Senior care in Texas runs from about $5,627/month for a semi-private nursing home room to about $7,604/month for a private one, based on 2025 median costs. Assisted living runs about $5,666/month, and in-home care about $30/hour. Over a long stay, that adds up fast. This guide covers how to pay for senior care in Texas: Medicaid, Medicare, VA benefits, long-term care insurance, and private pay.

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, plus what Medicare charges for covered home health care:,

Care Type Typical Monthly Cost Details
Home care (non-medical) about $5,720 about $30/hour, based on 44 hours/week
Home health (skilled/medical) $0 under Medicare if you qualify Must be homebound and need part-time skilled care
Assisted living about $5,666 $67,992/year statewide median
Nursing home (semi-private) about $5,627 about $185/day
Nursing home (private) about $7,604 about $250/day

Texas runs below the national median for non-medical home care, assisted living, and nursing homes. 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 can pay for nursing home care, care at home, and the care services in assisted living for people who meet its financial rules and, for the waivers, an institutional level of care.,,

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 keep some of the applicant's income, up to a $4,066.50/month spousal allowance, but income the spouse already has counts against that amount, so the allowance is not paid on top of the spouse's own income. Texas calls $4,066.50 the Minimum Monthly Maintenance Needs Allowance (or Spousal Allowance), while CMS publishes the same figure as the federal Maximum.

What Medicaid Covers

Expect a wait, though. HCBS waiver programs that cover home care and assisted living can have interest lists, because, unlike regular Medicaid, Texas may cap how many people a waiver serves. Meeting the income and asset limits is also not the whole test for a waiver: HHSC must determine that the person requires services to the same extent they would need if they lived in one of the institutional settings and did not receive waiver services. So get on the interest list early, even before you know whether your loved one qualifies; the FAQ below explains how.

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 per benefit period, normally after a qualifying 3-day inpatient hospital stay. Days 1-20 cost $0 a day after the $1,736 Part A deductible, which you don't pay twice if you already paid it for a hospital stay in the same benefit period. Days 21-100 have a daily copay of $217 in 2026. After day 100, Medicare pays nothing. Missing the 3-day stay is not always the end of it. You may not need the 3-day stay at all if your doctor participates in an Accountable Care Organization approved for a Skilled Nursing Facility 3-Day Rule Waiver, and a Medicare Advantage plan may also waive it. No second qualifying stay is needed if you re-enter a skilled nursing facility within 30 days. And if the hospital changed your status from inpatient to "outpatient getting observation services" on or after February 14, 2025, you can ask for a fast appeal through your state's BFCC-QIO, following the instructions on the Medicare Change of Status Notice (CMS-10868); going home does not end that right. The separate retrospective track, for admissions between January 1, 2009 and February 13, 2025, stopped taking new requests on January 2, 2026, and a later request is denied unless you establish good cause for filing late.
  • Home health care: You pay $0 for covered home health services, but only if you meet every condition: you're homebound, you need part-time or intermittent skilled care (nursing or therapy), a doctor or other allowed provider sees you and orders the care, and a Medicare-certified home health agency provides it. In most cases, skilled nursing and home health aide care together are limited to 8 hours a day and 28 hours a week, with up to 35 hours a week for a short time if your provider decides it's necessary.

What Medicare doesn't cover:

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 one dependent (such as a spouse): Up to $34,488/year
  • Surviving spouse: Up to $18,697/year

Those are ceilings, not checks. The VA bases the payment on the difference between the veteran’s income for VA purposes and the rate, so each figure above is the maximum amount of pension payable, and a veteran with countable income is paid that rate less the income. The award is paid out monthly: the rate less countable income, divided by 12 and rounded down to the whole dollar.

To qualify, the veteran must have enough active-duty service with at least 1 day during wartime (generally at least 90 days for those who started before September 8, 1980, or 24 months for most who enlisted after September 7, 1980), 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 meets this condition without any permanent-and-total rating. The veteran also needs to meet at least one aid-and-attendance requirement, such as needing another person's help with daily activities like bathing, feeding and dressing, and must have a net worth within VA's $163,699 limit. 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. It also leaves out the house you live in, your car, and most home furnishings, so a paid-off home doesn't count against you. The VA also looks back 36 months from the date it receives the pension claim. Giving away an asset for less than fair market value in that window can bring a penalty period of up to five years, if that asset would otherwise have pushed net worth over the limit.

Aid and Attendance comes as an increased monthly payment added to the veteran's VA pension, so the veteran must qualify for that pension first.

Veteran-Directed Care

The VDC program gives enrolled veterans a flexible budget to hire their own workers, including family, friends, or neighbors, if they're eligible for VA community care, meet the clinical criteria, and the program is available where they live. Like Medicaid's CDS option, it puts the person getting care in charge of hiring.

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 cover in-home care, assisted living, and nursing home care, paying up to a set daily or monthly benefit once the policy's benefit triggers and elimination period are met.

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, and those assets are also protected from Medicaid estate recovery. A Partnership policy doesn't guarantee Medicaid, though: your loved one still has to meet every other eligibility rule.
  • Premiums have been rising significantly nationwide. If your loved one gets a rate-increase notice, read it closely and ask the insurer what choices the policy gives before letting it lapse.
  • It works best when bought ahead of need. A policy pays only after its benefit triggers and elimination period are met, so it helps most when it's already in place before care starts.

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

Private pay starts with what your loved one has. 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 can all go toward the bill.

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: a reverse mortgage loan advance isn't income for Medicaid, but cash from the lender that you still have in the month after you got it counts as a resource. With a $2,000 asset limit for Medicaid, you'd need to spend the funds quickly. The home itself stays an excluded resource while your loved one lives there, so a reverse mortgage fits best for someone who isn't on Medicaid and wants to pay for care while staying in the home.

Life Insurance Options

A life insurance policy can sometimes help pay for care, but each route has tax and benefit consequences to price in first:

  • Accelerated death benefits: Whether this is available depends on the policy. Some older policies don't offer it, but many insurers now make the option available, so ask the agent or the company. A policyholder is usually eligible only if the option was added before the insured became terminally ill, so don't count on adding it once care is needed. Whatever is paid out is subtracted from what the beneficiaries later receive.
  • Life settlements: Selling the policy to a third-party investor for a lump sum that is generally more than its cash surrender value but less than its death benefit. It's usually available only to women about 74 and older and men about 70 and older, the proceeds may be taxed, and there may be little or nothing left for heirs. Many states regulate life settlement providers, but not all do, so confirm with the state insurance regulator that the broker or provider is licensed.
  • Medicaid effects: Any of these moves can affect Medicaid and SSI eligibility. Under federal SSI rules, an accelerated benefit payment counts as income in the month it's received, and cash from selling or surrendering a policy can push your loved one over the asset limit unless it's spent down. Check with the insurer, and confirm the tax and Medicaid consequences, before acting.

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 it was your principal residence while you owned it and you no longer live there but intend to return (the primary evidence of that intent is your own statement, documented on a signed Form H1245, Statement of Intent to Return Home, or a comparable written statement from your spouse or authorized representative). 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 if your spouse lawfully resides in the home, or if your child lawfully resides there and is under 21, or is blind or permanently and totally disabled under the standard the rule defines.
  • One automobile, excluded regardless of value
  • Burial spaces held for your burial, your spouse's, or another immediate family member's, excluded regardless of value, and an irrevocable prepaid burial contract, which is not a countable resource. Burial funds are different. Texas excludes only up to $1,500 per person, and only for money set aside for your own burial expenses or your spouse's. The funds must be liquid, kept separate from other funds, and specifically designated for burial expenses. The exclusion is not allowed for your children or anyone else: buying a burial fund for a minor child, or for an adult child who is not disabled, is treated as a transfer of assets, unless the child meets Social Security Administration disability criteria. The $1,500 is also reduced by the face value of any life insurance already excluded under the life insurance exclusion, any burial insurance policy for your burial expenses, any amount held in an irrevocable trust, burial contract, or other irrevocable arrangement for your burial expenses (except the part that represents excludable burial spaces), and any life insurance policy that irrevocably names a funeral provider as beneficiary, where the owner has irrevocably waived the right to, and cannot obtain, any cash surrender value. An irrevocable prepaid burial contract reduces the $1,500 dollar for dollar.
  • Personal effects and household goods used on a regular basis. Items bought or held for their value or as an investment are counted, unless another exclusion applies.

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. Asset transfers inside that window can trigger a transfer-of-assets penalty, which Texas figures using a daily rate of $262.37 (effective Sept. 1, 2025).

So be careful with gifts. Handing cash or the house to an adult child inside that window is exactly the kind of transfer the look-back checks, so talk to an elder law attorney before moving anything.

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. An attorney can tell you whether a Qualified Income Trust (Miller Trust, for income over the $2,982 limit) or the spousal protections above fit your situation.,

You can search for an elder law attorney through the National Academy of Elder Law Attorneys.

Frequently Asked Questions

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

If your parent's income is over Texas's $2,982/month special income limit for nursing home or HCBS waiver Medicaid, they can set up a Qualified Income Trust (Miller Trust) to qualify. The trust must be irrevocable and hold only income, and it has to be run carefully: each income source put into it goes in whole, in the same month it's received, or your parent can be ineligible for that month. It doesn't lower what they pay toward their own care, and when they die, the State of Texas is repaid from what's left in it, up to what Medicaid spent. An elder law attorney can set one up correctly.

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

Yes. Your parent's Social Security can go toward their 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 pay an assisted living facility's room and board or the personal care most residents get there, and a Medigap policy doesn't fill that gap. A Medicare-covered medical service is still covered if your parent lives in assisted living. For the assisted living bill itself, look to Medicaid's STAR+PLUS HCBS program (care services only, not room and board), long-term care insurance, or your parent's own income and savings, including any VA pension.,

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 your loved one moves into a nursing facility, ask about Money Follows the Person: HHSC says a nursing facility resident may become eligible for STAR+PLUS HCBS that way. Ask about shortcuts, too. Someone already on Medicaid and enrolled with a health plan may be able to skip the STAR+PLUS HCBS interest list through the upgrade process. And a person on a waiver interest list may be able to get Community First Choice attendant services while they wait, if they meet its requirements. Anyone can put their name on the list, and eligibility isn't decided until a slot opens, so sign up now rather than waiting to qualify: the STAR+PLUS interest list line is 1-877-438-5658.

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 tax still applies. 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 in Texas for 2026: eligibility, the $34,488 yearly ceiling for a veteran with a spouse, how to apply, and free help. 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 assisted living in Texas: confirm the HHSC license, ask about inspections, 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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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.