Nursing Home Costs in Georgetown, Texas (2026)

What the crossover actually is

The crossover is not a moral question and it is not the moment the money is gone. It is the point at which the marginal month of private pay stops buying anything you value more than what you give up to buy it.

Three things sit on the “what you give up” side. First, choice of facility: private-pay residents get admitted faster and to more buildings, so paying privately genuinely buys options — until the money is short enough that the family is one bad month from a forced move. Second, protection for a spouse at home: assets spent on facility care are assets not available to the person still living in the Georgetown house. Third, time and stress: a Texas Medicaid application takes weeks to assemble and process, and starting it under pressure with a facility bill outstanding is materially worse than starting it deliberately.

On the “what you buy” side is the private rate advantage — real, and worth paying for while it changes outcomes. The crossover is where those two curves meet, and it is different for a single widow with $70,000 in savings than for a married couple with $600,000 and a house.

The mistake to avoid is treating this as a single decision made once. It is a number you recalculate quarterly as the bill rises, income changes and assets fall. Families who write the arithmetic down and revisit it never get surprised. Families who avoid the arithmetic get surprised in month fourteen.

The three numbers that set the crossover in Georgetown

You need exactly three figures, and all three are local.

1. The monthly bill. Cost-of-care survey ranges for the Georgetown and greater Austin market as of 2026:

• Skilled nursing, private room: roughly $7,800–$9,400 per month, against a Texas median in the $6,800–$8,300 range. The Austin metro prices above the state, and Georgetown prices with the metro.
• Skilled nursing, semi-private room: roughly $6,800–$8,200 per month. Texas has an unusually wide private-to-semi-private spread, so the room choice moves the crossover by months.
• Assisted living, base rate: roughly $5,200–$6,500 per month locally, against a Texas median around $4,700–$5,700; memory care commonly $1,200–$2,000 higher.

2. Monthly income. Social Security, pension, annuity payments, rental income. Under Texas Medicaid nursing facility rules, nearly all of a resident’s income is applied to the cost of care through a co-payment calculation, so income is not “kept” after eligibility — it is redirected. That matters for the crossover math because a high-income resident gets less relief from qualifying than a low-income one.

3. Countable assets. Not everything counts. A home may be exempt within limits while a resident intends to return or a spouse lives there, one vehicle is generally exempt, and personal belongings are excluded. Retirement accounts, brokerage balances, non-exempt cash and — importantly — life insurance above the small-policy threshold generally do count.

Runway equals countable assets divided by the bill minus income. At a $8,600 bill and $3,000 of income the drain is $5,600; $140,000 of countable assets funds about twenty-five months. That is your starting map.

The Texas income cap — the rule that surprises Williamson County families

This is where Texas diverges from most of the country, and it is the single most important thing on this page for a Georgetown family with a decent pension.

Texas is an income-cap state for nursing facility Medicaid. Rather than allowing an applicant to “spend down” excess income on medical bills to qualify, Texas applies a hard monthly income limit — the special income limit, set at three times the federal SSI benefit rate and adjusted each year. In recent years that figure has sat just under $3,000 a month for a single applicant; the 2025 figure was in that range and the 2026 figure changes with the federal adjustment, so confirm the current number with Texas Health and Human Services rather than relying on any published article.

An applicant whose gross monthly income exceeds the cap by even a few dollars is ineligible on income — full stop — unless a Qualified Income Trust, commonly called a Miller Trust, is established. The trust is a legal instrument into which excess income is deposited each month; income routed through it is disregarded for the cap. It must be drafted correctly, funded every month, and administered with a dedicated bank account, and mistakes in the monthly mechanics can break eligibility retroactively.

Why this matters to the crossover specifically: a Georgetown retiree with a teacher’s or federal pension plus Social Security can easily be over the cap while having very little in the bank. That household is asset-poor and income-ineligible at the same time — the worst possible combination if nobody has set up the trust. The fix is not complicated but it is not do-it-yourself either. Retain a Texas elder law attorney to draft and set up the Qualified Income Trust, and do it before the application, not after a denial.

Georgetown / Williamson County, TX — as of 2026	Georgetown & Austin metro	Texas median range
Skilled nursing, private room (monthly)	$7,800–$9,400	$6,800–$8,300
Skilled nursing, semi-private (monthly)	$6,800–$8,200	$5,900–$7,200
Assisted living base rate (monthly)	$5,200–$6,500	$4,700–$5,700
Runway on $140,000 at $5,600 net drain	about 25 months
Countable asset limit, single applicant	$2,000 — verify 2026 figure with Texas HHSC
Monthly income cap (special income limit)	Just under $3,000 in recent years; adjusted annually — verify 2026 with HHSC
Over the income cap?	A Qualified Income Trust (Miller Trust) is required
Look-back on transfers	60 months

Three worked examples at Georgetown prices

All three use a private room at $8,600 a month, a 2026-range figure for the Georgetown market. Run your own version with your own numbers.

Example 1 — single, modest assets. Widow, $2,100 a month in Social Security, $48,000 in savings, no house. Net drain $6,500. Runway: about seven months. Here the crossover is nearly immediate — the money buys seven months of choice and then it is gone. The right sequence is to start the Texas Medicaid application early, keep enough on hand to cover the processing gap, and use the private-pay months to secure a facility that accepts Medicaid residents long-term rather than one that will require a move.

Example 2 — single, larger assets, over the income cap. Retired engineer, $4,100 a month in pension and Social Security, $240,000 in savings. Net drain $4,500, runway about fifty-three months. Long runway — but this person is over the Texas income cap, so eligibility at the end of it will require a Qualified Income Trust. The crossover here is not about money running out; it is about setting up the trust and the application well before it does, and about deciding how much of the $240,000 is worth spending versus preserving for heirs given that most income will go to care either way.

Example 3 — married, spouse at home in Georgetown. Husband in the facility, wife at home, combined assets $380,000 plus the house. Here the crossover analysis changes shape entirely, because federal spousal impoverishment rules protect a share of resources and a minimum monthly income allowance for the spouse who remains in the community. Spending down as though the couple were a single person is a common and costly error. This is the scenario that most needs an attorney, and the one where the right answer is least likely to be “spend everything first.”

The crossover is not the same as spending everything

A persistent myth is that qualifying for Medicaid requires going to zero. It does not, and believing it costs Williamson County families real money.

Several categories are treated differently from a bank balance. The homestead may be exempt within an equity limit while the applicant intends to return or a spouse or dependent lives there — although it remains exposed to estate recovery afterward. One vehicle is generally exempt. Personal property and household goods are excluded. Certain irrevocable burial arrangements and a small amount of designated burial funds are excluded, which is why prepaid funeral planning is a routine part of legitimate spend-down. And a community spouse is protected by both a resource allowance and a minimum monthly maintenance needs allowance.

What is not exempt is equally important. Gifts are not spend-down. Transferring money to an adult child, forgiving a loan, or retitling property for less than fair value inside the 60-month look-back creates a penalty period during which Medicaid will not pay — and the penalty starts when the applicant would otherwise be eligible, meaning it lands exactly when the family has no money left. That is the trap.

The legitimate moves are paying real debts, buying exempt items, making home repairs, prepaying burial, and in married cases using the spousal rules properly. All of them should be sequenced by a Texas elder law attorney. Nothing on this page is legal or eligibility advice. The general mechanics of a nursing home Medicaid spend-down give the broader picture.

Texas Medicaid, STAR+PLUS, and where a Williamson County application goes

Georgetown is the county seat of Williamson County, Texas. The program is Texas Medicaid; long-term services and supports for older adults are delivered through STAR+PLUS, the state’s managed long-term care program, and care in a licensed facility is covered under the Medicaid nursing facility program.

Where to apply: long-term care Medicaid in Texas is administered by the Texas Health and Human Services Commission (HHSC), not by county government. Applications are filed through HHSC — online at the state’s benefits portal, by phone, or in person at an HHSC benefits office; offices serving Williamson County residents operate in the Georgetown and Round Rock area. The city of Georgetown does not run Medicaid eligibility. This is a genuine difference from most states, where a county department takes the application, and it confuses families who moved to Texas from elsewhere.

Rules to confirm rather than assume, as of 2026:

• Countable asset limit: $2,000 for a single applicant, with a separate and much larger community spouse resource allowance. Verify with HHSC.
• Income cap: the special income limit described above, adjusted annually; a Qualified Income Trust is required above it.
• 60-month look-back on transfers for less than fair market value.
• Estate recovery: Texas operates a Medicaid Estate Recovery Program subject to statutory exceptions and hardship waivers. Ask an attorney how it applies to a Georgetown homestead.
• Life insurance: countability turns on aggregate face value across policies on the insured’s life; above the threshold, cash surrender value counts. See how life insurance counts toward the asset test.

For free help: HICAP, the Health Information, Counseling and Advocacy Program, is Texas’s State Health Insurance Assistance Program and is delivered through the area agencies on aging. The Area Agency on Aging of the Capital Area, administered by the Capital Area Council of Governments in Austin, serves Williamson County. Insurance is regulated by the Texas Department of Insurance.

Where a life insurance policy sits relative to the crossover

A life insurance policy is one of the few assets that can move the crossover date rather than just be consumed by it — and it is also the asset most likely to be sitting unexamined in a drawer while a Georgetown family runs the numbers.

One local fact makes this unusually common here. Georgetown’s older population grew enormously over the last two decades around large age-restricted communities, and a great many residents relocated from other states in their late fifties and sixties carrying policies bought decades earlier for reasons that no longer apply — a mortgage since paid off, children long since grown, a business long since sold. Those are precisely the contracts worth re-examining.

A policy has four possible endings: keep paying it, surrender it for cash value, sell it in a life settlement if it qualifies for more than the surrender value, or let it lapse for nothing. The last is the default when premiums stop during a crisis and it is the worst outcome available.

Where a sale can genuinely help: a permanent policy with meaningful face value on an insured now old enough or ill enough that a secondary market exists; a universal life contract whose internal cost of insurance has outrun the family’s ability to fund it; a policy whose beneficiaries are financially independent. At a $5,600 net monthly drain, converting a policy can extend the runway by a year or more and let a family reach the crossover on their own schedule rather than under a facility’s payment deadline. Surrendering versus selling is the comparison to run before calling the carrier.

Where it does not help, plainly: a small burial-sized policy already inside the Medicaid life insurance exclusion should generally be left alone, particularly in Texas where irrevocable burial arrangements are a normal part of legitimate planning. A term policy on a healthy insured with no conversion right rarely draws a worthwhile offer. A policy a surviving spouse relies on should not be sold to buy months. And proceeds are countable the day they arrive, which can push an approval date — sequence any sale with a Texas elder law attorney.

Pine Lake Life Solutions does not purchase policies. We offer a free policy review — what the contract is, what it is worth kept, whether a market exists, and frequently the conclusion that selling is wrong. For eligibility mechanics see the Georgetown Medicaid spend-down guide; for the transaction side see life settlements in Georgetown.

---

Frequently Asked Questions

What county is Georgetown, Texas in, and where is the Medicaid application filed?

Georgetown is the county seat of Williamson County, Texas. Unlike most states, county government does not take the Medicaid application here. Long-term care Medicaid is administered by the Texas Health and Human Services Commission, with applications filed online through the state benefits portal, by phone, or at an HHSC benefits office; offices serving Williamson County operate in the Georgetown and Round Rock area.

How much does a nursing home cost in Georgetown compared with the Texas median?

As of 2026, cost-of-care survey ranges put a private skilled nursing room in the Georgetown and greater Austin market at roughly $7,800 to $9,400 a month, above a Texas median in the $6,800 to $8,300 range. Assisted living locally runs about $5,200 to $6,500 base, against a Texas median near $4,700 to $5,700. Confirm current rates with each facility.

What is the Texas Medicaid income cap and what happens if my parent is over it?

Texas is an income-cap state for nursing facility Medicaid, applying a hard monthly limit set at three times the federal SSI benefit rate and adjusted each year — just under $3,000 in recent years. An applicant over the cap is ineligible unless a Qualified Income Trust, often called a Miller Trust, is established and funded monthly. Verify the current figure with Texas HHSC.

What is a Miller Trust and do Williamson County families need one?

A Qualified Income Trust, commonly called a Miller Trust, is a legal instrument that receives an applicant’s excess monthly income so it is disregarded against the Texas income cap. It requires correct drafting, a dedicated bank account, and disciplined monthly funding. Many Georgetown retirees with a pension plus Social Security exceed the cap while holding few assets, so the trust is frequently necessary.

Do I have to spend everything before Texas Medicaid will pay?

No. A homestead may be exempt within equity limits while a spouse lives there or the applicant intends to return, one vehicle is generally exempt, personal property is excluded, and certain irrevocable burial arrangements are excluded. A community spouse is separately protected by a resource allowance and an income allowance. Gifts, however, are not spend-down and can trigger a penalty period.

Why do so many Georgetown residents have old life insurance policies?

Georgetown’s older population grew rapidly over the last two decades around large age-restricted communities, and many residents relocated from other states in their late fifties and sixties carrying permanent policies purchased decades earlier for a mortgage since paid off or children long since grown. Those contracts are worth re-examining before they lapse or are surrendered by default.

When is selling a life insurance policy the wrong move for a Georgetown family?

When the policy is small enough to sit inside the Medicaid life insurance exclusion, when it is term coverage with no conversion right on a healthy insured, when a surviving spouse depends on the death benefit, or when proceeds would arrive at a moment that pushes the applicant over the asset limit. Sequence any decision with a Texas elder law attorney first.

Related Reading

• Medicaid Spend Down Georgetown Tx
• Life Settlements Georgetown 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.