Last verified: March 2026. These figures may change. Check the Texas Health and Human Services Commission (2-1-1) for the most current details.

Key Takeaways

  • Home care in Texas costs approximately $5,720/month for a home health aide at 44 hours/week, while assisted living averages $5,250/month including room and board
  • Home care is cheaper when your loved one needs fewer than 40 hours of help per week. Past that point, assisted living costs less.
  • Community Attendant Services (CAS) is the only Texas Medicaid program with no waitlist, providing up to 50 hours/week of personal care at home
  • Medicaid covers assisted living through the STAR+PLUS HCBS waiver, but room and board aren't included and the waitlist can stretch years
  • Texas ranks among the 10 cheapest states for home care and 16th cheapest for assisted living

In This Guide

Choosing between home care vs assisted living in Texas starts with two questions: how much help your loved one needs and what you can afford. The answer is different for every family. You can chat with Brevy to check eligibility in a few minutes.

This guide breaks down the real costs, services, and funding options for both choices in 2026. We'll cover what each option includes, how Medicaid pays for each one, and how to figure out which fits your situation. The in-home care costs in Texas for 2026 and Texas assisted living cost figures below are based on the latest available data.

Important: The figures in this guide are based on 2024 data from the Genworth/CareScout Cost of Care Survey and current Medicaid rules from Texas HHS. Eligibility rules change frequently. Contact Texas Health and Human Services at 2-1-1 or a Medicaid planning attorney to verify current requirements.

What Each Option Costs in Texas

Texas is one of the cheaper states for long-term care. Here's what you're looking at, according to the 2024 Genworth/CareScout Cost of Care Survey:

Home care:

  • Home health aide: approximately $68,640/year ($5,720/month) based on 44 hours/week
  • Homemaker services: approximately $64,064/year ($5,339/month) based on 44 hours/week
  • Both are 12-15% below the national average
  • Texas ranks 44th out of 51 states (8th cheapest) for home care costs

Home care is priced by the hour. That means your actual monthly bill depends entirely on how many hours you use. At 20 hours/week, you'd pay around $2,600/month. At 44 hours/week, it's $5,720. That flexibility is home care's biggest financial advantage.

Assisted living:

  • Median: approximately $63,000/year ($5,250/month)
  • Range: from about $1,500/month in Amarillo to $7,604/month near Corpus Christi
  • About 11% below the national average of $5,900/month

Assisted living is a flat monthly fee. Housing, meals, supervision, and personal care are bundled into one price. That predictability helps with budgeting, but you pay the full rate whether your loved one needs 10 hours of hands-on help or 60.

Adult day care (a third option worth knowing):

  • Approximately $26,000/year ($2,167/month) for five days a week
  • The most affordable daily care option in Texas, costing roughly 59% less than assisted living

The Cost Crossover Point

The real question: when does assisted living become cheaper than home care?

The crossover happens around 40 hours per week. Below that, home care saves money. Above it, assisted living's flat rate wins because housing, meals, and round-the-clock staff are all bundled in.

For 24/7 care at home, you'd pay approximately $21,840/month. Assisted living is still $5,250.

Not sure which option fits your budget? Chat with Brevy to compare your costs -- it takes a few minutes.

What You'll Pay by City

Home care and assisted living costs vary widely across Texas.

Home health aide hourly rates by city:

  • Austin: approximately $27.25/hour
  • Dallas-Fort Worth: approximately $25.50/hour
  • Houston: approximately $24/hour
  • San Antonio: approximately $24/hour
  • Laredo: approximately $16/hour
  • Brownsville and McAllen: approximately $15/hour

Urban North and Central Texas markets run 60-80% higher than rural South Texas. Where your loved one lives matters as much as what type of care they need.

Assisted living monthly costs by city:

  • Austin: $6,035-$6,650
  • Houston: $5,600-$5,994
  • San Antonio: $5,180-$5,279
  • Dallas: $5,150-$5,241
  • El Paso: approximately $4,584
  • Amarillo: approximately $1,500 (lowest in the state)

About 58% of Texas assisted living communities charge a one-time, non-refundable entrance fee on top of monthly costs. Private rooms typically cost $800-$1,500/month more than shared accommodations.

What Services You Get

Home Care

Home care in Texas is delivered by licensed Home and Community Support Services Agencies (HCSSAs). It falls into two categories.

Non-medical personal care includes help with bathing, dressing, grooming, toileting, meal prep, light housekeeping, laundry, errands, companionship, medication reminders, and transportation.

Skilled home health care includes part-time nursing (wound care, IV therapy, medication management), physical therapy, occupational therapy, speech therapy, and medical social services. A physician must order skilled services.

Home care's biggest advantage: one-on-one, dedicated attention on your schedule. Your loved one stays in their own home, keeps their routines, and gets care tailored to their needs. Care can range from a few hours per week to 24/7 live-in support.

Assisted Living

Texas assisted living facilities (ALFs) serve four or more unrelated residents in a homelike setting. The monthly rate typically covers:

  • Three meals daily plus snacks
  • 24-hour staff supervision
  • Help with bathing, dressing, grooming, toileting, and mobility
  • Medication administration or supervision
  • Housekeeping and laundry
  • Social and recreational activities
  • Emergency response systems
  • Transportation to medical appointments

Many facilities also offer specialized memory care units for residents with Alzheimer's or dementia.

Assisted living's biggest advantage: built-in community. Your loved one gets daily social interaction, structured activities, and round-the-clock supervision without the isolation that can come with staying home alone.

Texas licenses ALFs under two active types. Type A serves residents who can follow emergency directions and don't need nighttime attendance. Type B serves residents who need help evacuating, can't follow emergency directions, or need overnight staff awake at all times. If your loved one has dementia or wanders at night, look for a Type B facility. Ask any community you're considering which type they hold.

Want to see what services your family qualifies for? Start a free eligibility check with Brevy -- no paperwork needed.

How Medicaid Covers Each Option

Medicaid is the largest payer for long-term care in Texas. The program for seniors and adults with disabilities is called STAR+PLUS.

Home Care Through Medicaid

Texas Medicaid covers home care through two programs:

Community Attendant Services (CAS) is the one to know. It's the only Texas Medicaid long-term care program with no waitlist. CAS provides up to 50 hours/week of personal attendant services, though most participants get 15-20 hours.

You can hire family members (adult children, grandchildren) as paid caregivers through consumer-directed care. Spouses can't be hired.

STAR+PLUS HCBS waiver covers more: in-home nursing, respite care, home modifications (grab bars, ramps), home-delivered meals, emergency response systems, and therapy. But the waitlist stretches years.

Both programs require income at or below $2,982/month and assets at or below $2,000.

Assisted Living Through Medicaid

The STAR+PLUS HCBS waiver also covers assisted living as an alternative to a nursing home. Medicaid pays for personal care services in a licensed facility serving 4-16 residents.

But Medicaid doesn't cover room and board in assisted living. You pay that from your own income. The personal needs allowance for assisted living residents is $85/month.

Same eligibility applies: income at or below $2,982/month, assets at or below $2,000, and nursing facility level of care. Same long waitlist. People transitioning from nursing homes get priority through Money Follows the Person.

How to Apply for Medicaid

Apply online at YourTexasBenefits.com, by phone at 2-1-1, or in person at your local HHSC office. For the STAR+PLUS HCBS waiver specifically, call 1-877-438-5658. Have bank statements and proof of income ready before you start. The income verification step is where most applications stall.

What About Medicare?

Medicare doesn't cover long-term home care or assisted living. It covers short-term skilled nursing and therapy for homebound patients at $0 cost, limited to 28 hours/week. A physician must order the care, and a Medicare-certified agency must deliver it.

Medicare doesn't cover 24-hour care, homemaker services, custodial personal care, or meal delivery. This catches many families off guard.

Have questions about Medicaid eligibility? Ask Brevy -- it's free and takes a few minutes.

How to Decide: Home Care vs Assisted Living in Texas

When Home Care Fits Better

Home care makes sense when your loved one:

  • Needs fewer than 30-40 hours/week of help
  • Is cognitively intact and safe to be alone between visits
  • Has a home that can be modified for safety (grab bars, ramps, stair lifts)
  • Has family nearby to fill in gaps
  • Strongly wants to stay in their own home
  • Qualifies for Medicaid CAS (immediate benefits, no waitlist)

When Assisted Living Fits Better

Assisted living makes sense when your loved one:

  • Needs 24-hour supervision, especially with dementia
  • Has frequent falls, wandering, or medication errors at home
  • Is socially isolated and it's affecting their health
  • Has no family caregivers available locally
  • Needs more than 40 hours/week of care (assisted living becomes the cheaper option)
  • Can no longer manage home upkeep

The Hybrid Approach

You don't have to pick one or the other. Many families combine adult day care ($2,167/month) with part-time home care for evenings and weekends. Total cost runs roughly $3,500-$4,500/month, still below assisted living's $5,250.

Others start with home care and move to assisted living as needs grow. Calling your local Area Agency on Aging (1-800-252-9240) before making a decision is usually the smartest first move. They offer free benefits counseling and can walk you through options specific to your situation.

Ready to explore your options? Talk to Brevy about your eligibility -- they'll help you figure out what you qualify for.

FAQ

Is home care or assisted living cheaper in Texas?

It depends on how many hours of care are needed. At fewer than 40 hours per week, home care is cheaper. At 44 hours per week, a home health aide costs approximately $5,720/month while assisted living averages $5,250/month. For round-the-clock care, assisted living is far less expensive because the flat monthly rate includes housing, meals, and supervision.

Does Texas Medicaid cover assisted living?

Yes, through the STAR+PLUS HCBS waiver. Medicaid pays for personal care services but doesn't cover room and board. You'll need income at or below $2,982/month and assets at or below $2,000. The waitlist can stretch years.

Can I get Medicaid home care in Texas without a waitlist?

Yes. Community Attendant Services (CAS) is the only Texas Medicaid long-term care program with no waitlist. It provides up to 50 hours/week of personal care and lets you hire family members as paid caregivers. You'll need income at or below $2,982/month and assets at or below $2,000.

Does Medicare pay for home care or assisted living?

Medicare doesn't cover long-term home care or assisted living. It only covers short-term skilled nursing and therapy for homebound patients, limited to 28 hours/week. For ongoing care, you'll need Medicaid, private insurance, or out-of-pocket funds.

Sources

  1. Genworth/CareScout, "2024 Cost of Care Survey: Texas Results," investor.genworth.com
  2. CareScout, "2024 Cost of Care Survey: Median Cost Data Tables," assets.carescout.com
  3. Texas Health and Human Services Commission, "STAR+PLUS Program," hhs.texas.gov
  4. Texas HHS, "Assisted Living Facilities," hhs.texas.gov
  5. Texas HHS, "Home and Community Support Services Agencies," hhs.texas.gov
  6. Texas HHS, "Long-Term Care Services," hhs.texas.gov
  7. Medicare.gov, "Home Health Services," medicare.gov
  8. Caring.com, "Home Health Care Costs in Texas by City," caring.com

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Medicaid rules vary by state and change frequently. Always verify eligibility and benefits with your state Medicaid agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

<p class="disclaimer">The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Medicaid rules vary by state and change frequently. Always verify eligibility and benefits with your state Medicaid agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.</p>