How to Afford Assisted Living in Texas 2026 Guide

What assisted living costs in Texas

The latest CareScout state table available for this guide is its 2025 Cost of Care Survey. It reports a Texas statewide median of $5,666 per month for a private one-bedroom assisted living community, or $67,992 per year. That is a statewide median, not a quote. Prices can be much higher or lower by city, room type, memory-care needs, medication help, transfers, and other services. See the 2025 state cost table.

Do not plan on Medicare paying the ordinary assisted living bill. Medicare long-term care rules say Medicare does not pay for most long-term custodial care. Medicare can still cover separate medical services when normal Medicare coverage rules are met.

STAR+PLUS Medicaid is the main public payment path

Texas STAR+PLUS HCBS is designed to provide long-term services and supports in the community instead of a Medicaid-certified nursing facility. Current Texas policy allows an eligible member to live in a licensed assisted living facility. The program is for adults age 21 or older who meet Medicaid financial rules, Texas residency rules, nursing-facility level-of-care requirements, and other program conditions. See the current STAR+PLUS eligibility rules.

For 2026, Texas lists a special income limit of $2,982 per month for an individual and $5,964 for a couple for nursing-facility and HCBS waiver eligibility. The basic countable-resource limits are $2,000 for an individual and $3,000 for a couple. These figures are screening numbers, not a do-it-yourself eligibility decision. Texas also has rules for spouses, excluded assets, home equity, transfers, trusts, and other situations. The current figures are in the Texas budget reference chart.

The interest list is not the same for everyone

Texas maintains a STAR+PLUS HCBS interest list for some people who are not already in the right Medicaid/STAR+PLUS pathway. A medical-assistance-only applicant may wait until a program slot is released. A person who already receives full Medicaid and is enrolled with a STAR+PLUS managed care organization may be able to bypass the interest list through an upgrade process. Texas also has a Money Follows the Person route for some nursing-facility residents returning to the community. The current interest-list procedures explain these differences.

How to apply

The Medicaid application used for this program is Form H1200, Application for Assistance – Your Texas Benefits. Texas permits Medicaid applications online through YourTexasBenefits.com and through other channels. The official H1200 application page provides the current form information. Our Texas benefits portals guide can help if the online system is unfamiliar.

If income is above the special income limit, do not transfer money or give assets away just to “get under the limit.” Ask HHSC whether a Qualified Income Trust (QIT), sometimes called a Miller trust, or another Medicaid rule is relevant. Texas has a specific STAR+PLUS QIT form, but the trust must be handled correctly. Get current HHSC guidance and legal help when needed.

The room-and-board gap is the hardest part

Texas policy is direct: a STAR+PLUS HCBS member living in assisted living must pay the person’s own room and board and any applicable copayment. The managed care plan determines covered services in the individual service plan, but Medicaid is not a blank check for the facility’s full monthly price. The current assisted living policy confirms the room-and-board responsibility.

The 2026 Texas Medicaid budget chart lists an $85 personal-needs allowance for a recipient in assisted living. That number is part of the Medicaid copayment calculation; it does not mean the facility can charge only a small amount. HHSC and the plan determine the applicable financial responsibility, while the facility may have separate charges that must be understood before signing a residency agreement.

Ask every facility for a written monthly estimate that separates base room and board, care charges, medication management, incontinence supplies, transportation, move-in fees, and any higher-care tiers. Also ask whether the facility is licensed and participates with the person’s STAR+PLUS managed care plan. Texas lists the Long-Term Care Provider Search under its TULIP license-lookup resources.

If room and board still cannot be covered, compare lower-cost housing plus in-home services. Our Texas senior apartments guide and Texas home care guide cover two alternatives that may fit a person who can live safely outside assisted living.

Veterans and surviving spouses: check pension benefits early

A qualifying veteran may receive Veterans Pension, and a qualifying surviving spouse may receive Survivors Pension. If the person meets the VA’s Aid and Attendance criteria, the Maximum Annual Pension Rate (MAPR) used in the pension calculation is higher. The actual pension is based on the difference between the applicable MAPR and the person’s income for VA purposes; some unreimbursed medical expenses can reduce countable income.

For the rate period from December 1, 2025 through November 30, 2026, the VA Veterans Pension rates show a no-dependent Aid and Attendance MAPR of $29,093 per year. The Survivors Pension rates show $18,697 per year for a surviving spouse with no dependent child who qualifies for Aid and Attendance. The current pension net-worth limit is $163,699 through November 30, 2026. These are calculation limits, not guaranteed checks.

Texas veterans can get free claims help from the Texas Veterans Commission. The current TVC claims appointments route connects veterans and families with accredited claims assistance. You can also use our Texas veterans guide for state and local support.

PACE and home-based care can sometimes avoid a facility move

The Program of All-Inclusive Care for the Elderly (PACE) is not a statewide assisted-living payment program. It is a comprehensive care model for certain people age 55 or older who meet nursing-facility medical-necessity rules and live in a PACE service area. Texas currently lists designated service areas in El Paso, Lubbock, and Amarillo/Canyon. PACE can provide medical care, in-home services, day health care, meals, transportation, and other needed services. See the current Texas PACE rules.

For someone who can remain safely at home with support, home care may cost less than moving into assisted living. Family caregiver programs can also matter when a relative is doing much of the hands-on work. Our Texas caregiver pay guide explains the main pathways and limits.

Private-pay and benefit-stacking strategies

Many Texas families use more than one source. A workable plan might combine Social Security or pension income, savings, a VA pension, long-term care insurance, and Medicaid-covered care services. The goal is to match each dollar to the part of the bill it can legally cover.

• Long-term care insurance: ask the insurer whether assisted living is covered, the daily or monthly maximum, elimination period, benefit period, and whether the chosen facility meets policy rules.
• Retirement income and savings: use a written 12-month budget before committing to a community. Include likely care-level increases, not just the opening rate.
• Home equity: selling a home can create a care fund, but moving or transferring property can affect Medicaid planning. Get individualized legal or financial advice before a major transfer.
• Other benefits: programs that lower Medicare premiums, food costs, utilities, or housing costs do not pay the assisted living invoice directly, but they can protect cash needed for room and board.

For broader housing help, see our Texas housing assistance guide.

How to start without wasting time

1. Write down the care needs. Note help needed with bathing, dressing, eating, toileting, transfers, medication, memory, nighttime supervision, and mobility.
2. Gather current finances. List monthly income, bank accounts, investments, insurance, property, debts, and recent transfers. Do not guess at Medicaid eligibility from one number.
3. Call the statewide aging line. Use 1-855-937-2372 if you need help finding the right Texas HHS or local aging office.
4. Call the managed care plan. If the person already has STAR+PLUS, ask the service coordinator whether the HCBS upgrade route applies.
5. Call facilities only after the payer question is clear. Ask whether they participate with the person’s plan and request a written estimate of every charge.
6. Open the VA route in parallel. Do not wait for one program to finish before starting another legitimate route.

Document checklist

• Photo identification and Social Security number.
• Medicare and Medicaid cards, if any.
• Recent Social Security, pension, annuity, and veterans-benefit statements.
• Recent bank and investment statements.
• Life insurance and long-term care insurance policies.
• Information about a home, other real estate, vehicles, and major assets.
• Records of recent gifts or asset transfers.
• Medical records or care assessments showing functional needs.
• Power of attorney or guardianship documents, if someone is acting for the applicant.
• A written facility fee sheet and proposed residency agreement.

If disability-related programs or accommodations are part of the plan, our Texas disability help guide may point to additional state and local supports.

Reality checks before you commit

Common mistakes to avoid

• Waiting until move-in day: Medicaid and VA processes can take time. Start as soon as long-term care looks likely.
• Calling every residence first: learn the likely payer route first so you can ask whether the facility accepts it.
• Assuming Medicare pays: ordinary custodial long-term care is generally not a Medicare benefit.
• Using only the base monthly price: ask about care-level fees, medication help, incontinence supplies, transportation, deposits, and rate increases.
• Moving money before advice: asset transfers can damage Medicaid or VA eligibility.
• Ignoring written notices: denial and reduction notices can carry appeal rights and deadlines.

Phone scripts for the most important calls