His Doctors Say He May Never Live to See the House Again. One Line on His Medicaid Application Can Keep the House Off the Spend-Down

Imagine a widowed Texas retired person who entered a care home after a stroke. His doctors doubt he’ll ever be strong enough to live on his own again. His daughter holds his power of attorney, and she’s at his kitchen table with a Medicaid application and one question she’s tempted to leave blank: does he intend to return home?

Her answer can decide whether the house he paid off decades ago counts against him. Under Texas Medicaid rules, a former home can stay excluded from countable resources when the owner has an ownership interest, lived there as his principal residence while owning it, and intends to return. The state treats a signed Form H1245, Statement of Intent to Return Home, as its main evidence of that intent.

If the family never documents his intent to return, Texas may have no basis to keep the empty house excluded on that ground, and its value can become an eligibility problem.

A lot of families expect Medicare to cover this. Medicare covers older Americans and pays for short rehab stays in a skilled nursing facility. Run jointly by the federal government and states, Medicaid serves people with limited income and assets. It pays for extended stays in a care facility, and each state writes its own eligibility rules. This story covers how Texas does it.

How Form H1245 Keeps a Texas House Off the Spend-Down

Texas lays out its home rules in section F-3100 of its Medicaid for the Elderly and People with Disabilities Handbook. The intent approach matters most for a single resident whose house now sits empty.

A second approach skips the question of intent entirely. The home stays excluded even if he leaves with no plan to return, as long as a spouse or dependent relative still lives there.

If he can’t sign the form himself, a comparable written statement from his spouse or authorized representative can document his intent. The form’s instructions also let his responsible party or his physician fill it out. Sometimes a guardian or representative has to say which property is his principal residence. In that case, caseworkers weigh their statements alongside his voter registration, federal tax returns and the appraisal district’s homestead records.

The form records more than a wish. It captures the home’s current status (rented, vacant or listed for sale) and warns that selling or transferring the house could affect his benefits. Families usually file it only once, because each recertification asks the intent question again.

Medical Odds and Personal Intent Answer Different Questions

A forecast predicts what will probably happen. Intent describes what he wants to happen if his body allows.

Doctors can give a man long odds, and he can still truly plan to go home if his strength comes back. Plenty of residents feel exactly that way, and they mean it. A return may be unlikely while the resident still intends to go home if his condition improves. The form asks about his intent, so his answer goes on it, whatever his chart says.

Families slip up when they treat the medical report as the answer. The true reply seems to be no, so the house ends up counted by default.

Three Limits That Still Apply to a Protected Texas Home

First, the statement has to reflect his actual intent. The instructions tie the form to a resident who plans to return home. If he’s told his kids he’s done with the house and wants it sold, the form can’t claim otherwise.

Second, a property he owned but never lived in while owning it can’t be excluded this way. A lake cabin he bought and never moved into won’t qualify.

Third, Texas has a separate home-equity limit of $752,000 in 2026. Even a house excluded as a countable resource can create a problem if his equity rises above that ceiling.

Estate recovery is a separate issue. Texas can seek repayment from the estate of someone who received Medicaid long-term services and supports after that person dies. A house excluded for eligibility can still face that estate-recovery claim. The exclusion protects his coverage while he’s alive. Protecting the house after his death takes separate planning.

A Single Sentence That Decides Whether the House Counts

The intent-to-return question needs a careful, true answer from the man who owns the house. Families who keep the home off the spend-down sit down with him and ask directly whether he wants to go home if his health allows. Then they put his answer on Form H1245, in his own words or his representative’s.

If he says yes, that one sentence can keep the house out of the spend-down while he works on getting stronger. If he says no, the family plans around a countable home and knows what it’s facing. Leaving the question unanswered can leave Texas without the evidence it needs to keep the empty house excluded.

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