If one spouse is entering a nursing facility in Williamson County and the other is staying home, the rules that decide your outcome are not the $2,000 asset limit everyone talks about – they are the spousal impoverishment rules, and the single most consequential date in the entire case is the snapshot date, the first day of the first month of continuous institutional care. Everything the couple owns is counted as of that date, and decisions made before it are worth far more than decisions made after it.
This matters more in Williamson County than almost anywhere in Texas, because the retiree density here is extraordinary. Georgetown, the county seat, holds one of the largest active-adult communities in the state on its west side, several thousand homes deep, and Georgetown has repeatedly ranked among the fastest-growing cities in the United States over the past several years. Round Rock, Cedar Park and Leander added their own waves of buyers who are now in their seventies. The typical household here is a married couple who moved from somewhere else, sold a house at a gain, and hold most of their net worth in a paid-off Texas homestead plus a retirement account.
Texas is also a community property state, which changes the analysis in ways a generic Medicaid article will get wrong. Long-term care coverage runs through Texas Medicaid – STAR+PLUS, the state’s managed long-term services program, and the Medicaid nursing facility program. Applications are handled by the Texas Health and Human Services Commission, not by Williamson County. Nothing below is legal or eligibility advice: verify every figure with HHSC and take your actual facts to an elder law attorney licensed in Texas.
In This Article
- The Snapshot Date, and Why It Outranks Everything Else
- What the Spouse at Home Keeps: the Community Spouse Resource Allowance
- Income: the Maintenance Allowance and the Texas Miller Trust
- The Homestead, MERP, and Why Texas Is Different
- Where the Application Actually Goes – and It Is Not the County
- Life Insurance in a Married Couple’s Spend-Down
- When Selling the Policy Is the Wrong Answer Here
- Frequently Asked Questions
The Snapshot Date, and Why It Outranks Everything Else
When a married applicant enters a nursing facility, Texas Medicaid values the couple’s countable resources as of the first day of the first month of continuous institutionalization. That is the snapshot. It fixes the number from which the community spouse’s protected share is calculated, and it does not move because you file the application later.
Two practical consequences. First, resources spent, restructured or converted after the snapshot do not reduce the snapshot figure – they reduce what is left, which is a different thing. Second, the snapshot is triggered by a continuous institutional stay, which commonly begins with a hospital admission that rolls into a skilled nursing stay. Families frequently do not realize the clock started until weeks later.
So the order of operations is: identify the snapshot date, inventory everything the couple owned that day with statements, and only then start planning. If the parent is in a Georgetown or Round Rock hospital right now and a nursing facility transfer is likely, this week is the week to gather statements – not after the transfer.
Community property adds a Texas-specific wrinkle. Whether an asset is community or separate property affects characterization for other purposes, but for Medicaid eligibility both spouses’ countable resources are generally combined at the snapshot regardless of whose name is on the account. Do not assume a separately titled account is out of the calculation.
What the Spouse at Home Keeps: the Community Spouse Resource Allowance
The community spouse is entitled to keep a protected share of the couple’s countable resources, called the Community Spouse Resource Allowance. It is set within federal minimum and maximum figures that are adjusted annually. For 2025, the federal maximum was $157,920 and the minimum was $31,584; Texas has applied the maximum standard, meaning the spouse at home could generally protect countable resources up to that ceiling. Verify the 2026 figures with HHSC before you rely on them – these numbers change every January.
Then the institutionalized spouse is allowed the individual countable-asset limit, long $2,000 – again, verify the 2026 figure with HHSC. Everything above the CSRA plus that individual allowance is what the couple is expected to spend before eligibility begins.
Work a real Williamson County case. A Georgetown couple has $340,000 in countable resources at the snapshot – brokerage accounts, certificates of deposit, and cash – plus a paid-off homestead and two vehicles. If the CSRA ceiling is roughly $158,000 and the applicant’s allowance is $2,000, roughly $180,000 must be spent down. That does not mean handed to a nursing home. Legitimate uses include paying the couple’s actual bills, repairing or improving the homestead, replacing a vehicle, prepaying an irrevocable funeral arrangement, and paying legal and care-management fees. Which of those fits your case is a question for an attorney, because the wrong structure creates a transfer penalty.
Note what is not counted: the homestead where the community spouse lives, one vehicle, ordinary household goods and personal effects, and certain burial arrangements. That is why so many Williamson County couples look asset-rich on paper and still qualify – most of their net worth is in the house.
Income: the Maintenance Allowance and the Texas Miller Trust
Resources and income are separate tests, and Texas handles income in a way that surprises nearly every family. If the applicant’s own monthly income exceeds the special income limit for institutional Medicaid – $2,901 a month in 2025, with the 2026 figure to be verified with HHSC – the applicant is over the income cap. Texas does not simply reduce the benefit. Instead, the standard solution is a Qualified Income Trust, commonly called a Miller trust: income above the limit is deposited into the trust each month and disbursed under strict rules.
A Miller trust is not optional in those cases and it is not something to improvise. It must be drafted correctly, funded every single month, and administered through a dedicated account. Missing a month’s deposit can cost eligibility for that month. This is the single most common technical failure point in Texas long-term care Medicaid cases, and it is why an elder law attorney licensed in Texas earns their fee here.
Separately, the community spouse is protected by the Minimum Monthly Maintenance Needs Allowance, which allows a portion of the institutionalized spouse’s income to be diverted to the spouse at home when the spouse’s own income falls below the standard. The federal maximum was $3,948 a month in 2025; Texas has applied a single figure at or near that ceiling. Verify the 2026 number with HHSC. For a Cedar Park wife with $1,400 a month of her own Social Security whose husband receives $2,900, this provision is the difference between keeping the house and losing it.
| Item at the Snapshot Date | How Texas Medicaid Generally Treats It | 2025 Figure (Verify 2026 with HHSC) |
|---|---|---|
| Community spouse’s protected resources (CSRA) | Protected up to the state’s standard | Federal max $157,920 / min $31,584 |
| Applicant’s countable resources | Must be at or below the individual limit | $2,000 |
| Applicant’s monthly income | Over the cap requires a Qualified Income (Miller) Trust | Special income limit $2,901/month |
| Spouse at home’s income floor (MMMNA) | Applicant income may be diverted to the spouse | Federal max $3,948/month |
| Homestead with community spouse living there | Generally not countable; MERP may look to the estate later | Texas homestead acreage protections apply |
| Term life insurance, no cash value | Generally not a countable resource | N/A |
| Permanent policies, aggregate face value | Over the burial threshold, cash value generally counts | Confirm current threshold with HHSC |
The Homestead, MERP, and Why Texas Is Different
Texas homestead protection is among the strongest in the country, and it shapes every spend-down in this county. While the community spouse lives in the home, it is generally not a countable resource, and Texas homestead law protects generous acreage – substantially more than most states – from creditors generally.
Estate recovery is where the analysis has to be careful. Texas operates the Medicaid Estate Recovery Program, and MERP applies to long-term care services received on or after March 1, 2005. Texas MERP has published exemptions and hardship waivers, including protections tied to a surviving spouse, a surviving child under 21, a surviving blind or disabled child, and an unmarried adult child who resided in the homestead for a defined continuous period before death, as well as thresholds below which the state does not pursue small estates. Those rules are specific and they change – confirm the current exemptions and thresholds directly with HHSC and with an attorney rather than relying on any summary, including this one.
The local twist is valuation. Williamson County home values rose sharply between 2020 and 2022 and have stayed well above their pre-2020 levels, so a homestead that was worth $260,000 when a Georgetown couple bought it may appraise at more than double that now. That inflates the estate that MERP could potentially look to, and it inflates what heirs stand to lose – which is exactly why families here ask about the house first and the policy second.
There is also a 60-month look-back on transfers. Gifts, below-market sales, and transfers of the homestead to children within five years before application can generate a penalty period during which Medicaid pays nothing. Deeding the Georgetown house to a daughter to “protect” it is the most expensive mistake made in this county, and it is usually made with good intentions and no advice.
Where the Application Actually Goes – and It Is Not the County
This is where Williamson County differs from families in most other states, and getting it wrong costs weeks. Texas does not process long-term care Medicaid through county social services agencies. The Texas Health and Human Services Commission determines eligibility. Applications are submitted online through the state’s benefits portal, by mail or fax to HHSC, or in person at an HHSC benefits office; there are HHSC eligibility offices serving the Austin and Round Rock area. There is no Williamson County Medicaid office that will decide your case.
Two other agencies matter locally. The clinical side – the medical necessity and level-of-care determination that establishes the applicant actually needs nursing facility care – runs through the state’s assessment process and the STAR+PLUS managed care organization once enrolled. And for free, unbiased counseling on Medicare, supplements and long-term care questions, Texas operates the Health Information, Counseling and Advocacy Program through the aging network; Williamson County is served by the Capital Area Council of Governments Area Agency on Aging.
For questions about a life insurance policy itself – whether a carrier is licensed, how to file a complaint, how to locate a lost policy – the regulator is the Texas Department of Insurance. Do not confuse insurance questions with Medicaid questions; they go to different agencies and the answers are not interchangeable.
Life Insurance in a Married Couple’s Spend-Down
Life insurance is counted through the face-value aggregation rule, and the mechanics catch families off guard. Term insurance with no cash value is generally not a countable resource. For permanent policies, the state looks at the total face value of all policies on one person: if that total is at or under the small burial exclusion threshold the state applies, the cash surrender value is generally excluded; if the total exceeds it, the cash surrender value of those policies generally becomes countable. It is the aggregate face amount that trips the switch, not the cash value – so three small policies can push a household over a line that any one of them alone would not.
In a married case, the ownership matters. A policy owned by the community spouse on her own life, and a policy owned by the applicant, are treated within the couple’s combined resource calculation at the snapshot, so “it’s in her name” is not an answer. Inventory every policy on either spouse, including old employer group certificates, before the snapshot rather than after.
Surrendering is not the only option, and it is frequently the worst one. A settlement in the secondary market may produce substantially more than cash surrender value – federal research including the Government Accountability Office study of life settlements (GAO-10-775) found sellers typically received roughly 10 to 35 percent of face value, and materially more than surrender. A reduced paid-up election can end the premium while keeping a smaller death benefit. An irrevocable funeral trust can move a defined amount out of the countable column. An accelerated death benefit or chronic-illness rider already inside the contract may pay out with no fees. Read how life insurance is treated as a Medicaid asset and the current figures on the Texas asset and income limits page before choosing.
When Selling the Policy Is the Wrong Answer Here
Four situations, and the married case makes the last one decisive. First, small face amounts: policies under roughly $100,000 rarely attract secondary-market interest at all, and the review will simply come back negative. Second, a policy already sitting inside the burial exclusion: selling converts an excluded asset into countable cash and can make eligibility harder rather than easier, which is the exact opposite of the intent. Third, a healthy insured: offers are driven by life expectancy, so a 68-year-old in good health will see thin pricing, and waiting is often better than selling badly.
Fourth, and most important in Williamson County: the community spouse who will need the death benefit. If the wife staying in the Georgetown house has modest income of her own and the husband’s Social Security will largely disappear from the household at his death, his life insurance may be the only thing standing between her and a forced sale of the homestead. Converting that into a spend-down payment to a nursing facility can be a catastrophic trade even when it is technically permitted. This is precisely the scenario where the couple’s own elder law attorney, not any company, should make the call. Compare the routes on our surrender versus sell page, the nursing home spend-down overview, and the local Williamson County cost page for the monthly figures.
For context on what a month costs here: as of 2026, planning ranges built from Genworth-style cost-of-care surveys and Texas state survey data put a semi-private nursing facility room in the Williamson County and greater Austin market at roughly $5,800 to $6,800 a month and assisted living at roughly $4,500 to $5,500 – above the Texas statewide median, which has run lower than almost any state in the country. Confirm current private-pay rates with the facility directly.
If a policy is part of your picture and you want to know whether it has any value before making an irreversible decision, a free policy review of the declarations page will tell you – and if the answer is no, you should hear that plainly. Pine Lake Life Solutions provides education and policy reviews only; we do not purchase policies, we are not licensed in every state, and nothing here is legal, tax or Medicaid-eligibility advice.
Frequently Asked Questions
Does my wife have to spend everything if I go into a nursing home in Georgetown?
No. Spousal impoverishment rules protect a share of the couple’s countable resources for the spouse at home – the Community Spouse Resource Allowance, which had a federal maximum of $157,920 in 2025. Texas has applied the maximum standard. Verify the 2026 figures with the Texas Health and Human Services Commission, and get advice before spending anything.
What is the snapshot date and why does it matter so much?
It is the first day of the first month of continuous institutional care, and Texas values the couple’s countable resources as of that date. It fixes the number the protected spousal share is calculated from, and filing later does not move it. Gather every account statement from that date before you do any planning.
Do I apply through Williamson County?
No. Texas does not process long-term care Medicaid through county agencies. The Texas Health and Human Services Commission determines eligibility, through the state benefits portal, by mail or fax, or at an HHSC benefits office serving the Austin and Round Rock area. Assuming there is a county Medicaid office is a common way families lose weeks.
What is a Miller trust and do we need one?
If the applicant’s monthly income exceeds the institutional special income limit – $2,901 in 2025, verify 2026 with HHSC – Texas generally requires a Qualified Income Trust, called a Miller trust. Income above the limit is deposited monthly and disbursed under strict rules. Missing a monthly deposit can cost that month’s eligibility, so have an attorney set it up.
Is our Georgetown house safe?
While the community spouse lives there it is generally not a countable resource, and Texas homestead protections are unusually strong. Estate recovery is the separate question: Texas MERP applies to long-term care services received on or after March 1, 2005, with published exemptions and hardship waivers. Confirm the current rules with HHSC and an attorney.
Can we just deed the house to our daughter?
That is the most expensive mistake made in this county. There is a 60-month look-back, and a transfer of the homestead within five years before application can create a penalty period during which Medicaid pays nothing at all. Do not retitle, gift or sell below market value without an elder law attorney licensed in Texas reviewing it first.
How is life insurance counted in a married couple’s case?
Through the face-value aggregation rule. Term insurance without cash value is generally not countable. For permanent policies, if the total face value on one person exceeds the state’s small burial threshold, the cash surrender value generally becomes countable – and at the snapshot, both spouses’ resources are combined, so a policy in her name is still in the calculation.
When should a married couple not sell a policy?
When the spouse at home will need the death benefit. If the husband’s Social Security largely leaves the household at his death and his policy is what keeps his widow in the homestead, converting it into a nursing facility payment can be a catastrophic trade. Also skip it for small face amounts, policies inside the burial exclusion, and a healthy insured.
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Related Reading
- Nursing Home Costs Williamson County Tx
- Sell Life Insurance Policy Williamson County Tx
- Texas Medicaid Asset Income Limits
- Life Settlement Licensing Texas
- Sell Life Insurance Policy Bell County Tx
- Nursing Home Medicaid Spend Down
- Life Insurance Counts Medicaid Asset
- Surrender Vs Sell Policy
Pine Lake Life Solutions does not purchase life insurance policies and does not provide legal, tax, or investment advice. Information provided is for educational purposes only. Eligibility for any option, including life settlements, is not guaranteed and depends on individual circumstances, policy terms, underwriting, and market conditions. Consult independent legal, tax, or financial professionals before making decisions regarding a life insurance policy.