Texas Medicaid and Assisted Living
Texas Medicaid may help some eligible people receive long-term services and supports, but families should not assume Medicaid simply pays an assisted-living bill. Program eligibility, covered services and provider participation are specific.
Last editorial review: August 19, 2026. See our research methodology.
What Texas STAR+PLUS Is
Texas Health and Human Services describes STAR+PLUS as a Texas Medicaid managed-care program for adults who have disabilities or adults age 65 or older. The program combines health coverage with long-term services and supports for eligible members.
Texas HHS also maintains specific STAR+PLUS handbook guidance for assisted-living services. That is important because "Medicaid" is not a single blank check that pays every charge in every assisted-living community.
What Families Need to Separate
| Question | What it means |
|---|---|
| Is the person Medicaid eligible? | Financial and other eligibility rules apply; age alone is not enough |
| Is the person eligible for the relevant STAR+PLUS services? | Program and service eligibility must be established |
| Does the assisted-living setting participate? | Not every community participates in every Medicaid arrangement |
| Which services are covered? | Covered long-term services and supports are defined by program rules |
| What does the resident still pay? | Families must understand non-covered charges and room-and-board responsibilities |
Assisted Living Under STAR+PLUS HCBS
Texas HHS's STAR+PLUS handbook states that Home and Community Based Services members who choose to reside in a personal-care facility must reside in a licensed assisted-living facility contracted with the member's managed-care organization for assisted-living services. That wording matters. It means facility licensing, contracting and member eligibility all matter. Simply finding a facility that says "Medicaid" on a third-party directory is not enough.
Questions to Ask Before You Count Medicaid in the Budget
- Is the resident currently enrolled in Medicaid?
- Is STAR+PLUS the relevant program for this person?
- Does the assisted-living community contract with the member's managed-care organization for the needed service?
- Which services are covered and which charges remain private pay?
- What happens if the resident's care needs change?
- What happens if eligibility, plan enrollment or provider participation changes?
Medicaid vs Medicare for Assisted Living
These programs are often confused. Medicare's current long-term-care guidance says Medicare generally does not cover most non-medical long-term custodial care. Medicaid is a separate program and may cover qualifying long-term services and supports under state-specific rules.
That distinction is critical when a family is building an assisted-living budget. "My parent has Medicare" does not mean the long-term assisted-living bill will be covered.
How to Verify a Texas Assisted-Living Community
Verify the facility
Confirm the exact legal facility name and current Texas licensing information.
Verify the plan relationship
Ask the managed-care organization whether the provider participates for the relevant service.
Verify the resident responsibility
Get a written explanation of which recurring charges remain the resident's responsibility.
Do Not Build the Budget Until These Three Answers Are Clear
1. Is the person eligible?
2. Is the service covered?
3. Does the selected provider participate?
If any one of those is uncertain, treat Medicaid support as unconfirmed rather than guaranteed.
Official Texas Sources
Texas HHS STAR+PLUS overview
Texas HHS STAR+PLUS assisted-living services
Texas HHS STAR+PLUS HCBS guidance
Why "Does Medicaid Pay for Assisted Living?" Is the Wrong First Question
The more useful sequence is: Is the person Medicaid eligible? Which Texas Medicaid program applies? Is the person eligible for the relevant long-term services and supports? Does the selected provider participate? Which charges remain the resident's responsibility? Families often skip directly to the final question and then discover that eligibility or provider participation does not line up with the chosen community.
Do Not Confuse Service Coverage With Housing Coverage
Long-term-care programs may cover certain services without simply paying every component of an assisted-living invoice. Families should ask the managed-care organization and provider to separate covered services from housing, room-and-board obligations and other private-pay charges. That distinction belongs in the budget from the beginning.
Provider Participation Can Be the Bottleneck
A resident may qualify for a Medicaid program and still need to find a community that participates in the relevant arrangement. Ask the community for the exact managed-care organizations and programs it contracts with, then verify that information with the plan or state source. Third-party directories can become outdated.
What to Collect Before Calling Texas HHS or a Plan
- The person's Medicaid status, if already enrolled.
- Age and disability information relevant to program screening.
- Current living situation.
- Current care needs.
- Preferred assisted-living communities or geographic area.
- Managed-care plan information, if applicable.
- Any notices or eligibility documents already received.
Ask the Community to Separate Covered and Non-Covered Charges
Request a written explanation of what the provider expects the resident to pay directly. Ask whether there are community fees, deposits, room upgrades or services outside the program benefit. Ask how payment changes if the resident's care level changes or if eligibility is interrupted.
Build a Contingency Plan
Do not select a community that becomes immediately unaffordable if Medicaid approval takes longer than expected or if participation changes. Families should understand the private-pay exposure during application, appeal or transition periods. The safest budget assumes that unverified benefits are not guaranteed.
Re-Verify Before Move-In
Benefit rules, plan networks and facility participation can change. Verify eligibility, plan enrollment and provider participation again before signing a contract or paying a deposit. If a community says that approval is guaranteed, treat that as a reason to contact the responsible Medicaid source directly.
Frequently Asked Questions
What is STAR+PLUS?
STAR+PLUS is a Texas Medicaid managed-care program for qualifying adults who have disabilities or are age 65 or older.
Does STAR+PLUS include long-term services and supports?
Texas HHS describes STAR+PLUS as combining health coverage with long-term services and supports for eligible members.
Can STAR+PLUS include assisted-living services?
Texas HHS has an assisted-living-services section in its STAR+PLUS handbook for qualifying HCBS members residing in licensed assisted-living settings.
Does Medicaid pay every assisted-living charge?
No. Covered services, room-and-board responsibilities and other charges depend on program rules and the individual's situation.
Does every Texas assisted-living community participate?
No. Provider participation varies. Verify participation directly with the plan, state resources and the facility.
Is being over 65 enough to qualify?
No. Age alone does not establish Medicaid or STAR+PLUS eligibility. Financial and program requirements apply.
Can someone already in assisted living apply?
Potentially, but eligibility, program enrollment and whether the setting participates must be evaluated under current Texas rules.
Is STAR+PLUS the same as Medicare?
No. STAR+PLUS is a Texas Medicaid managed-care program. Medicare is a separate federal health-insurance program.
Does Medicare pay long-term assisted-living room and board?
Medicare generally does not cover most long-term custodial care or assisted-living room and board.
What should I verify with a community?
Ask whether it participates in the relevant Medicaid arrangement, what services are covered, what the resident pays and what happens if eligibility changes.
Can I rely on a directory saying a facility accepts Medicaid?
No. Participation can change. Confirm directly with the provider and the appropriate Medicaid plan or state source.
What is the safest first step?
Check current Texas HHS eligibility and STAR+PLUS information before building a care budget around Medicaid.