifts and trigger penalties later 7. Medicaid Long Term Care Benefits The payer of last resort for most families, and the one that requires the most planning Texas has strict income and asset limits, a five-year lookback on gifts, and estate recovery rules Tools like Miller trusts for income and spousal protections exist, and they work best before a crisis Which Option Is Best for Your Family? The best way to pay for long-term care in Texas is a layered plan: insurance or VA benefits where available, careful use of savings, and early Medicaid planning to protect the healthy spouse and the family home. The worst plan is writing checks until the money is gone. That is the plan most families are on by default. FAQ How much does a nursing home cost in Houston? Most Houston-area nursing homes cost between $6,000 and $9,000 per month, and memory care often costs more. Costs rise every year. Does Medicare pay for long-term care in Texas? No. Medicare covers up to 100 days of skilled rehabilitation after a hospital stay. It does not pay for ongoing custodial nursing home care or for ongoing custodial care at home. Can Medicaid take your house in Texas? The Texas homestead is generally protected during your lifetime, and the state may file an estate recovery claim after death. Planning ahead can protect the home for your family. When should I start Medicaid planning in Texas? Five years before you need care is ideal because of the lookback period. Planning is still possible in a crisis; the earlier you start, the more you protect. Every family's situation is different. Come see us at our Kirby Drive office or virtually, and we will map the options together. Call 713-529-5900. Law Office of Christina Lesher, PC, 5615 Kirby Dr, Suite 412, Houston, TX 77005.
Image of last will and testament.
By Penny Jones • July 14, 2026
After reviewing thousands of Texas wills, eight errors show up over and over. Find out if your will has any of them.
Houston probate attorney guiding a client through signing estate documents at the Law Office.
By Penny Jones • June 10, 2026
Houston probate explained: the two things most families miss, how long Texas probate takes, and how to make it easier. Guidance from Christina Lesher.

6 Ways an Inheritance Can End Your Child's Medicaid (and How to Prevent Each One)

Penny Jones • November 12, 2026
Leave a gift that helps, never one that harms: inheritance planning to protect a child's Medicaid.

TL;DR: The six inheritance mistakes that end a child's Medicaid are: a direct bequest in a will, dying without a will, naming the child on life insurance or retirement accounts, UTMA custodial accounts, court settlements paid outright, and gifts from grandparents. Every one is preventable with a supplemental needs trust and coordinated beneficiary designations.


Nobody in these stories did anything wrong on purpose. Every mistake below was an act of love with the wrong paperwork. Here are the six I see in my Houston practice, each with its fix.


1. A Direct Bequest in a Will

The will says "to my daughter, equally with her brothers." The gift arrives, and Medicaid and Social Security eligibility ends.

Fix: a supplemental needs trust written into the will or trust that receives her share instead


2. Dying Without a Will

Texas intestacy law hands the child a share automatically, with no protective wrapper

Fix: both parents execute wills with SNT provisions; this is the core reason special needs parents cannot rely on generic online or Chat GPT wills


3. Life Insurance and Retirement Accounts Naming the Child

Beneficiary designations override the will; a policy naming the child pays the child

Fix: audit every designation and point them to the trustee of a supplemental needs trust.


4. UTMA and Custodial Accounts

Money in the child's name counts against the child at 21.

Fix: redirect savings into an ABLE account or first party Supplemental Needs Trust before adulthood


5. Settlements and Court Awards Paid Outright

Personal Injury settlements or child support paid directly to create the same problem at a larger scale

Fix: a first-party special needs trust holds the award or support to preserve benefits


6. Generous Grandparents

Grandparents' wills and gifts routinely name grandchildren directly, and nobody checks

Fix: one family conversation plus trust supplemental for the family gifts.


FAQ


Does an inheritance count against Medicaid in Texas?

Yes. Assets inherited outright count toward eligibility limits and can end coverage until spent down. Trust planning prevents this.


Can grandparents leave money to a special needs grandchild?

Yes, safely, by naming the child's supplemental needs trust instead of the child. The gift then helps without harming benefits.


What happens to a child's Medicaid at age 18?

Eligibility is reassessed under adult SSI rules, and money in the child's own name counts. The years before 18 are the planning window.

One meeting can find every leak in your family's plan. Call 713-529-5900 and bring your beneficiary statements.


6 Leaks, 1 Bucket: six inheritance mistakes and a supplemental needs trust to help protect a child's Medicaid.
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About the Author:

Christina Lesher is a Houston elder law attorney with over 25 years of experience in elder care, social work, and legal services. Since 1997, she has helped families navigate Medicaid planning, estate planning, probate, guardianship, and special needs planning. Drawing on her personal experience caring for her grandfather with dementia, Christina combines legal knowledge with compassionate, hands-on guidance to help Texas families protect their loved ones and plan for the future.


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