Assisted Living in Texas
Warmer temperatures, environmental diversity and 13,900 square miles of Gulf Coast property make Texas a hotspot for retirees in the United States. Seniors make up 12.9% of the state’s population, and this demographic is projected to be the fastest-growing age group over the next 30 years. Whether looking for the charm of a small, historic town or a variety of experiences in one of Texas’ larger cities, seniors have the opportunity to choose a community that meets their needs and expectations.
Texas assisted living costs average $3,998 per month, which is comparable to the surrounding states, which range from $3,748 in Louisiana up to $4,498 in New Mexico. This cost varies depending on the location, level of assistance needed and hospitality features. Medicaid can mitigate these costs through waiver programs along with other government programs and private financing options.
This guide covers the average cost of assisted living in Texas, Medicaid assistance, other financing options and additional senior aid resources.
How Much Does Assisted Living Cost in Texas?
When compared to nearby states, the 2021 Genworth Cost of Care Survey shows Texas’ average assisted living costs are midrange, at $3,998 per month. This price is lower than the national monthly average of $4,500. New Mexico offers the most expensive average, at $4,498, making it an outlier as the only state above $4,000. The other states all fall below the Texas average, with Louisiana holding the lowest cost at $3,748 and Oklahoma ($3,855) and Arkansas ($3,760) falling in between.
The Cost of Assisted Living in Texas’ Top Cities
One of the most impactful factors on the cost of assisted living in Texas is the facility’s location. Sitting close to the southern tip, McAllen is one of the more expensive areas, with an average cost of $4,850. Those who prefer to live at the north end of the state, in Amarillo, pay just slightly less at $4,600. Seniors can find a bargain by choosing a facility in Corpus Christi, averaging at just $3,388, or in San Antonio, which has assisted living costs about $3,413. El Paso in western Texas sits reasonably at $3,750, while Dallas ($4,195) and Houston ($4,245) come in a few hundred dollars more than the state average.
The Cost of Assisted Living vs. Other Types of Care
Choosing assisted living ($3,998) offers the most savings in Texas when compared with other available types of care. Adult day health care is the only option that may be more budget-friendly, at $769 each month on average. Home care options, with or without health components, average $4,576 per month, and nursing home care, when residing in a semiprivate room, costs around $5,125.
Home Health Care
Adult Day Health Care
Nursing Home Care (semiprivate)
Can You Use Medicaid To Pay for Assisted Living in Texas?
Assisted living is not directly covered by Texas Medicaid, though an available waiver program can help mitigate some of the costs associated with supportive services. The STAR+PLUS waiver, created to replace the Community-Based Alternatives waiver, is available to seniors who qualify for Medicaid and require medical care that would make them eligible for a nursing home. Many long-term services are covered, and the recipient can receive benefits whether living at home or in a residential facility, including assisted living. This program has limited enrollment and enables seniors to choose their health care plan.
Medicaid’s Coverage of Assisted Living in Texas
Texas Medicaid coverage of assisted living costs is limited to expenses covered by the STAR+PLUS waiver plan. While this waiver doesn’t offer assistance with room-and-board fees, it can be used to offset the cost of some long-term services and supports necessary for seniors who demonstrate a medical need for a nursing home level of care. Seniors who would prefer an alternative to nursing home living can access supportive services that make them eligible to live at home or in an assisted living facility.
Waivers Programs for Assisted Living in Texas
The STAR+PLUS waiver is available to those who are disabled and anyone over 65 years old who is both eligible for Texas Medicaid and for whom nursing home care is medically necessary. Seniors who are covered by both Medicaid and Medicare, or dual eligible, may still qualify for the STAR+PLUS waiver as long as they don’t live in a facility for intellectual disabilities or receive benefits from the Medicaid 1915 waiver.
STAR+PLUS does not affect your Medicare services. There are a predetermined number of slots available for enrollment, so seniors may find themselves on a waitlist before getting the opportunity to access covered services. Once approved, the recipient works with a STAR+PLUS staff member, who coordinates with their family members and doctors to set up the appropriate services.
The waiver can cover a variety of assistive services, but this may vary depending on the health care plan chosen by the recipient. Some possible services and supports include:
- Personal attendant services
- Adaptive aids and medical equipment
- Respite services
- Medical supplies
- Daily activity and health services
- Physical, occupational and speech therapies
- Financial management services
- Cognitive rehabilitation services
- Emergency response services
Signing up for STAR+PLUS requires enrollment in Texas Medicaid through the Texas benefits website or by dialing 211. Once approved for the STAR+PLUS waiver, seniors are sent an enrollment packet, and they have 15 days to choose their health care plan and a primary care doctor. Choices can be submitted by mail, over the phone or in person at an enrollment event. If a preferred plan and doctor aren’t selected by the deadline, they are chosen for the recipient. Once seniors select a health care plan, they receive assistance setting up their services.
Eligibility for Medicaid in Texas
Seniors must meet specific income and asset limits to be eligible for Texas Medicaid. In Texas, the income total should include any wages, alimony, pension payments, Social Security income, Social Security Disability income, stock dividends and IRA withdrawals. Assets include any checking or savings accounts, cash, stocks and bonds, investments and any non-primary real estate. The primary residence is exempt if equity interest is less than $636,000 or if a non-applicant spouse is still living in the home.
An applicant living on their own should not exceed $30,276 per year in income and should not have more than $2,000 in assets. If the applicant has a spouse who isn’t applying for Medicaid, the income and asset limits remain the same for the applicant, but the spouse must have no more than $137,400 in assets. If both spouses are applying, combined income cannot exceed $60,552, and asset value must stay below $3,000.
|Income Limits*||Asset Limits|
|Two-Person Household (Only One Person Applying)||$30,276||$2000 for applicant$137,400 for non-applicant|
|Two-Person Household (Both People Applying)||$60,552||$3,000|
For seniors to qualify, they must also meet the following eligibility criteria:
- Be at least 65 years old or have a qualifying disability
- Be a legal U.S. citizen, legal alien or permanent resident
- Be a legal Texas resident
Applying for Medicaid in Texas
Seniors can apply for Texas Medicaid online by creating an account on the Your Texas Benefits website. The site offers a prescreening tool to ensure eligibility and to identify possible services available. For those who don’t have access to a computer, applications can be submitted over the phone by calling (877) 541-7905.
Before You Apply:
Before starting the Medicaid application, seniors need to have the following information:
- Birthdate and social security number
- Citizenship or immigration status
- Income information
- Value of assets
- Monthly expenses
Where To Go To Get Help
Submitting a Medicaid application can be complex, and seniors may find themselves with questions about the process. The following resources are available to offer assistance for Medicaid applicants.
|Texas Medicaid Hotline||Phone: (800) 252-8263TDD: (512) 424-6597Email: [email protected]||Representatives are available to answer Medicaid-related questions and assist with applications.|
|Texas Department of Health and Human Services||(877) 541-9705||Advisors offer information on available benefits and eligibility, answer application questions and give advice on needed services.|
|Texas Health Information, Counseling and Advocacy Program||(800) 252-9240||This program offers information and assistance regarding enrollment in Medicare, Medicaid and long-term care.|
|Local Health and Human Services Office||Visit or call your local office.||Advisors can assist with in-person applications, offer advice on benefits and answer Medicaid questions.|
|Your Texas Benefits||Online Help Center||This comprehensive Texas Medicaid website offers application submission, a prescreening tool, benefits overview and troubleshooting options.|
Can You Use Medicare to Pay for Assisted Living in Texas?
Unfortunately, Medicare does not cover the cost of assisted living in Texas. Unlike nursing homes, assisted living facilities are not considered to be “clinical settings’ and so are not eligible for Medicare coverage. That being said, you can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.
For more information about what Medicare visit medicare.gov.
Are There Other Financial Assistance Options for Assisted Living in Texas?
|How to Apply||How It Works|
|Aid and Attendance||Apply online at va.gov.||If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.|
|Reverse Mortgages||Research and learn about the different types at ftc.gov||If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.|
|Long-Term Care (LTC) Insurance||Learn about how to receive LTC insurance benefits at acl.gov.||While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.|
Free and Low-Cost Resources for Seniors in Texas
Another way to reduce the expense of assisted living is to take advantage of the many free and low-cost resources available to seniors in Texas. Some of these services offer information to help navigate government programs, while others provide assistance with a variety of activities and needs.
|Area Agencies on Aging||(800) 252-9240||Seniors who are 60 or above can receive assistance on a variety of issues by calling or visiting their local AAA office. Agents can offer guidance on benefit applications, housing, nutrition and elder rights and can connect seniors with the appropriate support programs.|
|2-1-1 Texas||211||The 2-1-1 hotline is available 24/7 and can help connect seniors to supportive services such as counseling or help to find housing and food. It also offers up-to-date information from several state and local health and human service programs.|
|Aging & Disability Resource Centers||(855) 937-2372||Staff at the nearest ADRC are available to direct seniors to relevant local, state and federal programs and organizations that offer supportive services.|
|Texas Assisted Living Association||(512) 653-6604||TALA offers information on assisted living facilities in Texas and helps connect seniors with financial assistance programs and VA aid. It also provides a full list of licensed Texas medical providers.|
|Office of the Independent Ombudsman for State Supported Living Centers||(877) 323-6466||The Office of the Independent Ombudsman is responsible for protecting seniors living in residential facilities by working with an on-site assistant ombudsman. The office is tasked with advocating for residents and their families and conducting audits on facilities when necessary. It’s also a resource to file complaints of elder abuse, neglect and exploitation.|
|Texas Legal Services Center||(512) 477-6000||Texas Legal Services Center offers free legal advice to low-income seniors regarding benefits, pensions and consumer and elder law.|
|Seniors Farmers’ Market Nutrition Program||(877) 839-6325||The Seniors Farmers’ Market Nutrition Program works with the Texas Department of Agriculture to provide low-income seniors with locally sourced vegetables, fruits, herbs and honey.|
|Care Planning Council of Texas||Use the online message center||Seniors can find listings for a variety of supportive services and a full roster of active senior centers across the state on the Care Planning Council of Texas website. The site also offers comprehensive information on a variety of topics, including veterans’ benefits, reverse mortgages and elder law, and provides a list of relevant books for purchase.|
COVID-19 Rules for Assisted Living in Texas
The following information is based on research done on several government websites, including hhs.texas.gov and cms.gov. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/15/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.
Visiting Loved Ones
|Can I visit my relative in person if he/she wants emotional support from me?||Yes (Conditions Apply)|
|Can I visit my relative in person for end-of-life compassion care?||Yes|
|Will my loved one be required to self-quarantine after I visit him or her?||No|
|Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?||Yes|
|Are Hairdressers and other non-medical contractors still allowed in senior living facilities?||Yes|
|Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?||Yes|
|Are visitors being screened for elevated temperatures?||Yes|
|Are visitors being asked questions about health, travel, and potential virus contact?||Yes|
Outings and Group Activities
|Are residents allowed to leave the facility for non-medical reasons?||Yes|
|Are residents of senior living facilities who leave and return required to self-quarantine?||No (Conditions Apply)|
|Are senior living facilities required to cancel all group outings?||No|
|Are residents still eating together in the dining hall?||Yes (Conditions Apply)|
|Are facilities still allowed to host group activities within the community?||Yes (Conditions Apply)|
Safety Measures for Staff & Contractors
|Are staff members and contractors being screened for elevated temperatures?||Yes|
|Are staff members and contractors being tested for Coronavirus?||Yes (Conditions Apply)|
|Are staff members and contractors being asked questions about health, travel, and potential virus contact?||Yes|
Safety Measures for Residents
|Are staff members required to regularly screen residents for coronavirus symptoms?||Yes|
|Are residents relied on to screen themselves and self-report potential coronavirus symptoms?||No|
|Are staff members required to take residents’ temperatures?||Yes|
|Are residents being tested for coronavirus?||Yes (Conditions Apply)|
Assisted Living Laws and Regulations in Texas
Texas assisted living facilities are regulated through the Health and Human Services Commission, which contracts with local Area Agencies on Aging to provide assistance to seniors. The HHSC ensures facilities are following all state laws and regulations and that licensing requirements are up to date.