Senior care in Texas runs from about $5,666/month for assisted living to about $7,600/month for a private nursing home room, based on 2025 median costs. In-home care runs about $30/hour. Most families can't cover that out of pocket forever. This guide covers how to pay for senior care in Texas: Medicaid, Medicare, VA benefits, long-term care insurance, and private pay. Texas has more funding options than most people realize.

Here's what actually pays for senior care in Texas, who qualifies, and what each option covers.

In This Guide

What Senior Care Costs in Texas

Before figuring out how to pay, you need to know what you're paying for. Here's what the main types of senior care cost in Texas in 2026, based on 2025 median figures:

Care Type Average Monthly Cost Details
Home care (non-medical) ~$5,720 ~$30/hour, based on 44 hours/week
Home health (skilled/medical) $0 with Medicare/Medicaid Covered when medically necessary
Assisted living ~$5,666 $67,992/year statewide median
Nursing home (semi-private) ~$5,627 ~$185/day
Nursing home (private) ~$7,604 ~$250/day

Texas is significantly cheaper than the national average for most care types. A semi-private nursing home room here runs about $5,627/month ($67,525/year), well below the national median of about $114,975/year. That still adds up fast. At $5,627/month, a two-year nursing home stay runs about $135,000.

How to Pay for Senior Care in Texas Through Medicaid

Texas Medicaid is the primary payer for long-term senior care in Texas. It covers home care, assisted living services, and nursing home care for those who qualify financially and medically.

Financial Eligibility

To qualify for Texas Medicaid long-term care in 2026:

  • Income: Up to $2,982/month (single applicant)
  • Assets: $2,000 or less in countable assets
  • Spouse protections: The at-home spouse keeps the Spousal Protected Resource Amount, Texas's name for the Community Spouse Resource Allowance: the greater of half the couple's combined countable resources or $32,532, and never more than $162,660, so the top figure is a ceiling and not the amount every couple keeps. The spouse can also receive up to $4,066.50/month from the applicant's income. Watch the label on that last figure: Texas's budget reference chart calls $4,066.50 the Minimum Monthly Maintenance Needs Allowance (its Spousal Allowance), while CMS publishes the same $4,066.50 as the federal Maximum Monthly Maintenance Needs Allowance. Same dollar amount, opposite label, and the HHSC chart is what a Texas caseworker applies.

What Medicaid Covers

The catch: HCBS waiver programs that cover home care and assisted living have long interest lists, because Texas may cap how many people a waiver serves. Regular Medicaid, which is where nursing facility care sits, is not capped that way. This creates a frustrating reality where getting into a nursing home is easier than getting services that keep your loved one at home.

For the full picture, read our guide to Texas Medicaid programs for seniors.

Not sure whether your parent qualifies for Medicaid? Chat with Brevy's care navigator at brevy.com.

Medicare

Here's where families get surprised. Medicare doesn't cover long-term care.

What Medicare does cover:

  • Skilled nursing facility: Up to 100 days following a qualifying 3-day hospital stay. Days 1-20 are fully covered. Days 21-100 have a daily copay of $217 in 2026. After day 100, Medicare pays nothing.
  • Home health care: $0 cost for skilled nursing and therapy if ordered by a doctor and the patient is homebound. Covers up to 28 hours/week.

What Medicare doesn't cover:

  • Ongoing personal care (bathing, dressing, meals)
  • Long-term nursing home stays
  • Assisted living
  • Non-medical home care (companionship, housekeeping)

For more details, see our Medicare plans and coverage guide.

VA Benefits

If your loved one is a veteran (or the surviving spouse of one), VA benefits can be a significant funding source.

Aid and Attendance

The VA's Aid and Attendance pension provides payments to veterans who need help with daily activities. VA publishes the maximums as annual rates:

  • Veteran alone: Up to $29,093/year
  • Veteran with spouse: Up to $34,488/year
  • Surviving spouse: Up to $18,697/year

The award is paid out monthly, at one-twelfth of the yearly amount.

To qualify, the veteran must have served during wartime, must not have a dishonorable discharge, and must meet at least one of four conditions: at least 65 years old, a permanent and total disability, a patient in a nursing home for long-term care because of a disability, or getting Social Security Disability Insurance or Supplemental Security Income. Those last two are independent routes, so a wartime veteran under 65 who is on SSI qualifies without any permanent-and-total rating. The veteran also needs help with activities of daily living (ADLs) and a net worth below $163,699. VA's net worth calculation counts the claimant's and their dependents' assets and annual income together, so comparing savings alone against $163,699 gives you the wrong answer. There's a 3-year look-back on asset transfers.

This money can be used for any type of care: home care, assisted living, or nursing home.

Veteran-Directed Care

The VDC program gives veterans a flexible budget to hire their own caregivers, including family members. It works similarly to Medicaid's CDS option.

For the full details, see our VA Aid and Attendance guide.

Long-Term Care Insurance

If your loved one bought a long-term care insurance policy years ago, now is when it pays off. These policies typically cover home care, assisted living, and nursing home care up to a daily or monthly benefit amount.

A few things to know about LTC insurance in Texas:

  • Texas participates in the Long-Term Care Partnership Program. Partnership-qualified policies let you protect additional assets from Medicaid spend-down equal to the amount of benefits the policy paid out. For example, if your policy paid $200,000 in benefits, you can keep an extra $200,000 in assets when applying for Medicaid.
  • Premiums have been rising sharply. Across the country, policyholders are getting notices of large rate increases, something the Texas Department of Insurance warns about directly. If this happens, your options are to pay the higher premium, reduce benefits, or let the policy lapse. Talk to the Texas Department of Insurance before making changes.
  • New policies are expensive and harder to get. Buying LTC insurance after age 65 is costly, and health conditions may disqualify you. This is really a tool for people who planned ahead.

If your family member has an existing policy, dig it out now. Read the benefit triggers, daily maximums, and elimination period before you need it.

How to Pay for Senior Care in Texas Without Medicaid

When government programs and insurance don't cover everything, families turn to private funds.

Out-of-Pocket Savings

Most families start here. At about $5,627/month for a semi-private nursing home room, three years of care can top $200,000. Retirement savings, Social Security income, and pensions are the most common private funding sources.

Reverse Mortgages

For homeowners 62 and older, a reverse mortgage converts home equity into cash without monthly mortgage payments. The 2026 lending limit is $1,249,125.

Important Medicaid considerations: reverse mortgage payments don't count as income for Medicaid, but any money not spent in the month received counts as an asset the following month. With a $2,000 asset limit for Medicaid, you'd need to spend the funds quickly. This works better for people who aren't on Medicaid and want to fund home care or assisted living while staying in their home.

Life Insurance Options

Some life insurance policies can be converted or used for care:

  • Accelerated death benefits: Many policies allow early payout if the policyholder is terminally ill or needs long-term care
  • Life settlements: Selling a life insurance policy to a third party for a lump sum, typically more than the policy's cash surrender value but less than its death benefit
  • Policy loans: Borrowing against the cash value of a whole life or universal life policy

Community and Nonprofit Resources

Medicaid Planning: Protecting Assets

Medicaid planning is the process of legally arranging finances to qualify for Medicaid while protecting as much of the family's assets as possible. It isn't hiding money. It's using the rules as they're written.

Exempt Assets in Texas

Not everything counts toward Medicaid's $2,000 asset limit. These are protected:

  • Your home, if you or your spouse own it and it is the principal place of residence, or if you no longer live there but intend to return (Texas takes a signed Form H1245, Statement of Intent to Return Home, as the primary evidence of that intent). One limit applies: for vendor payment in an institutional setting and for HCBS waiver services, the equity interest in the home cannot exceed the substantial home equity limit, which Texas set at $752,000 effective January 1, 2026. That equity test does not apply at all if your spouse, your child, or your adult child with a disability is living in the home.
  • One automobile, excluded regardless of value
  • Burial spaces, excluded regardless of value, and an irrevocable prepaid burial contract, which is not a countable resource. Designated burial funds are different: they are excluded only up to $1,500 per person, and that $1,500 maximum is reduced dollar for dollar by the face value of any excluded life insurance and by any irrevocable prepaid burial contract you own
  • Personal effects and household goods used on a regular basis

The 5-Year Look-Back

Texas enforces a 60-month (5-year) look-back period for Medicaid nursing home applications, and it runs back from the later of the date the person entered the institution or the date they applied, not simply from the application. Any gifts, transfers below market value, or suspicious financial moves within that window can trigger a penalty period where Medicaid won't pay.

This is the single biggest mistake families make. Transferring a house to an adult child, giving cash gifts, or paying off someone else's debts within five years of applying for Medicaid can delay coverage by months or years.

When to Talk to an Attorney

If your loved one has significant assets and may need Medicaid within the next five years, consult an elder law attorney now. Common strategies include Miller Trusts (for income over the $2,982 limit), irrevocable trusts, spousal protections, and Medicaid-compliant annuities.

Find a certified elder law attorney through the National Academy of Elder Law Attorneys or the Texas chapter of NAELA. Most offer a free or low-cost initial consultation.

Frequently Asked Questions

What pays for senior care if my parent has too much income for Medicaid?

Texas allows a Qualified Income Trust (Miller Trust) to redirect income above $2,982/month into a trust, making the applicant eligible for Medicaid. This is a legal and commonly used tool. An elder law attorney can set one up for a few hundred dollars. Without a Miller Trust, people just over the income limit would have to spend down or go without coverage.

Can I use my parent's Social Security to pay for care?

Yes. Social Security income can be used for any type of care. If your parent is on Medicaid in a nursing home, their income (including Social Security) goes toward the cost of care after the allowed deductions come out: a $75/month personal needs allowance for a nursing facility resident, guardianship fees, the maintenance needs of a spouse or family, and incurred medical expenses. The allowance is much larger in other settings, so someone getting care at home on an HCBS waiver keeps far more: $2,901 a month, versus $85 in assisted living or foster care. Medicaid covers the care services separately.

Does Medicare pay for assisted living?

No. Medicare doesn't cover assisted living, adult day care, or long-term non-medical care. It only covers skilled medical services (nursing, therapy) for limited periods. For assisted living coverage, you'd need Medicaid (STAR+PLUS HCBS waiver), long-term care insurance, VA benefits, or private pay.

How do I pay for care while waiting for the Medicaid HCBS waitlist?

This is one of the hardest situations families face. Options include: private pay for home care hours, VA benefits if the senior is a veteran, family caregiving (unpaid or through CDS if already on Medicaid), community programs through your local Area Agency on Aging, and negotiating reduced hours to make private pay more affordable. If the person's needs increase to nursing facility level, that care is covered under regular Medicaid rather than through the capped, interest-listed waivers.

Next Steps

Start by figuring out where your loved one falls: What care do they need now? What can they afford out of pocket? And what programs might they qualify for?

Here's where to go from here:

  • Check Medicaid eligibility: Review the income limit ($2,982/month for a single applicant) and the $2,000 asset limit in our Texas Medicaid programs guide
  • Explore VA benefits: See whether your loved one qualifies for Aid and Attendance and how to apply
  • Understand your care options: Compare home care, assisted living, and nursing homes to match the right level of care to the budget
  • Get paid as a family caregiver: Learn how Consumer Directed Services and other programs pay relatives

Learn More

FinancialTexas Senior Property Tax ReliefTexas senior property tax relief: the $60,000 school exemption and deferral for homeowners 65 or older or disabled, the over-65 tax freeze, and how to apply. FinancialTexas Retirement Income TaxTexas retirement income tax is zero. No state income tax, so Social Security, pensions, IRA, and 401(k) withdrawals are untaxed. Property taxes are high. MedicaidTexas Medicaid Programs for SeniorsTexas Medicaid programs for seniors 65+ include STAR+PLUS, CAS, HCBS waivers, and PACE. Find out what each one covers, who qualifies, and how to enroll. MedicaidTexas Medicaid Long-Term Care and Nursing HomesTexas Medicaid pays for nursing home care under regular Medicaid, not a capped waiver. See the 2026 income and asset limits and what the at-home spouse keeps. VA BenefitsVA Aid and Attendance for Texas SeniorsLearn about VA Aid and Attendance benefits in Texas for 2026. Covers eligibility, monthly rates up to $2,874, how to apply, and free help from Texas VSOs. Care TypesTexas Nursing Homes: Costs and OptionsNursing homes in Texas in 2026: a semi-private room runs about $67,525/year, well below the national median. What it costs, how Medicaid pays, how to choose. Care TypesTexas Assisted Living GuideHow to choose an assisted living facility in Texas: check the HHSC inspection record, learn what STAR+PLUS Medicaid covers, and compare 2025 care costs. CaregiverGet Paid as a Family Caregiver in TexasLearn how to get paid as a family caregiver in Texas through Medicaid CDS, CAS, VA programs, and CMPAS. Covers pay rates, eligibility, and step-by-step process. FinancialHow to Pay for Senior CareHow to pay for senior care: what it costs nationally and how Medicaid, Medicare, VA benefits, and private pay each fit. Who qualifies, what's covered, in 2026.
Your next step Find personalized help paying for senior care in Texas at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.