Texas Medicaid & Elder Care
Texas offers Medicaid programs for seniors, primarily through the STAR+PLUS HCBS Waiver and Community First Choice, to provide long-term care in home and community settings, often requiring a Miller Trust for income over the cap.
Medicaid Report Card
Overall State Performance Index
Based on CMS Nursing Home Compare + state Medicaid agency data
View Methodology arrow_forwardTexas Monthly Costs
The average monthly cost for a private room in a Texas nursing home is approximately $7,300, or $88,000 annually.
Waiver Programs
STAR+PLUS Home and Community Based Services (HCBS) Waiver
Also called: STAR+PLUS Waiver, STAR+PLUS
The STAR+PLUS HCBS Waiver is a managed care program for elderly and disabled Texans who require a nursing facility level of care. It provides a broad range of medical and non-medical services to support individuals in their homes, adult foster care, or assisted living facilities, aiming to prevent nursing home placement.
- check_circle Adult Day Care / Adult Day Health
- check_circle Adult Foster Care
- check_circle Assisted Living Services
- check_circle Delivered Meals
- check_circle Environmental Adaptive Aids
- check_circle Home Modifications
- check_circle Home Care
- check_circle Medical Care / Medical Supplies
- check_circle Nursing Services
- check_circle Personal Care (assistance with ADLs)
- check_circle Personal Emergency Response Systems
- check_circle Service Coordination
insights Program Snapshot
- Functional criterion
- Nursing Facility Level of Care (NHLOC)
- Administered by
- Managed Care Organizations (MCOs) under HHSC
- Self-direction
- Yes, participants can hire personal caregivers (excluding spouses)
- Replaced
- Community Based Alternatives (CBA) Waiver in 2014
2026 Eligibility Requirements
| Criteria | Individual Limit | Married (Both Applying) |
|---|---|---|
| Monthly Income | $2,982 | $5,964 |
| Asset Limit | $2,000 | $3,000 |
| Home Equity Limit | $752,000 | |
| Level of Care | Nursing Home Level of Care (NHLOC) | |
Estate Recovery Warning
Texas's Medicaid Estate Recovery Program (MERP) is aggressive, seeking repayment for long-term care services from the estates of deceased recipients aged 55 or older. This often includes claims against real property, though certain exemptions and hardship waivers are available.
Spend-Down & Asset Protection
PROTECTED ASSETS
COMMON PITFALLS
- warning Look-back Period: Gifts or asset transfers made within 60 months (5 years) prior to applying for Medicaid can trigger heavy penalties.
- warning Excess Income: Failing to establish a Qualified Income Trust (Miller Trust) if monthly income exceeds the state's income cap will result in ineligibility.
- warning Joint Accounts: All assets of a married couple are generally considered jointly owned, regardless of whose name is on the account, for Medicaid eligibility purposes.
First Steps for Families
Locate your ADRC
Contact your local Texas Aging and Disability Resource Center.
Gather 5 years of records
Bank statements, deeds, asset transfers for the Medicaid look-back period.
Financial assessment
Consult a Medicaid planner if assets exceed $2,000.
How to Apply for Texas Long-Term Care Medicaid
Assess Level of Care
Obtain a medical certification from a physician confirming the need for a Nursing Home Level of Care.
Gather Records
Collect comprehensive financial statements for the past 60 months, income verification, and identity documents.
Setup Miller Trust
If monthly income exceeds the Medicaid cap, establish a Qualified Income Trust (Miller Trust) to hold the excess income.
Submit Application
Apply through the Texas Health and Human Services Commission (HHSC) online at YourTexasBenefits.com, by calling 2-1-1, by mail, or in person at a local office.
Attend Interviews
Participate in required interviews and evaluations with HHSC caseworkers to determine eligibility.
Approval & Care
Upon approval, receive benefit activation and select a managed care health plan for service delivery.
Documents You'll Need
Financial Verification
- 5 years of bank statements
- Stock/bond certificates
- Retirement account information
- Life insurance policies
Income Verification
- Social Security award letters
- Pension stubs
- VA benefit statements
- Pay stubs
Medical/Identity
- Social Security card
- Medicare card
- Doctor's clinical assessments
- Valid driver's license or state ID
- U.S. birth certificate or passport
Property/Residency
- Home deed
- Vehicle registration
- Utility bills or rent receipts (proof of Texas residency)
Frequently Asked Questions About Texas Medicaid
Does Texas Medicaid pay for assisted living?
While Regular Medicaid does not directly cover assisted living facility room and board in Texas, the STAR+PLUS HCBS Waiver program may cover care services provided within licensed assisted living facilities. This waiver helps eligible seniors who require a nursing home level of care to receive personal care assistance, medication management, and other support services in a community setting.
What is the Texas Medicaid income limit for seniors in 2026?
For 2026, the monthly income limit for a single senior applying for Texas Medicaid long-term care, including nursing home care or HCBS waivers, is $2,982. For married couples where both apply, the limit is $5,964. If only one spouse applies, only their income is counted towards the $2,982 limit.
How long is the HCBS waiver waitlist in Texas?
The STAR+PLUS HCBS Waiver in Texas has limited enrollment and often has a waiting list for services, as it is not an entitlement program. Specific waitlist counts or average wait times are not consistently published. In contrast, the Community First Choice (CFC) program, which also provides home and community-based services, is an entitlement and has no waitlist.
Will Medicaid take my parent's house in Texas?
Texas's Medicaid Estate Recovery Program (MERP) may seek repayment for long-term care costs from a deceased Medicaid recipient's estate, which can include their home. However, recovery is typically delayed if a surviving spouse lives in the home, and exemptions exist for certain minor or disabled children. The state will not recover more than the amount paid for services.
Can I be paid to care for my parent through Texas Medicaid?
Yes, through certain Texas Medicaid programs, family members can be paid to provide personal care services for their parents. The STAR+PLUS HCBS Waiver allows participants to self-direct their care and hire caregivers, including some family members (excluding spouses). The Community First Choice (CFC) program also offers consumer-direction, allowing participants to choose family members (excluding spouses) as paid caregivers.
Medicaid vs Medicare for long-term care in Texas?
Medicare primarily covers acute medical care and limited short-term skilled nursing or rehabilitation, not ongoing long-term care in Texas. Medicaid, administered by the Texas Health and Human Services Commission, is the primary payer for long-term care services, including nursing home care and home and community-based services through programs like STAR+PLUS HCBS Waiver, for eligible low-income seniors.
TOPICAL GUIDES — HOW MEDICAID WORKS
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Last updated: April 24, 2026. Sources: Texas Health and Human Services Commission, CMS Nursing Home Compare, Genworth 2024 Cost of Care Survey. Eligibility rules are set by each state Medicaid agency and update annually. We cite the agency name, statute, or CMS data source for every figure on this page; see our methodology and editor.