Home Care in Texas

According to the Genworth Cost of Care Survey for 2021, you can expect to pay an average of $4,576 per month for home care in Texas. This applies to in-home care, which typically includes personal care and companion services, as well as home health care, which consists of medical or rehabilitation services provided by a licensed professional.

When compared to nearby states, Texas is in the middle of the pack when it comes to home care costs. Oklahoma and New Mexico—with average costs of $4,862 and $4,605, respectively—are more expensive. With average costs of $4,185 and $3,623, Arkansas and Louisiana have lower average costs of care than Texas. The national average for home care is $4,957, almost $400 per month higher than the state average.

Texas is also in the middle of the range when comparing its home health care costs against those of nearby states. With average costs of $4,862 and $4,652, respectively, Oklahoma and New Mexico are more expensive than Texas. Louisiana is the least expensive state, with average monthly costs of $3,718 for home health care. Arkansas has average monthly costs of $4,195. The national average of $5,148 is about $550 more per month than the state average.

In Texas, nursing home care costs an average of $5,125 per month, making it the most expensive senior care option. Assisted living averages $3,998 per month, while adult day care has average costs of just $769 per month. In-home care and home health care average $4,576 per month, making them some of the most expensive care options for Texas seniors.

It depends. Standard Medicaid pays for home health care directly, but it doesn’t cover non-clinical care. The STAR+PLUS waiver pays for long-term services and supports, including personal care to help you stay in your home instead of moving to an assisted living community or nursing home.

For Medicaid to cover the cost of home health services, your doctor must certify that you have a medical need that can be addressed with each service. You must also be able to show that you can receive the services safely in your home.

STAR+PLUS Waiver

The STAR-PLUS waiver gives Texas seniors access to a variety of services and supports, including home modifications and help with basic activities of daily living. If you qualify for STAR+PLUS, you’ll work with a service coordinator to determine which services are a good match for your needs. STAR+PLUS also covers respite care, which gives caregivers a short break to relax and take care of their own needs. If your caregiver needs a short break, you may be able to use the STAR+PLUS waiver to hire someone to help you while they’re gone.

To qualify for STAR+PLUS, you must be approved for Medicaid and meet at least one of the following criteria:

• Receiving benefits from the Social Security Income (SSI) program
• Eligible for STAR+PLUS Home and Community-Based Services
• Residing in a nursing home
• Enrolled in the Medicaid Breast and Cervical Cancer program
• Receiving Medicaid through a Social Security Exclusion program

If you’d like to enroll in STAR+PLUS and aren’t already signed up for Medicaid, visit Your Texas Benefits to complete an application. Once enrolled, you’ll have the opportunity to sign up for STAR+PLUS. If you’re approved, you’ll have 15 days to select a health plan and designate someone to serve as your primary care provider.  After 15 days, Texas Health and Human Services will assign you to a plan and designate a PCP for you.

To qualify for Medicaid, you must meet certain financial eligibility requirements. For regular Medicaid, the income limit is $10,092 per year for single applicants and $15,132 per year for married couples. Medicaid also has limits on the value of the assets you own. In Texas, the limit is $2,000 for single applicants and $3,000 for married couples.

To apply for Medicaid coverage in Texas, visit the Your Texas Benefits website and create an account. Once you register, you’ll be able to log in and complete an application for Medicaid and other benefits. You can also download an application and fill it out by hand. The completed application can be faxed to (877) 447-2839, turned in at your local benefits office or mailed to the following address:

Texas Health and Human Services Commission
PO Box 149024
Austin, Texas 78714-9024

What Information You Will Need

Medicaid verifies all the information provided on each application, so it’s important to gather your financial documents and proof of identity. You may be asked to provide the following:

• Citizenship records
• Driver’s license or non-driver ID card
• Statements for checking and savings accounts
• Copies of insurance policies and financial contracts
• Information on stocks, bonds and other investments
• Pay stubs or tax returns to prove your income

How to Get Help Applying for Medicaid

The Texas Medicaid application asks detailed questions about your financial situation. It can be a little overwhelming to answer these questions on your own, especially if a caregiver normally helps you manage your finances. Fortunately, Texas has several resources to help seniors apply for coverage and use their Medicaid benefits once they’re approved.

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

• Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
• Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
• Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
• Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for Home Care in this guide.

With the right services and supports, many Texas seniors can maintain their independence and continue living in their homes. These organizations offer free and low-cost resources to help seniors stay as safe and healthy as possible as they age in place.

All home health care workers employed by agencies that participate in Medicaid and/or Medicare must be fully vaccinated against SARS-CoV-2 to prevent the spread of COVID-19. This is based on a rule issued by the Centers for Medicare & Medicaid Services, a federal agency. State officials challenged the legality of the rule, but a district court dismissed the case on January 20, 2022. Texas doesn’t have any vaccination-related mandates for home care or home health care workers employed by agencies that don’t participate in Medicare and Medicaid.

These rules are current as of April 2022, but they change often, so it’s wise to check with your local Area Agency on Aging if you’re concerned about having an aide enter your home. Home care agencies may also have their own policies related to COVID-19, so check with your local agency for a complete list of rules.

Texas Health and Human Services is responsible for regulating home care providers in Texas. The regulations are outlined in Title 2 of the Texas Health and Safety Code. THHS monitors compliance with the rules to ensure seniors and disabled adults receive appropriate care.

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

Learn More About Home Care in Texas’s Top Cities

• Arlington
• Austin
• Dallas
• El Paso
• Fort Worth
• Harker Heights
• Houston
• Katy
• Plano
• Richardson
• San Antonio
• Sugar Land