How Austin families actually pay for care
Medicare does not pay for assisted living. Texas has no broad state-funded assisted living benefit. Most Austin families pay privately, and the main alternatives are the Medicaid STAR+PLUS waiver, VA Aid and Attendance for wartime veterans and surviving spouses, and long-term care insurance.
Medicaid STAR+PLUS
Texas Medicaid managed care combining acute care with long-term services and supports. The STAR+PLUS Home and Community Based Services (HCBS) waiver is the part that funds care for people who would otherwise need nursing facility placement.
What it covers: Personal attendant and personal care services, adult day care, respite, nursing services, adaptive aids, minor home modifications, personal emergency response systems, and assisted living services delivered in a licensed facility.
Eligibility basics:
- Texas resident and U.S. citizen or qualified non-citizen
- Age 21 or older and disabled, or age 65 or older
- Meets Nursing Facility Level of Care
- Monthly income under $2,982 for an individual
- Countable assets under $2,000 for an individual, with the home and one vehicle generally exempt
How to start: Call 2-1-1 or apply at YourTexasBenefits.com to join the interest list, then complete a Medicaid application, a medical necessity assessment, managed care plan selection, and a service plan with a service coordinator.
Managed care plan availability in the Travis service delivery area has changed since 2024. Confirm which plans currently serve your county on the HHSC health plans by service area listing before choosing. HHSC health plans by service area
Does Texas have a state assisted living benefit?
Texas has no broad state-funded assisted living entitlement. Texas has not expanded Medicaid and offers no general subsidy that pays a private-pay family's assisted living bill. What does exist:
- STAR+PLUS HCBS assisted living services, which cover care but not room and board, require nursing facility level of care and financial eligibility, and typically involve an interest list. Facilities must contract with the managed care organization, and many Austin-area communities do not.
- Residential Care under Community Care for Aged and Disabled, a Title XX state-funded program providing personal care in a licensed facility or adult foster home for people who are not Medicaid eligible. It is small, capped by block grant funding, and interest-list driven.
- Community Attendant Services and other in-home Community Care programs for people who want to stay at home.
Residential Care capacity, income limits, wait times, and which Austin-area facilities hold contracts change and are not published in a single place. Confirm current availability with the Capital Area Area Agency on Aging.
Nursing home Medicaid in Texas, 2026
- Income, single applicant: $2,982 per month
- Countable assets, single applicant: $2,000, with the home and one vehicle generally exempt
- Personal needs allowance: $75 per month — Texas raised the personal needs allowance from $60 to $75 effective January 1, 2024, well above the $30 federal minimum.
- Community spouse resource allowance: reported at $162,660
Nearly all remaining income, after Medicare premiums, any spousal allowance, and allowable medical expenses, is applied to the cost of care.
VA Aid and Attendance
Aid and Attendance is not a flat check. VA pays the difference between countable income and the maximum annual pension rate. Unreimbursed medical expenses, including assisted living and home care costs, reduce countable income, which is why a veteran with substantial care bills can qualify despite moderate income.
| Situation | Maximum annual rate | Approximate monthly |
|---|---|---|
| Veteran, no dependents | $29,093 | about $2,424 per month |
| Veteran with one dependent | $34,488 | about $2,874 per month |
| Two veterans married, both eligible | $46,143 | about $3,845 per month |
| Veteran, no dependents, Housebound | $21,313 | about $1,776 per month |
| Surviving spouse, no dependents | $18,697 | about $1,558 per month |
| Surviving spouse, one dependent child | $22,304 | about $1,859 per month |
Net worth limit: $163,699 for December 1, 2025 through November 30, 2026, with a three-year look-back on asset transfers. Rates effective December 1, 2025. Monthly figures are the annual maximum divided by twelve. VA publishes these rates annually, not monthly.
Source: VA veterans pension rates
Medicaid estate recovery
Texas may file a claim against the estate of a deceased Medicaid recipient who was 55 or older when services were received and who first applied for long-term services and supports on or after March 1, 2005. It applies to nursing facility care, state supported living centers, 1915(c) waivers including STAR+PLUS, and Community Attendant Services. The state never recovers more than it paid, and exemptions and hardship waivers exist.
