Finding a Houston senior home that actually accepts your parent's Medicaid plan takes more than a basic web search. Most families discover too late that a licensed facility and a Medicaid-contracted facility are two entirely different things. The three STAR+PLUS managed care organizations (MCOs) serving Greater Houston each contract with a different subset of providers. A facility may accept one MCO but turn away another. In this guide, our team breaks down exactly how to verify Medicaid participation, what the income limits look like in 2026, and how long you should realistically budget for a Harris County application to clear.

Key Takeaways

  • Licensure is not Medicaid participation. An HHSC-licensed Type A or Type B facility must separately contract with a STAR+PLUS MCO to accept Medicaid residents. Many Houston facilities are licensed but hold no MCO contract.
  • Most Houston residential care homes are not STAR+PLUS providers. If you are comparing small 6- to 16-bed homes in Sugar Land or The Woodlands, expect most to be private-pay only. Their HHSC license status does not change this fact.
  • The realistic timeline is 3 to 6 months. From application submission to confirmed placement in a STAR+PLUS-contracted facility, Harris County families should plan for a private-pay bridge period. This gap can cost $3,800 to $10,500 per month depending on care type.
  • County matters for application routing. Fort Bend and Montgomery county residents do NOT submit through the Harris County HHSC regional office. This detail delays applications when families get it wrong.

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: Does a Texas HHSC license mean an assisted living facility in Houston, TX accepts Medicaid?
No, state licensure and Medicaid participation are two completely different credentials. A Type A or Type B assisted living facility must hold a separate contract with a STAR+PLUS Managed Care Organization (MCO) to accept Medicaid. Always ask the community director directly which specific MCOs they are currently contracted with before signing a lease.
Q: What is the STAR+PLUS program for senior care?
STAR+PLUS is the specific Texas Medicaid managed care program that covers the cost of assisted living and long-term care for eligible adults. Instead of traditional Medicaid, the state uses regional Managed Care Organizations (MCOs) to administer these benefits in the Harris County area. Families must apply through this specific program to receive financial assistance for residential senior care.
Q: What is the difference between a Type A and Type B assisted living facility?
In Texas, a Type A facility is for residents who do not require routine attendance during sleeping hours and can evacuate the building unassisted during an emergency. A Type B facility is licensed to care for seniors who need nighttime assistance or help evacuating, which is required for memory care residents. When touring communities across the Greater Houston area, verify their license type to ensure they can legally support your loved one's mobility needs.

What "Medicaid-Approved" Actually Means for Houston Senior Homes

A Texas HHSC license and a STAR+PLUS Medicaid contract are two separate credentials. Confusing them is the most expensive mistake Houston families make. HHSC licensure governs whether a facility can legally operate and care for residents. STAR+PLUS participation governs whether Medicaid will pay the bill. A facility needs both to serve a Medicaid-funded resident. The three MCOs administering STAR+PLUS in the Houston metro include UnitedHealthcare Community Plan, Molina Healthcare of Texas, and Aetna Better Health of Texas. Each negotiates contracts independently. A facility may be contracted with one or two MCOs but not all three.

The table below shows how facility type maps to Medicaid eligibility. Pay close attention to the last row. Most small Houston residential care homes (Type E, 4 to 16 beds) do not hold STAR+PLUS contracts even when fully licensed. Families in Sugar Land and The Woodlands often discover this only after touring and falling in love with a home.

Facility Type HHSC License Required? Accepts Nursing-Facility Medicaid? Can Hold STAR+PLUS Contract?
Type A Assisted Living Yes No Yes (if contracted with MCO)
Type B Assisted Living Yes No Yes (if contracted with MCO)
Type E Residential Care Home (4–16 beds) Yes No Rarely. Most are private-pay only.
Certified Nursing Facility Yes Yes Yes (federally certified)

How to Verify a Houston Facility's Medicaid Status in 3 Steps

The TULIP portal at tulip.hhs.texas.gov shows a facility's license type and inspection history. It does not confirm active MCO contracts. That gap trips up families every day. Use the three steps below to get a complete picture before you tour. The star rating system has real limits. A 5-star facility can still be a bad fit if they don't accept your parent's specific MCO plan. For Houston nursing homes that accept Medicaid, cross-reference TULIP results with CMS Care Compare, which adds federal inspection records and staffing data.

  1. Go to TULIP and search. Visit tulip.hhs.texas.gov and search by facility name or street address. The results page will show the license type, current license status, and any open complaints.
  2. Read the license type carefully. A Type E residential care home license does not carry automatic Medicaid eligibility. Note any deficiencies. A pattern of citations around medication management or staffing is a red flag regardless of Medicaid status.
  3. Call the facility and ask directly. Ask which STAR+PLUS MCOs they currently contract with. Name them specifically: UnitedHealthcare Community Plan, Molina Healthcare of Texas, or Aetna Better Health of Texas. Cross-check that answer against your parent's MCO enrollment.
Quick Answers
Q: What is the income limit to qualify for Medicaid long-term care in Houston, TX?
The current Texas Medicaid income cap for long-term care is $2,829 per month, and the individual asset limit is $2,000. If an applicant's income exceeds this threshold, they can still qualify by establishing a Miller Trust, also known as a Qualified Income Trust. Local elder law attorneys in the Houston area typically charge between $500 and $1,500 to properly set up this required trust.
Q: How long does the STAR+PLUS Medicaid approval process take?
The timeline for Medicaid and STAR+PLUS waiver approval in Texas typically ranges from 45 to 90 days after submitting the application. However, gathering the required financial records and scheduling the medical necessity assessment often adds several weeks to this timeline. Families should begin the paperwork at least three months before they anticipate needing an assisted living placement.
Q: Will facilities let my parent move in while their Medicaid application is pending?
Most communities require families to cover the full private-pay rate out-of-pocket while waiting for the state to process their paperwork. Very few licensed facilities in the region accept a "Medicaid pending" status due to the unpredictable approval timeline. You should proactively budget for at least two to three months of private payments before the waiver benefits officially begin.

"In Harris County, we have seen families spend two months touring licensed facilities only to learn none of them hold an active STAR+PLUS contract. The TULIP portal is a starting point, not a finish line. The MCO contract question has to be asked out loud, directly to the facility."

HALF Publishing Team

Texas Medicaid Income and Asset Limits for Houston-Area Applicants

Texas nursing-facility Medicaid has a hard income cap of $2,829 per month. Applicants above that threshold must establish a Miller Trust before the application can be approved. The asset limit is $2,000 for an individual and $3,000 for a couple. Exempt assets include the primary home (if a spouse still resides there), one vehicle, and a prepaid funeral contract. Houston elder law attorneys typically charge $500 to $1,500 to draft and fund a Miller Trust. The account must be open before HHSC processes eligibility.

Harris County families with excess countable assets must spend down to $2,000 before the application is approved. Common strategies include paying off debt, making home modifications, or purchasing a prepaid burial contract. Consult an elder law attorney before moving any assets. Once placed in a STAR+PLUS facility, the resident contributes nearly all income toward the cost of care, minus a $60/month personal needs allowance. The table below covers the key thresholds.

Threshold Amount Notes
Income Cap $2,829/month 300% of SSI federal benefit rate. Miller Trust required if exceeded.
Asset Limit (Individual) $2,000 Countable assets only. Home and vehicle typically exempt.
Asset Limit (Couple) $3,000 Community spouse may retain additional resources under CSRA rules.
Personal Needs Allowance $60/month Resident keeps this amount. Remainder goes to facility as patient pay.
Miller Trust Trigger Income above $2,829/month Trust must be established before HHSC processes eligibility.

The Houston STAR+PLUS Application Timeline

The realistic window from Medicaid application to confirmed placement in a Houston STAR+PLUS facility is 3 to 6 months. It is not the 45 days some families expect. HHSC has 45 days to process an elderly/disabled Medicaid application. However, scheduling a functional needs assessment in Harris County typically adds 2 to 6 weeks on top of that. MCO enrollment and finding a bed at a contracted facility adds another 30 to 90 days. Private-pay bridge costs during this window are significant. Houston assisted living facilities average $3,800 to $5,500 per month. Memory care runs $5,500 to $9,200 per month. Nursing home private-pay averages $7,500 to $10,500 per month.

One detail derails applications regularly. Fort Bend and Montgomery county residents must file through their respective HHSC regional offices, not the Harris County office. Families looking at Sugar Land options and those exploring The Woodlands should confirm the correct regional office before submitting anything. You can visit the Texas STAR+PLUS waiver program overview on the HHSC website for full program details.

What to do now:

  1. Submit your Medicaid application online at YourTexasBenefits.com or call 2-1-1 Texas to apply by phone.
  2. Request the functional needs assessment as soon as eligibility is confirmed. This step has its own wait time and cannot start until the financial eligibility decision is made.
  3. Before every facility tour, ask which STAR+PLUS MCOs the facility is contracted with. Verify that answer matches your parent's plan enrollment.
Quick Answers
Q: How long does it take to get into a Medicaid assisted living facility in Houston, TX?
Realistically, expect a 3 to 6-month process from your initial application to confirmed placement. The state has 45 days to process financial eligibility, while scheduling the functional assessment in Harris County often adds another 2 to 6 weeks. Families should plan for private-pay bridge costs or alternative care during this waiting period before MCO enrollment and facility placement finalize.
Q: Should I choose a STAR+PLUS contracted facility in Harris County or a neighboring county?
Your decision should balance facility availability with your family's visitation convenience. Harris County offers the highest concentration of contracted Type A and Type B facilities, giving you more options near major medical hubs. However, expanding your search into Fort Bend or Montgomery counties might yield shorter waitlists for specific facility styles, so it pays to tour options across county lines.
Q: How do I decide which STAR+PLUS health plan is best for my parent's care?
Start by making a list of your preferred assisted living communities and asking which specific Managed Care Organizations (MCOs) they accept. Since not all facilities contract with every MCO operating in the Gulf Coast region, matching the health plan to your top-choice community is crucial. You should also verify that your parent's current primary care doctors and specialists are in-network with that specific plan.

Harris, Fort Bend, Montgomery, and Galveston Counties Compared

Medicaid eligibility rules are uniform across Texas. However, application routing, oversight contacts, and facility density vary enough by county to meaningfully change your experience. Harris County has the highest concentration of STAR+PLUS-contracted Type A and Type B facilities in the metro. You will find strong clusters near the Texas Medical Center corridor, Bellaire, and Friendswood. Fort Bend County has a growing but smaller set of contracted providers. Montgomery County has fewer options due to its suburban-to-rural geography. Galveston County sees limited STAR+PLUS-contracted inventory with reported longer placement wait times.

Houston-area families in coastal Galveston County or low-lying Harris County flood zones should ask any prospective Medicaid facility for its HHSC-required emergency evacuation plan before signing anything. A facility's plan quality is a direct signal of its operational competence. It is not just a compliance checkbox. Take the county breakdown below as a starting point. STAR+PLUS contracts change. Calling the facility directly remains the only reliable verification.

County HHSC Region STAR+PLUS MCOs Serving Area Relative Facility Density
Harris Region 6 (Houston) UnitedHealthcare, Molina, Aetna Better Health Highest in metro
Fort Bend Region 6 (sub-office) UnitedHealthcare, Molina, Aetna Better Health Moderate and growing
Montgomery Separate regional assignment UnitedHealthcare, Molina, Aetna Better Health Limited. Fewer contracted ALFs.
Galveston Separate regional assignment UnitedHealthcare, Molina, Aetna Better Health Sparse. Longer wait times reported.
Quick Answers
Q: Do Medicaid rules for assisted living differ between Harris County and surrounding areas like Fort Bend?
Eligibility rules are the exact same statewide, but the application routing and processing steps differ based on your location. Fort Bend and Montgomery counties fall under different Texas Health and Human Services (HHSC) regional offices than Harris County, meaning a different local team will handle your functional assessment. Always submit your application to the specific HHSC office assigned to the county where the senior currently resides.
Q: How do I start searching for a Medicaid-accepting facility in Houston, TX?
Begin by contacting your assigned STAR+PLUS Managed Care Organization (MCO), such as UnitedHealthcare or Molina, to request a current list of their contracted assisted living facilities. You can then use our free directory to research those specific communities, compare amenities, and find contact information. Once you narrow down your options, call the facilities directly to schedule tours and ask about their current Medicaid bed availability.
Q: What is the next step if the assisted living communities I contact have a long waitlist?
If you encounter long wait times, which is especially common in areas like Galveston or Montgomery counties, consider expanding your search radius into Harris County where there is a higher density of contracted facilities. While you wait for a bed to open up, ask your STAR+PLUS service coordinator about home and community-based waiver services that can provide temporary in-home caregiver support.

Find the Right Facility on Houston Assisted Living Facilities

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What to do next:

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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.