STAR+PLUS is Texas Medicaid managed care with long-term services and supports. Its home and community based services waiver covers assisted living care services but explicitly not room and board, requires nursing facility level of care, and runs on an interest list.
What the waiver actually pays for
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.
Two separate gates
Families tend to think of Medicaid eligibility as one test. It is two, and clearing one says nothing about the other.
- Financial. Income under $2,982 per month and countable assets under $2,000 for a single applicant, with the home and one vehicle generally exempt.
- Functional. A Nursing Facility Level of Care determination. A person can qualify financially and fail medical necessity, which is a common and demoralising surprise.
The third gate nobody mentions
Even with both cleared, the community itself must contract with your managed care organisation. A meaningful share of Austin-area assisted living does not participate at all. This is why the question to ask any community you are seriously considering is not just whether they accept Medicaid, but how many current residents are on STAR+PLUS.
Getting on the interest list
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.
Join the list early, even while paying privately and expecting to for some time. Nothing is lost by being on it, and the timeline does not compress because your circumstances became urgent.
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
