Medicaid for Senior Care in Texas
What Medicaid Actually Covers for Senior Care
Navigating senior care options in Texas can feel overwhelming, but understanding what Medicaid truly covers is a great first step. For many families, the primary program to know is the STAR+PLUS Home and Community Based Services (HCBS) Waiver. This program is designed for seniors who need a nursing home level of care but prefer to receive support at home, in adult foster care, or in an assisted living community. It helps cover services like personal care, adult day care, delivered meals, minor home modifications for accessibility, medical supplies, nursing services, and therapies such as physical, occupational, and speech therapy. You can even hire certain family members, like an adult child, as a caregiver for some of these consumer-directed services. It's important to know that while STAR+PLUS HCBS covers many vital services to help your loved one stay in their community, it generally does not cover room and board costs in assisted living or private homes. If a nursing home becomes necessary, Texas Medicaid does cover room, board, nursing services, and personal care in Medicaid-certified facilities.
Do You Qualify?
Eligibility for Texas Medicaid for senior care in 2026 involves meeting specific financial and medical criteria. For a single applicant seeking nursing home care or a Medicaid waiver, the monthly income limit is generally $2,982, and the asset limit is $2,000. If your parent is married and only one spouse is applying, the applicant spouse still has an income limit of $2,982 and an asset limit of $2,000, but the non-applicant spouse can keep a protected resource amount between $32,532 and $162,660. Income sources like pensions are typically counted towards these limits. A common concern is owning a home; thankfully, the primary residence is usually an exempt asset if the applicant or their spouse lives there, with an equity limit of $752,000 for a single applicant in 2026, and no limit for married applicants. If your parent's income is over the limit, Texas is an "income-cap" state, meaning a Qualified Income Trust (QIT), also known as a Miller Trust, is often necessary to become income-eligible. If assets are over the limit, a "spend-down" process allows you to use those excess assets on non-countable items to meet the requirements. Beyond finances, your parent must also meet a medical necessity for care, typically requiring a Nursing Facility Level of Care.
Waitlists & How to Apply
The reality of waitlists for Texas Medicaid waiver programs is an important consideration. While Nursing Home Medicaid and Regular Medicaid do not have waitlists, programs like the STAR+PLUS HCBS Waiver are not entitlements and have a limited number of enrollment spots, leading to "interest lists." As of late 2025, the STAR+PLUS Waiver had approximately 15,850 people on its interest list. Wait times can vary significantly, from a few months to several years, depending on the program and individual circumstances. It's highly recommended to get your loved one on these interest lists as early as possible. To apply for Medicaid in Texas, you have several options: you can apply online through the Your Texas Benefits website, call 2-1-1 (TTY 711) or 1-877-541-7905 to reach Texas Health and Human Services, mail a paper application (Form H1010 or H1200 for MEPD), or visit a local HHS benefits office. For the STAR+PLUS HCBS interest list specifically, you can call 1-877-438-5658. Be prepared with documents proving age, income, assets, Texas residency, U.S. citizenship, and medical needs. While the state aims to make an eligibility decision for applicants aged 65 or older within 45 days, actual processing times can be longer, sometimes averaging around 79 days.
Last updated: March 2026. Sources: CMS, state Medicaid agency, Genworth 2024.