This is the situation families delay talking about longest, and delay is the one thing that reliably makes it worse.
Short answer
Spend-down, Medicaid timing, and why waiting makes this harder.
What to do, in order
- Work out the actual runway. Current balance, monthly burn including care-level charges, and expected increases. Most families are working from a number that is six months stale.
- Join the Medicaid interest list now. Call 2-1-1 or use YourTexasBenefits.com. The list does not move faster because your situation became urgent, and nothing is lost by joining while still paying privately.
- Find out whether the current community takes STAR+PLUS. Ask whether they contract with Medicaid managed care and how many current residents are on it. A meaningful share of Austin communities do not, which means a forced move later.
- Check for benefits already on the table. VA Aid and Attendance is heavily under-claimed in this metro, and care costs reduce countable income, so income alone does not disqualify.
- Talk to an elder law attorney before moving money. Transfers carry look-back consequences, and well-intentioned gifting is one of the most common ways families make eligibility worse.