Medicaid covers personal care services inside Houston assisted living facilities. It does not pay your monthly rent. That single fact changes every financial plan a Houston family makes. Most families learn this painful reality only after they have already signed a lease. The gap between what the STAR+PLUS program pays and what an assisted living facility actually charges can run $3,000 or more per month in Harris County. We break down what Texas Medicaid covers, who qualifies, and exactly how to apply in the Houston metro area.

Key Takeaways

  • STAR+PLUS covers personal care services, not room and board. Families must pay monthly rent separately. You will typically use Social Security income, savings, or family contributions to cover this base cost.
  • Strict financial limits apply. The income limit is 300% of the SSI federal benefit rate. The asset limit is $2,000 for an individual. These thresholds apply uniformly across Harris, Fort Bend, and Montgomery counties.
  • Not every Houston ALF accepts STAR+PLUS. Suburbs like The Woodlands and Sugar Land have far fewer participating facilities than inner Houston. Your managed care organization (MCO) choice also directly affects which ones are in-network.
  • Call 2-1-1 Texas first. It is the local entry point for STAR+PLUS screening in the Houston metro. You can reach them by phone or online 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: Does Medicaid pay for room and board at assisted living facilities?
No, the Texas STAR+PLUS Medicaid program covers personal care services, but it strictly does not pay for base rent or room and board. Most residents must cover these housing costs separately using Social Security income, personal savings, or family contributions. Families should calculate their available monthly budget for room and board before touring communities.
Q: What is the STAR+PLUS Medicaid program in Houston, TX?
STAR+PLUS is a Texas Medicaid managed care program that provides long-term services and support for seniors and adults with disabilities. For eligible Houston residents, it covers the cost of medical care and daily assistance within licensed facilities, though it does not cover the physical apartment rent. You can initiate the screening process for this program through the local Houston Area Agency on Aging.
Q: What exactly are personal care services in a senior living community?
Personal care services refer to the daily, non-medical assistance provided to seniors, such as help with bathing, dressing, grooming, and medication management. In Texas, Medicaid waivers often cover these specific services to help seniors maintain their independence without needing a full-scale nursing facility. When evaluating communities, ask the facility director for an itemized list of care services to understand exactly what your Medicaid plan will cover.

What Medicaid Actually Pays For in Houston Assisted Living

Texas Medicaid absolutely does not pay for room and board at assisted living facilities. The Texas HHSC STAR+PLUS program is a Medicaid managed care program for seniors and adults with disabilities. It covers personal care services, medication management, nursing oversight, and some therapies. These services are delivered inside an assisted living setting. The monthly base rent runs $3,500 to $5,500 for assisted living in Houston depending on the care level and county. That base rent is the resident's responsibility entirely.

Most families assume Medicaid works exactly like Medicare and covers everything after approval. It doesn't. STAR+PLUS is a services-only benefit. It gets layered on top of a facility placement that the family must independently afford. This catches many people off guard. If your parent needs help with bathing and dressing, Medicaid pays the caregivers for that time. Medicaid will not pay for the roof over their head.

Covered Under STAR+PLUS Not Covered Under STAR+PLUS
Personal attendant services (bathing, dressing, grooming) Monthly room and board / base rent
Medication management and administration oversight Meals included in base ALF rate
Licensed nursing oversight visits Housekeeping included in ALF rate
Physical, occupational, and speech therapy (when authorized) Transportation for personal errands
Some medical transportation to covered appointments Cable, phone, laundry fees (extra charges)

Families must plan for these out-of-pocket costs early. A resident in Katy might pay $4,000 for their apartment rent. If they need a high level of care, the facility might normally charge an extra $1,500 for that care. STAR+PLUS can cover that $1,500 care portion. The family still needs to write a $4,000 check every single month.

Quick Answers
Q: How long does it take to get approved for STAR+PLUS assisted living benefits in Houston, TX?
The approval process for STAR+PLUS in Harris County typically takes 45 to 90 days, though waitlists for the specific assisted living waiver can extend this timeline. Families should gather financial documents and medical records early to prevent application delays. If immediate placement is needed, be prepared to pay privately while waiting for Medicaid processing.
Q: Does STAR+PLUS cover the full monthly cost of an assisted living facility?
No, STAR+PLUS only covers the cost of personal care services and medical needs, not the room and board. Seniors in the Houston area must still pay for their monthly apartment rent, utilities, and food out of their own pocket. You can use Social Security, pensions, or personal savings to cover these remaining living expenses.
Q: When should families start planning for the out-of-pocket expenses of senior care?
Families should begin financial planning at least six to twelve months before a senior needs to transition into a facility. Because Texas Medicaid waivers do not cover room and board, you must evaluate personal savings, veteran benefits, and Social Security income early. Touring facilities in Harris County ahead of time will give you a realistic baseline for local rent prices.

STAR+PLUS Eligibility Requirements for Houston-Area Seniors

To qualify for STAR+PLUS in Texas, a senior must meet income and asset thresholds set by the state. They must also pass a functional assessment that confirms a strict medical need for care. The income limit is generally 300% of the federal SSI benefit rate. That is approximately $2,742 per month as of current Medicaid eligibility guidelines. The asset limit is $2,000 for an individual. Certain assets are exempt. A primary home is exempt if a spouse still lives there. One vehicle and basic personal belongings are also safe. Texas residency and U.S. citizenship or qualifying immigration status are strictly required.

Most families assume the functional assessment is just basic paperwork. In reality, it is a strict medical audit that many seniors fail on their first try because they hide their true needs from the state evaluator. The assessor will ask your parent to demonstrate daily tasks. If your parent pretends they can walk without help out of pride, they will be denied coverage.

Harris County, Fort Bend County, and Montgomery County all fall under the exact same HHSC income thresholds. However, the cost of care varies wildly by county. Medicaid's dollar-for-services simply does not stretch equally everywhere. A senior in The Woodlands may face much higher facility costs than one in the Inner Loop. They still receive the same STAR+PLUS service authorization. The table below reflects current Genworth Cost of Care Survey ranges for the Houston metro.

County Average ALF Monthly Cost STAR+PLUS Covers Estimated Out-of-Pocket Gap
Harris County $3,500–$4,500/mo Personal care services only $3,500–$4,500/mo (room & board)
Fort Bend County $3,800–$4,800/mo Personal care services only $3,800–$4,800/mo (room & board)
Montgomery County $4,200–$5,500/mo Personal care services only $4,200–$5,500/mo (room & board)

Texas HHSC licenses all Houston-area assisted living facilities under Type A or Type B standards. Keep in mind that HHSC licensing does not mean the facility automatically accepts STAR+PLUS. Families searching The Woodlands senior care options or Sugar Land assisted living facilities will find fewer participating locations than families looking in inner Houston. Always confirm directly with the facility administration whether they accept your specific MCO before committing to a placement.

"In Harris County, we consistently see families surprised by two things: that STAR+PLUS won't pay rent, and that their preferred suburb has almost no facilities that accept the program. Knowing both facts in week one is the difference between a workable plan and a crisis placement."

HALF Publishing Team

Quick Answers
Q: How much does assisted living cost in Houston, TX without Medicaid assistance?
According to current Genworth data, Houston-area assisted living facilities typically range from $3,500 to $5,500 per month out-of-pocket, depending on the level of care. Facilities in Harris County generally offer more affordable rates compared to comparable care in neighboring Montgomery County. We recommend using our Cost Calculator to compare specific communities and plan your budget before applying for state programs.
Q: Should we choose an assisted living facility in the city or a surrounding suburb if we plan to transition to Medicaid later?
If you anticipate needing STAR+PLUS Medicaid in the future, prioritize facilities within Harris County over outer suburbs, as they have a much higher concentration of Medicaid-accepting communities. Many families who start in private-pay facilities in areas like The Woodlands or Sugar Land are forced to relocate their loved ones when funds run out. Always ask a facility's administration about their Medicaid transition policies before signing a private-pay contract.
Q: How do families decide between assisted living and a nursing home in the Houston area?
The decision usually comes down to medical needs and Medicaid eligibility rules in Texas. Assisted living is ideal for seniors needing help with daily tasks like bathing and medication management, but STAR+PLUS Medicaid will not cover their room and board. If your loved one requires 24/7 skilled nursing care, a nursing home is necessary, and traditional Medicaid will cover both care and housing costs for eligible individuals.

Specific Eligibility Hurdles and the Five-Year Lookback

Qualifying for Medicaid involves intense financial scrutiny. The state of Texas uses a strict five-year lookback period to review all financial transactions. They do this to ensure seniors do not simply give away their money to qualify for government help. If your parent gifted money to a grandchild or sold a house below market value in the last five years, Medicaid will impose a penalty period. This penalty delays when coverage actually begins.

Families often try to hide assets. This never works. The state audits bank records closely. If you discover a financial issue during the lookback period, consult an elder law attorney immediately. They can help structure a legal spend-down plan. A spend-down allows you to pay off valid medical debts, purchase medical equipment, or prepay funeral expenses using excess assets. This legally lowers the asset pool to meet the $2,000 limit.

How to Apply for STAR+PLUS in Houston

The STAR+PLUS application process in Houston starts with a single phone call. The steps after that call determine how fast a senior actually gets services. Delays at any stage will cost your family thousands of dollars out of pocket. Follow this exact sequence.

  1. Call 2-1-1 Texas or visit hhs.texas.gov. This is the local entry point for STAR+PLUS screening in the Houston metro. The 2-1-1 line is available by phone and online. They will route you to the right HHSC office for a formal application.
  2. Complete the functional assessment. An HHSC assessor visits the senior to evaluate activities of daily living (ADLs). This assessment determines which services are authorized and at what level. The outcome directly affects how much STAR+PLUS pays per month.
  3. Choose a managed care organization (MCO). In Harris County, the STAR+PLUS MCOs currently include Molina Healthcare, Aetna Better Health, UnitedHealthcare Community Plan, and Humana. The MCO you choose determines which Houston-area assisted living facilities are in-network. Switching MCOs later is possible but adds massive delays.
  4. Find a STAR+PLUS-accepting facility. Use the HHSC provider directory or our local directory to identify facilities that accept your MCO. Confirm acceptance in writing before any financial commitments.

What to do next:

  • Call 2-1-1 Texas to start your STAR+PLUS eligibility screening today. It is free and takes about 20 minutes.
  • Ask any facility you are considering whether they accept your specific MCO (Molina, Aetna, UnitedHealthcare, or Humana).
  • Use our Cost Calculator to estimate the monthly gap between STAR+PLUS-covered services and total ALF costs in your specific county.
  • Take the Find Care assessment to match your parent's care level to facilities that accept STAR+PLUS in the Greater Houston area.

If STAR+PLUS covers services but the family still cannot bridge the room-and-board gap, options narrow quickly. Texas HHSC does operate a Medicaid waiver program for nursing-level care. Waitlists are incredibly long. Placement is never guaranteed in assisted living under a waiver. Veterans may have separate VA benefits that can stack with STAR+PLUS. Check VA.gov for Aid and Attendance eligibility. This can add $700 to $2,200 per month depending on the veteran's situation.

Quick Answers
Q: Can a senior be denied Medicaid in Texas for having too many assets?
Yes, the Texas STAR+PLUS program has a strict asset limit of $2,000 for an individual as of 2026. However, certain assets like one vehicle, personal belongings, and a primary home (if a spouse still lives there) are usually exempt. Families should consult a local Houston elder law attorney to discuss legal spend-down strategies before submitting an application.
Q: How do I apply for VA Aid and Attendance benefits for a senior in Houston, TX?
You can apply for VA Aid and Attendance by completing VA Form 21-2680 and mailing it to the Houston VA Regional Benefit Office. The application requires detailed medical evidence from a doctor confirming the veteran or spouse needs assistance with daily living activities. Because approval can take several months, families should start the paperwork well before moving into a facility.
Q: What is the first step to finding an assisted living facility that accepts Medicaid waivers?
Your immediate first step is to contact the Texas Health and Human Services Commission (HHSC) to get added to the STAR+PLUS waiver interest list, as wait times are incredibly long. While waiting for approval, you can use our free directory to research and filter communities across Greater Houston that are certified for Medicaid. Always contact the facility director directly to ask about their current Medicaid bed availability and internal waitlists.

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.