Last verified: March 2026. These figures may change. Check the Texas Health and Human Services Commission (2-1-1) for the most current details.

Key Takeaways

Texas elder care costs range from approximately $2,167/month for adult day care to $7,597/month for a private nursing home room, but Texas runs roughly 41% below the national average for nursing homes
Medicaid STAR+PLUS is the largest long-term care funding source in Texas, covering nursing homes and home-based services for those who qualify (income at or below $2,982/month, assets at or below $2,000)
VA Aid and Attendance pays up to $2,424/month for veterans or $1,558/month for surviving spouses who need help with daily activities
The Texas Long-Term Care Partnership Program lets you protect assets dollar-for-dollar against Medicaid spend-down if you buy a qualifying insurance policy
Community Attendant Services (CAS) is the only Texas Medicaid program with no waitlist, providing up to 50 hours/week of personal care

Elder care in Texas is expensive. A shared nursing home room costs approximately $5,869/month. Most families can't cover that out of pocket for long. The good news: several programs can help you pay for elder care in Texas, from Medicaid and VA benefits to insurance and home equity. You can chat with Brevy to check eligibility in a few minutes.

This guide covers every major senior care funding option in Texas for 2026. We'll start with what things cost, then walk through each program.

Important: The figures in this guide are based on 2026 data from CMS, the VA, Texas HHSC, and the Genworth/CareScout Cost of Care Survey. Eligibility rules change frequently and vary by situation. Contact Texas Health and Human Services at 2-1-1 or a Medicaid planning attorney to verify current requirements.

What Elder Care Costs in Texas

Texas is one of the more affordable states for long-term care. Here's what you're looking at in 2026, according to the Genworth/CareScout Cost of Care Survey:

Nursing home care:

Shared room: approximately $193/day ($5,869/month or $70,430/year)
Private room: approximately $250/day ($7,597/month or $91,168/year)
That's roughly 41% below the national average of $327/day for a shared room

Assisted living: approximately $5,250/month ($63,000/year), ranging from about $1,500/month in the Amarillo area to $7,604/month near Corpus Christi

Home health aide: approximately $5,720/month ($68,640/year) based on 44 hours per week

Adult day care: approximately $2,167/month ($26,000/year) for five days a week

A four-year nursing home stay at the shared-room rate runs over $280,000. That's why most families layer multiple funding sources together.

Not sure where to start? Chat with Brevy to check your eligibility -- it takes a few minutes.

How to Pay for Elder Care in Texas: Medicaid (STAR+PLUS)

Medicaid is the single largest payer for long-term care in the country. In Texas, the program is called STAR+PLUS.

What STAR+PLUS Covers

STAR+PLUS is Texas's Medicaid managed care program for adults with disabilities or age 65 and older. It covers both nursing home care and home-based services through managed care organizations including Community First, Molina, and United Healthcare.

The HCBS waiver lets you stay home or in assisted living instead of moving to a nursing facility. Services include personal assistance, home modifications, respite care, day activity programs, emergency response systems, nursing, and therapy.

Nursing home residents on Medicaid keep a $75/month personal needs allowance. The rest of their income goes toward facility costs.

Community Attendant Services (CAS) is the only Texas Medicaid long-term care program with no waitlist. It provides up to 50 hours per week of personal care, though most participants get 15-20 hours. You can hire family members as paid caregivers through consumer-directed care.

Do You Qualify?

In 2026, Texas Medicaid long-term care eligibility requires:

Income: $2,982/month or less (300% of the $994 SSI federal benefit rate)
Assets: $2,000 or less for a single applicant, $3,000 for a married couple (both applying)
Medical need: You must require a nursing facility level of care

If you're married, your spouse can keep up to $162,660 in assets through the Community Spouse Resource Allowance. They can also receive up to $4,066.50/month from the applying spouse's income.

If Your Income Is Too High: The Miller Trust

Texas is an income cap state with no spend-down pathway for income. If you earn more than $2,982/month, you'll need a Qualified Income Trust (also called a Miller Trust).

A Miller Trust is an irrevocable trust where you deposit income from a single source. That income is then disregarded when Medicaid checks your eligibility. Texas must be named as the remainder beneficiary. Get a Medicaid planning attorney to set this up.

Asset Spend-Down and the Look-Back Period

Texas enforces a 60-month (five-year) look-back period on asset transfers. Give away assets or sell them below fair market value during that window, and you'll face a penalty period of Medicaid ineligibility.

Legal ways to reduce assets below the $2,000 limit include paying off debt, making home modifications for accessibility, prepaying funeral expenses in irrevocable trusts, purchasing medical devices, and creating formal caregiver agreements at fair market value.

Your primary home (equity up to $752,000), one vehicle, burial plots, and personal belongings don't count as assets.

Calling your local Area Agency on Aging before you start spending down is usually the smartest first move. They offer free benefits counseling and can help you avoid mistakes that trigger penalties.

How to Apply

Apply online at YourTexasBenefits.com, by phone at 2-1-1, or in person at your local HHSC office.

Want to see if your family qualifies for Medicaid? Start a free eligibility check with Brevy -- no paperwork needed.

Medicare: Limited but Worth Knowing

Medicare doesn't pay for long-term custodial care. No nursing home stays, no assisted living, no ongoing home help with bathing and meals. This catches many families off guard.

What Medicare does cover: short-term skilled nursing after a qualifying three-day hospital stay.

Days 1-20: $0 coinsurance after the $1,736 Part A deductible
Days 21-100: $217/day coinsurance
After day 100: You pay everything

The benefit period resets after 60 consecutive days without skilled nursing care.

Medicare Savings Programs

If Medicare premiums strain your budget, Texas offers help:

QMB (income at or below $1,305/month): Covers Part A and B premiums, deductibles, and coinsurance
SLMB (income $1,305-$1,565/month): Covers Part B premium
QI-1 (income $1,565-$1,761/month): Covers Part B premium

Asset limits for all three: $9,950 individual, $14,910 couple.

VA Benefits for Texas Veterans

VA benefits are among the most underused senior care funding options in Texas. If your parent or spouse served during wartime, read this section carefully.

Aid and Attendance Pension

The VA pays monthly cash benefits to veterans and surviving spouses who need help with daily activities.

2026 rates (effective December 1, 2025):

Veteran, no dependents: $2,424/month ($29,093/year)
Veteran, one dependent: $2,874/month ($34,488/year)
Surviving spouse, no dependents: $1,558/month ($18,697/year)
Surviving spouse, one dependent: $1,858/month ($22,304/year)

To qualify, the veteran needs:

At least 90 days of active duty with one day during a wartime period
Age 65 or older, or a permanent total disability
Help with daily activities (bathing, dressing, eating), bedridden, or in a nursing home
Net worth below $163,699 (assets plus annual income, excluding home and one vehicle)

The VA enforces a three-year look-back period on asset transfers. Violations can trigger up to five years of ineligibility.

Texas State Veterans Homes

The Texas Veterans Land Board runs State Veterans Homes that provide nursing care at VA-subsidized rates well below private facilities. Monthly costs range from approximately $2,795 to $6,425 depending on the facility and level of care. Veterans with a 70% or higher service-connected disability can live there for free. Memory care units are available at each home.

Contact the Texas Veterans Call Center at 1-800-252-8387.

The VLB also offers home improvement loans up to $50,000 for aging-in-place modifications like ramps, widened doorways, and walk-in showers.

Have questions about your situation? Ask Brevy -- it's free and takes a few minutes.

Long-Term Care Insurance

If your loved one already has a long-term care insurance policy, it may cover nursing home, assisted living, home care, and adult day care. Check the policy for daily benefit amounts, benefit periods, and elimination periods (the waiting period before benefits kick in).

The Texas Long-Term Care Partnership Program

Texas offers a Partnership program that bridges private insurance and Medicaid. For every dollar your policy pays in benefits, you can protect an equal amount of assets from Medicaid spend-down.

Example: if your policy pays $350,000 in benefits, you could keep $352,000 ($350,000 plus the standard $2,000 limit) and still qualify for Medicaid. Partnership policies also protect assets from Medicaid estate recovery after death.

All Partnership policies include inflation protection and are tax-qualified. Coverage is portable to states with reciprocal programs. Only specially trained, authorized agents can sell them.

Other Ways to Pay

Reverse Mortgages (HECM)

Homeowners age 62 and older can convert home equity into care funds through an FHA-insured Home Equity Conversion Mortgage. In 2026, the maximum claim amount is $1,249,125. A 76-year-old might access roughly 45% of their home's value.

You can take funds as a lump sum, a line of credit (unused credit grows over time), monthly payments, or a combination. No monthly mortgage payments are required. HUD-approved counseling is mandatory before closing.

One caution for Medicaid planning: reverse mortgage proceeds aren't counted as income, but unspent funds count toward the $2,000 asset limit the following month. Spend the money in the same month you receive it.

Life Insurance Conversions

If your loved one has a life insurance policy they no longer need for its original purpose, four options can turn it into care funding:

Accelerated death benefits: Tax-free advances on the death benefit, typically 2% of face value per month, capped at 50% of the death benefit
Life settlements: Sell the policy to a third party for market value (available to women 74+ and men 70+; proceeds are taxable)
Viatical settlements: For terminally or chronically ill individuals; tax-free if life expectancy is two years or less
Conversion programs: Sell the policy in exchange for a defined amount of long-term care services

Free Community Resources

Area Agencies on Aging

Texas has 28 Area Agencies on Aging that serve anyone 60 and older across all 254 counties. Services are free and include benefits counseling, care coordination, caregiver support, nutrition programs, legal assistance, and ombudsman services for nursing home residents. No income requirements.

Call 1-800-252-9240 or dial 2-1-1.

PACE (Program of All-Inclusive Care for the Elderly)

PACE serves Texans age 55 and older who meet nursing facility criteria but want to stay home. It bundles medical care, social services, and long-term care into one program. Medicaid-eligible participants pay nothing.

Contact: 512-487-3450 or CAPM_PACE_Program@hhs.texas.gov.

Ready to explore your options? Talk to Brevy about your eligibility -- they'll help you figure out what you qualify for.

FAQ

Does Medicare pay for nursing home care in Texas?

No. Medicare doesn't cover long-term custodial care. It only covers short-term skilled nursing after a qualifying three-day hospital stay, and that coverage ends after 100 days. For long-term care, you'll need Medicaid, VA benefits, insurance, or private funds.

What if my income is over the Texas Medicaid limit?

Texas is an income cap state. If your income exceeds $2,982/month, you can set up a Qualified Income Trust (Miller Trust) to qualify. Income deposited into the trust is disregarded for eligibility purposes. A Medicaid planning attorney can help you set one up.

Can family members get paid to provide elder care in Texas?

Yes, through Medicaid's Community Attendant Services (CAS) program. CAS allows consumer-directed care, meaning the participant can hire adult children or other family members as paid attendants. CAS is the only Texas Medicaid long-term care program with no waitlist.

How do I protect my spouse's assets when applying for Medicaid?

Texas protects the community spouse through the Community Spouse Resource Allowance, which lets them keep up to $162,660 in assets. They can also receive up to $4,066.50/month from the applying spouse's income. A Medicaid planning attorney can help you structure assets before applying.

Sources

Texas Health and Human Services Commission, "Budget Reference Chart — Appendix XXXI," hhs.texas.gov
CMS, "2026 Medicare Parts A & B Premiums and Deductibles," cms.gov
U.S. Department of Veterans Affairs, "Veterans Pension Rates," va.gov
U.S. Department of Veterans Affairs, "Aid and Attendance Benefits," va.gov
Texas General Land Office, "Veterans Benefits," glo.texas.gov
Texas HHSC, "STAR+PLUS Program," hhs.texas.gov
Texas HHSC, "Program of All-Inclusive Care for the Elderly (PACE)," hhs.texas.gov
Texas HHSC, "Area Agencies on Aging," hhs.texas.gov
U.S. Department of Housing and Urban Development, "Home Equity Conversion Mortgages," hud.gov
Administration for Community Living, "Using Life Insurance to Pay for Long-Term Care," acl.gov
Own Your Future Texas, "About the Partnership Program," ownyourfuturetexas.org
Genworth/CareScout, "2024 Cost of Care Survey — Texas Results," investor.genworth.com

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

<p class="disclaimer">The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Medicaid rules vary by state and change frequently. Always verify eligibility and benefits with your state Medicaid agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.</p>

How to Pay for Elder Care in Texas (2026)