Does Texas Medicaid Pay for Assisted Living? STAR+PLUS Guide
Texas Medicaid can help pay for assisted living services for some eligible adults through STAR+PLUS Home and Community Based Services (HCBS), but it does not simply pay the entire assisted living bill.
Texas HHSC lists assisted living among the additional services available through STAR+PLUS HCBS. Members receiving assisted living services remain responsible for room and board and, when applicable, a copayment.
What is STAR+PLUS?
STAR+PLUS is a Texas Medicaid managed-care program serving qualifying adults with disabilities and adults age 65 or older. The STAR+PLUS HCBS program provides home- and community-based services for people who would otherwise need nursing-facility care.
Can STAR+PLUS HCBS include assisted living?
Yes. Texas lists assisted living among STAR+PLUS HCBS services. Other available services can include personal assistance, nursing, therapies, adaptive aids, emergency response, home-delivered meals, respite, and other supports based on assessed need and authorization.
Who may qualify?
Eligibility is individualized. Texas requires Medicaid eligibility and, for STAR+PLUS HCBS, a valid medical-necessity determination for nursing-facility level of care along with other program requirements.
Do not use a single online income number to decide eligibility. Medicaid financial pathways differ, and HHSC should determine eligibility based on the applicant’s circumstances.
Does Medicaid pay room and board?
No. Texas STAR+PLUS guidance states that members receiving assisted living services are responsible for room and board costs and, if applicable, a copayment.
Ask a participating facility and the managed care organization for a written explanation of what Medicaid pays and what the resident must pay.
Does every assisted living facility participate?
No. A Texas assisted living license does not automatically mean the facility contracts to provide STAR+PLUS HCBS assisted living services. Texas guidance also recognizes different contracted housing options.
Ask whether the facility currently participates, whether the specific apartment or unit is available under its contract, and whether there is a current opening.
How to apply or ask about eligibility
Texas directs people to apply for Medicaid through Your Texas Benefits or by calling 2-1-1. HHSC assesses STAR+PLUS HCBS needs during the Medicaid and service-coordination process.
What to ask a community
- Do you currently contract for STAR+PLUS HCBS assisted living?
- Which housing options are covered under your contract?
- Is there a current opening for a STAR+PLUS member?
- What room-and-board amount would the resident owe?
- Would a copayment apply?
- Which services are included in the authorized plan and which are not?
- What Type A or Type B license do you hold?
Medicaid eligibility and care fit are separate
Three questions need to align: whether the person qualifies for STAR+PLUS HCBS, whether the provider participates, and whether the facility can safely meet the person’s assessed needs.
See How to Choose Assisted Living in Texas for the care-selection side and Texas Assisted Living Costs for private-market planning.
Explore Texas senior care
NHP directory inclusion does not mean a community participates in STAR+PLUS or currently has an eligible opening. Verify participation directly.
Frequently asked questions
Does Texas Medicaid pay for assisted living?
STAR+PLUS HCBS can cover authorized assisted living services for eligible members, but members remain responsible for room and board and applicable copayments.
Do I need nursing-facility level of care?
Texas STAR+PLUS HCBS eligibility requires a valid medical-necessity determination for nursing-facility level of care, along with other requirements.
Does every Texas assisted living facility take STAR+PLUS?
No. Provider participation and contracting are separate from state assisted-living licensure.
For statewide context across Texas care settings, licensing, costs, Medicaid, and how the pieces fit together, see Senior Care in Texas: A Complete Guide for Families.
Sources and further reading
- Texas HHSC — STAR+PLUS
- Texas HHSC — STAR+PLUS HCBS Eligibility
- Texas HHSC — Assisted Living Services
Last reviewed September 2026. Medicaid eligibility, managed-care rules, provider participation, copayments, and availability can change. Confirm current information with Texas HHSC and the member’s managed care organization.
