STAR+PLUS covers personal care and supervision services inside licensed Houston-area assisted living facilities, but only at locations that have voluntarily contracted with your assigned Managed Care Organization. In Harris County, Fort Bend County, and Montgomery County, three MCOs split the market. These are Molina Healthcare of Texas, UnitedHealthcare Community Plan, and Aetna Better Health of Texas. The Houston Assisted Living Facilities team breaks down how the program actually works, what it pays for, and how to find a contracted facility before you commit to a move.

Key Takeaways

  • STAR+PLUS covers services, not room and board. Personal care, medication management support, and supervision are covered. The monthly facility fee is not. Families typically pay $1,200 to $2,000 per month out of pocket after Social Security income is applied.
  • Each MCO keeps its own facility list. A facility in Molina's network may not be in UnitedHealthcare's network. Confirm network status with your MCO directly before scheduling a tour.
  • Harris, Fort Bend, Montgomery, Brazoria, and Galveston counties all fall in the same Gulf Coast STAR+PLUS service area. They are served by the same three MCOs.
  • Functional eligibility requires a formal assessment. Contact the Area Agency on Aging Houston/Harris County at 832-393-4301 to start the process.

Reviewed by the HALF Publishing Team. Houston Assisted Living Facilities maintains an independent directory of licensed senior care communities across Greater Houston, with facility data sourced from the Texas HHSC, CMS quality ratings, and Google Reviews, updated regularly.

Quick Answers
Q: Can an assisted living facility in Houston, TX refuse a STAR+PLUS resident?
Yes, participation in the STAR+PLUS program is entirely voluntary for senior care communities. A facility licensed by the Texas Health and Human Services Commission (HHSC) is not required to accept Medicaid or contract with any Managed Care Organization (MCO). Families must verify that their chosen facility is actively in-network with their specific MCO before planning a move.
Q: What is a Managed Care Organization (MCO) in the Texas STAR+PLUS program?
An MCO is a private health insurance company contracted by the state of Texas to deliver Medicaid benefits to eligible seniors. In the Houston Gulf Coast service area, these organizations coordinate your long-term care services and pay the assisted living facility directly. If you are approved for STAR+PLUS, you will need to choose an MCO like Aetna Better Health, Molina, or UnitedHealthcare to manage your specific care plan.
Q: What is the functional eligibility assessment for Medicaid assisted living?
The functional assessment is a medical necessity evaluation used by Texas Medicaid to determine if a senior requires assistance with daily activities like bathing, dressing, or medication management. This evaluation confirms that the applicant meets the nursing facility level of care required to receive STAR+PLUS waiver benefits. To initiate this process locally, families should contact the Area Agency on Aging Houston/Harris County to schedule an evaluation.

How STAR+PLUS Pays for Assisted Living in Houston

STAR+PLUS is Texas Medicaid's managed care program for people who are aged, blind, or disabled and need long-term services. It pays for care inside licensed assisted living facilities through contracted MCOs, not through the state directly. In the Houston Gulf Coast service area, three MCOs hold STAR+PLUS contracts. These providers are Molina Healthcare of Texas, UnitedHealthcare Community Plan, and Aetna Better Health of Texas. Each MCO negotiates separately with assisted living facilities, which means their contracted facility lists are different. A facility that accepts Molina may not accept UnitedHealthcare. That single operational detail causes more placement problems than anything else families encounter.

MCO STAR+PLUS Plan Name Member Services (Harris County)
Molina Healthcare of Texas Molina STAR+PLUS 1-866-449-6849
UnitedHealthcare Community Plan UHC STAR+PLUS 1-888-887-9003
Aetna Better Health of Texas Aetna STAR+PLUS 1-866-352-6094

One more thing most families do not realize is that Texas HHSC assisted living facility licensing and STAR+PLUS contract status are tracked separately. A facility can hold a valid Type A or Type B HHSC license and still have no MCO contract at all. Most STAR+PLUS facility lists on MCO websites are updated quarterly at best. Always call the MCO directly to confirm a specific facility is still contracted before you tour. The Texas STAR+PLUS program overview from HHSC is the authoritative source for program rules, but facility network verification requires a phone call.

When you contact a facility in Katy or Sugar Land, ask specifically if they have open STAR+PLUS beds for your exact MCO. Facilities often limit the number of Medicaid residents they accept to maintain a specific profit margin. A community might have physical availability but no open Medicaid slots. Ask direct questions about their current Medicaid census before visiting.

Quick Answers
Q: How do I get a list of STAR+PLUS assisted living facilities in Houston, TX?
The fastest way to get an accurate list is to call your assigned MCO member services line and ask for their contracted facilities in your specific ZIP code. You can also use the Texas HHSC Long-Term Care Provider Search online or our Find Care tool to filter by city and care type. Always call the MCO directly, as online directories often lag behind actual contract changes and current bed availability.
Q: How long is the waitlist for Medicaid assisted living beds in the area?
Wait times for STAR+PLUS beds in Harris, Fort Bend, and Montgomery counties typically range from three to six months due to strict facility quotas. Because communities limit their Medicaid census to maintain profit margins, physical availability doesn't guarantee an open Medicaid slot. To minimize delays, apply to multiple facilities simultaneously and follow up monthly on your waitlist status.
Q: What out-of-pocket costs should I expect if STAR+PLUS covers my care?
While the STAR+PLUS program pays for your personal care services, you are still legally responsible for paying room and board directly to the facility. In Texas, this monthly payment is calculated based on your income, leaving you with a small state-mandated personal needs allowance. Always ask administrators for a written breakdown of these room and board charges before signing a residency agreement.

Who Qualifies for STAR+PLUS in Harris, Fort Bend, and Montgomery Counties

STAR+PLUS eligibility in the Houston area has two tracks: financial and functional. A resident must meet both before a facility can bill the program for services. On the financial side, income must fall at or below 300% of the SSI federal benefit rate. This is currently around $2,829 per month for an individual as of 2026. Applicants already receiving SSI automatically clear the financial bar. Those with income above that threshold may still qualify through a spend-down arrangement or a Miller Trust (qualified income trust). Consult an elder law attorney before assuming someone is ineligible.

"Families often spend weeks touring facilities before confirming their MCO network status. In Houston's STAR+PLUS market, that order of operations costs time no one can afford. Check network first, tour second."

HALF Publishing Team

Harris, Fort Bend, and Montgomery counties (along with Brazoria, Galveston, and surrounding counties) all sit inside the same Gulf Coast STAR+PLUS service area. This zone is administered through HHSC regional offices.

The functional eligibility piece requires a formal assessment showing the applicant needs a nursing facility level of care. The Texas Area Agencies on Aging coordinate local intake. In Harris County, that means contacting the Area Agency on Aging Houston/Harris County. They administer the Texas Medicaid PASRR and Functional Assessment tools. Without a completed functional assessment, no MCO can authorize STAR+PLUS services inside a facility. This step must happen before placement, not after. For Houston assisted living options across care levels and price points, the HALF directory filters by care type and location.

What to do next:

  1. Contact the Area Agency on Aging Houston/Harris County at 832-393-4301 to request a functional assessment.
  2. Call your assigned MCO member services line (see table above) to request a current list of contracted assisted living facilities in your ZIP code.
  3. Use our filter Houston-area assisted living by location tool to see what is available near your family.

What STAR+PLUS Covers Inside an Assisted Living Facility

STAR+PLUS covers the care services delivered inside a facility, not the cost of living there. That distinction matters because Houston-area assisted living is not cheap. The median base rate in Harris County runs approximately $3,800 to $4,500 per month according to current Genworth Cost of Care Survey data. Fort Bend and Montgomery County facilities trend 5 to 12% higher for comparable care levels. STAR+PLUS offsets the personal care and supervision component, but families still budget $1,200 to $2,000 per month out of pocket for room and board after Social Security income is applied.

Covered by STAR+PLUS Resident Pays Directly
Personal attendant services (bathing, dressing, grooming) Monthly room and board fee
Medication management support Cable and phone service
Adult day health services (if offered by facility) Personal items (clothing, toiletries)
Some therapy coordination Beauty and barber services
Supervision and safety monitoring Transportation beyond covered medical trips

Type A facilities (serving ambulatory residents who do not require nighttime care) are more likely to hold MCO contracts than Type B facilities, which serve higher-acuity residents requiring overnight supervision.

One point families often get wrong is that STAR+PLUS does not guarantee a private room, and it does not cover the higher base rate charged by memory care units. If a resident needs memory care, which in Harris County commonly runs $4,500 to $5,800 per month, STAR+PLUS can still cover the personal care and supervision components. This only applies if the specific memory care facility is contracted with the resident's MCO and the resident meets functional criteria. The room and board premium for memory care comes entirely from the resident's own income or family contribution. For more on Greater Houston senior care directory options across care types, the HALF directory lists licensed facilities by city and care level. The Medicaid long-term services and supports framework governs what STAR+PLUS can authorize at the federal level. HHSC implements those rules at the state level, and MCOs execute them facility by facility.

Quick Answers
Q: Does STAR+PLUS cover memory care in Houston, TX assisted living facilities?
STAR+PLUS can cover the personal care and supervision services inside a memory care unit if the facility is contracted with your Managed Care Organization (MCO) and the resident meets functional eligibility. However, room and board costs for memory care—which often run $4,500 to $5,800 per month in Harris County—are not covered by Medicaid. Families must pay this portion out of pocket, so be sure to compare these base costs carefully when reviewing local memory care options.
Q: How should families compare private pay versus Medicaid beds when choosing a community?
When evaluating communities in areas like The Woodlands or Clear Lake, ask the intake coordinator directly if they maintain separate waitlists for private pay and Medicaid residents. Many facilities prioritize private pay admissions, meaning a Medicaid bed might not be available even if the community has overall vacancies. To make the best financial decision, always confirm the current wait time specifically for a STAR+PLUS bed before paying any application fees.
Q: How do I decide which Managed Care Organization (MCO) is best for my senior care needs?
The best MCO depends entirely on which specific assisted living facilities are in their network across the Greater Houston area. Before selecting a plan like UnitedHealthcare or Molina in Harris County, ask your preferred communities which MCOs they actively contract with for STAR+PLUS waivers. Choosing your preferred facility first and your MCO second ensures your loved one's care will actually be covered where they want to live.

Understanding Waitlists and the Transition Process

Getting approved for Medicaid is complicated. Here is what actually matters. Having an approved STAR+PLUS plan does not mean a facility has to admit you. Many highly rated communities in The Woodlands or Clear Lake maintain separate waitlists for private pay and Medicaid residents. A 5-star Google review does not mean the facility has open Medicaid beds, and most intake coordinators will avoid mentioning their waitlist until you have already toured.

Families must plan ahead. Waitlists for desirable MCO-contracted facilities in Houston often stretch from three to six months. During this waiting period, families are responsible for organizing care at home or paying private rates. Moving into a facility as a private pay resident with the intent to switch to STAR+PLUS later is possible, but it carries strict rules. You must confirm in writing that the facility will accept a transition to Medicaid once funds deplete. Many facilities require one to two years of private payment before they allow a transition to a Medicaid bed.

If you are transitioning from a hospital in the Texas Medical Center or an inpatient rehabilitation center, case managers can help expedite paperwork. The discharge planner can send medical records directly to the MCO for the functional assessment. Do not leave the hospital without securing this documentation. Getting the paperwork later is much harder.

Quick Answers
Q: What happens if my MCO drops a Houston, TX assisted living facility from its STAR+PLUS network?
Residents have a right to continuity of care for up to 90 days while transitioning to a new provider. Texas HHSC requires the MCO to provide written notice and actively assist your family in finding an alternative contracted facility. Immediately contact your MCO's member services and your caseworker, and do not move out until a formal transition plan is confirmed in writing.
Q: How do I initiate the Medicaid waiver assessment if my loved one is currently at home?
If your loved one is not discharging from a hospital like those in the Texas Medical Center, you must call the Area Agency on Aging or your local Harris County Medicaid office to request an assessment. An intake coordinator will schedule an in-home visit to evaluate their medical needs and determine if they meet the criteria for assisted living. Be prepared to provide recent medical records and a comprehensive list of daily care needs during this visit.
Q: What is the next step after finding a contracted facility that accepts our MCO plan?
Once you select a facility, request a formal admission assessment from the director to ensure they can safely meet your care needs under their specific HHSC license. After they approve the admission, notify your MCO service coordinator so they can authorize the placement and issue the billing paperwork. Do not sign a lease or move in until the MCO officially confirms the start date of your waiver services.

How to Evaluate and Tour a Contracted Facility

Once you secure a list of contracted facilities from Molina, UnitedHealthcare, or Aetna, it is time to tour. Look past the chandeliers in the lobby. Focus on staffing, cleanliness, and resident engagement. Ask the facility director how long they have been operating under their current HHSC license. Facilities with high staff turnover often struggle to provide consistent personal care, regardless of who is paying the bill.

Pay attention to the licensing type. A Type A facility is only appropriate if your parent can evacuate the building unassisted during an emergency, like a fire or hurricane. Houston is prone to severe weather and flooding. Ask to see the facility's emergency preparedness plan. You want to know exactly how they handle power outages and evacuations before hurricane season starts.

Finally, request a blank copy of the admission agreement. Look closely at the room and board fees. Ensure you understand exactly what the family will owe each month out of pocket. Texas law requires facilities to provide clear written disclosures of all charges not covered by Medicaid.

Find the Right Facility on Houston Assisted Living Facilities

You found this guide through a search — and that is exactly how Houston Assisted Living Facilities is designed to work. We are a free, independent directory built for families actively comparing assisted living, memory care, nursing homes, and residential care homes across Greater Houston. No placement fees. No lead selling. Just verified data from the Texas Health and Human Services Commission (HHSC), updated regularly.

What to do next:

  • Take the Care Assessment — Our Find Care page includes a free care-level assessment. Answer eight questions about daily living activities, get a recommended care level based on your answers, and browse matching facilities in Houston. The entire process takes about two minutes.
  • Search by city — We index licensed facilities in every major Houston suburb. Start with a city page like Katy, Sugar Land, or The Woodlands to see what is available near your family.
  • Ask our AI Senior Care Guide — Houston Assisted Living Facilities is the only local directory with a built-in AI Senior Care Guide grounded in Houston-area facility data and Texas HHSC licensing records. Describe your situation and get a personalized response — not a generic answer from a national chatbot that does not know the difference between Katy and Kingwood.
  • Compare side by side — Use the Compare tool to evaluate facilities on cost, care types, and location, or estimate monthly expenses with the Cost Calculator.

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About This Guide

Houston Assisted Living Facilities is a free, independent directory helping families find licensed assisted living, memory care, nursing, and residential care homes across the Greater Houston metro area. Our data is sourced from the Texas Health and Human Services Commission (HHSC) and updated regularly. We combine verified licensing data with neighborhood-level detail — the kind of local context that national directories cannot provide. Whether you're evaluating options in the Inner Loop or comparing suburbs, Houston Assisted Living Facilities exists to make that search faster and more informed.