Senior care in Texas runs anywhere from $1,950/month for part-time home care to $6,250/month for a private nursing home room. Most families can't cover that out of pocket forever. The good news: Texas has more funding options than most people realize, and this guide covers every one of them.
Here's what actually pays for senior care in Texas, who qualifies, and what each option covers.
In This Guide
- Key Takeaways
- What Senior Care Costs in Texas
- Texas Medicaid
- Medicare
- VA Benefits
- Long-Term Care Insurance
- How to Pay Without Medicaid
- Medicaid Planning
- Frequently Asked Questions
- Next Steps
Key Takeaways
- Medicaid is the biggest payer for long-term senior care in Texas. Nursing home Medicaid has no waitlist. Home-based waivers do.
- Medicare doesn't cover long-term care. It covers up to 100 days of skilled nursing and home health visits, not ongoing help with daily life.
- VA Aid and Attendance pays up to $2,424/month for eligible veterans (or $2,874 with a spouse).
- Home care costs $24-$31/hour in Texas. Nursing homes average $5,080/month (semi-private). Assisted living runs about $4,570/month.
- Medicaid planning with an elder law attorney can protect your family's assets legally while still qualifying for benefits.
What Senior Care Costs in Texas
Before figuring out how to pay, you need to know what you're paying for. Here's what the main types of senior care cost in Texas in 2026:
| Care Type | Average Monthly Cost | Details |
|---|---|---|
| Home care (non-medical) | $1,950 - $4,576 | $24-$31/hour, depends on hours needed |
| Home health (skilled/medical) | $0 with Medicare/Medicaid | Covered when medically necessary |
| Assisted living | ~$4,570 | Varies $3,599 (San Antonio) to $5,355 (Houston) |
| Nursing home (semi-private) | ~$5,080 | $167/day statewide average |
| Nursing home (private) | ~$6,250 | $206/day statewide average |
Texas is significantly cheaper than the national average for most care types. A semi-private nursing home room here costs about half what it does nationally ($5,080 vs. $9,950). That still adds up fast. At $5,080/month, a two-year nursing home stay runs over $120,000.
Texas Medicaid
Medicaid is the primary payer for long-term senior care in Texas. It covers home care, assisted living services, and nursing home care for those who qualify financially and medically.
Financial Eligibility
To qualify for Texas Medicaid long-term care in 2026:
- Income: Up to $2,982/month (single applicant)
- Assets: $2,000 or less in countable assets
- Spouse protections: The at-home spouse can keep up to $162,660 in assets (CSRA) and receive up to $4,066.50/month from the applicant's income (MMNA)
What Medicaid Covers
- Nursing home care: Fully covered with no waitlist. This is an entitlement.
- Home care through STAR+PLUS: Personal attendant services, including through Consumer Directed Services where a family member can be the paid caregiver
- Assisted living care services: The STAR+PLUS HCBS waiver covers care services in assisted living (but not room and board)
- Home health: Skilled nursing and therapy at home
The catch: HCBS waiver programs that cover home care and assisted living have long waitlists. Nursing home Medicaid doesn't. This creates a frustrating reality where getting into a nursing home is easier than getting services that keep your loved one at home.
For the full picture, read our guide to Texas Medicaid programs for seniors.
Not sure if your parent qualifies for Medicaid? Ask Brevy's chatbot about eligibility for a quick assessment.
Medicare
Here's where families get surprised. Medicare doesn't cover long-term care.
What Medicare does cover:
- Skilled nursing facility: Up to 100 days following a qualifying 3-day hospital stay. Days 1-20 are fully covered. Days 21-100 have a daily copay of $204.50 in 2026. After day 100, Medicare pays nothing.
- Home health care: $0 cost for skilled nursing and therapy if ordered by a doctor and the patient is homebound. Covers up to 28 hours/week.
What Medicare doesn't cover:
- Ongoing personal care (bathing, dressing, meals)
- Long-term nursing home stays
- Assisted living
- Non-medical home care (companionship, housekeeping)
For more details, see our Medicare plans and coverage guide.
VA Benefits
If your loved one is a veteran (or the surviving spouse of one), VA benefits can be a significant funding source.
Aid and Attendance
The VA's Aid and Attendance pension provides monthly payments to veterans who need help with daily activities:
- Veteran alone: Up to $2,424/month
- Veteran with spouse: Up to $2,874/month
- Surviving spouse: Up to $1,478/month
To qualify, the veteran must have served during wartime, be 65+ or disabled, need help with ADLs, and have a net worth below $163,699. There's a 3-year look-back on asset transfers.
This money can be used for any type of care: home care, assisted living, or nursing home.
Veteran-Directed Care
The VDC program gives veterans a flexible budget to hire their own caregivers, including family members. It works similarly to Medicaid's CDS option.
For the full details, see our VA Aid and Attendance guide.
Is your parent a veteran? Chat with Brevy to find out which VA benefits they might qualify for.
Long-Term Care Insurance
If your loved one bought a long-term care insurance policy years ago, now is when it pays off. These policies typically cover home care, assisted living, and nursing home care up to a daily or monthly benefit amount.
A few things to know about LTC insurance in Texas:
- Texas participates in the Long-Term Care Partnership Program. Partnership-qualified policies let you protect additional assets from Medicaid spend-down equal to the amount of benefits the policy paid out. For example, if your policy paid $200,000 in benefits, you can keep an extra $200,000 in assets when applying for Medicaid.
- Premiums have been rising sharply. Many policyholders have received notices of 40-80% rate increases. If this happens, your options are to pay the higher premium, reduce benefits, or let the policy lapse. Talk to the Texas Department of Insurance before making changes.
- New policies are expensive and harder to get. Buying LTC insurance after age 65 is costly, and health conditions may disqualify you. This is really a tool for people who planned ahead.
If your family member has an existing policy, dig it out now. Read the benefit triggers, daily maximums, and elimination period before you need it.
How to Pay for Senior Care Without Medicaid
When government programs and insurance don't cover everything, families turn to private funds.
Out-of-Pocket Savings
Most families start here. The average 3-year cost of long-term care in Texas is approximately $207,855. Retirement savings, Social Security income, and pensions are the most common private funding sources.
Reverse Mortgages
For homeowners 62 and older, a reverse mortgage converts home equity into cash without monthly mortgage payments. The 2026 lending limit is $1,249,125.
Important Medicaid considerations: reverse mortgage payments don't count as income for Medicaid, but any money not spent in the month received counts as an asset the following month. With a $2,000 asset limit for Medicaid, you'd need to spend the funds quickly. This works better for people who aren't on Medicaid and want to fund home care or assisted living while staying in their home.
Life Insurance Options
Some life insurance policies can be converted or used for care:
- Accelerated death benefits: Many policies allow early payout if the policyholder is terminally ill or needs long-term care
- Life settlements: Selling a life insurance policy to a third party for a lump sum (typically 20-30% of face value)
- Policy loans: Borrowing against the cash value of a whole life or universal life policy
Community and Nonprofit Resources
- Area Agencies on Aging (1-800-252-9240) connect families with local programs, some of which provide free or subsidized services
- 2-1-1 Texas provides 24/7 referrals to community assistance
- PACE programs in El Paso, Amarillo, and Lubbock wrap all services into one program for qualifying seniors
Overwhelmed by the options? Chat with Brevy to get a personalized breakdown of what your family qualifies for.
Medicaid Planning: Protecting Assets
Medicaid planning is the process of legally arranging finances to qualify for Medicaid while protecting as much of the family's assets as possible. It isn't hiding money. It's using the rules as they're written.
Exempt Assets in Texas
Not everything counts toward Medicaid's $2,000 asset limit. These are protected:
- Your home (equity up to $752,000, as long as you intend to return or a spouse lives there)
- One vehicle, regardless of value
- Irrevocable prepaid funeral plan, regardless of value
- Up to $1,500 in designated burial funds per person
- Personal belongings and household goods
The 5-Year Look-Back
Texas enforces a 5-year look-back period for Medicaid nursing home applications. Any gifts, transfers below market value, or suspicious financial moves within that window can trigger a penalty period where Medicaid won't pay.
This is the single biggest mistake families make. Transferring a house to an adult child, giving cash gifts, or paying off someone else's debts within five years of applying for Medicaid can delay coverage by months or years.
When to Talk to an Attorney
If your loved one has significant assets and may need Medicaid within the next five years, consult an elder law attorney now. Common strategies include Miller Trusts (for income over the $2,982 limit), irrevocable trusts, spousal protections, and Medicaid-compliant annuities.
Find a certified elder law attorney through the National Academy of Elder Law Attorneys or the Texas chapter of NAELA. Most offer a free or low-cost initial consultation.
Frequently Asked Questions
Texas allows a Qualified Income Trust (Miller Trust) to redirect income above $2,982/month into a trust, making the applicant eligible for Medicaid. This is a legal and commonly used tool. An elder law attorney can set one up for a few hundred dollars. Without a Miller Trust, people just over the income limit would have to spend down or go without coverage.
Yes. Social Security income can be used for any type of care. If your parent is on Medicaid in a nursing home, all income (including Social Security) except $75/month goes toward the cost of care. If they're receiving home care, they keep more of their income, and Medicaid covers the care services separately.
No. Medicare doesn't cover assisted living, adult day care, or long-term non-medical care. It only covers skilled medical services (nursing, therapy) for limited periods. For assisted living coverage, you'd need Medicaid (STAR+PLUS HCBS waiver), long-term care insurance, VA benefits, or private pay.
This is one of the hardest situations families face. Options include: private pay for home care hours, VA benefits if the senior is a veteran, family caregiving (unpaid or through CDS if already on Medicaid), community programs through your local Area Agency on Aging, and negotiating reduced hours to make private pay more affordable. If the person's needs increase to nursing facility level, nursing home Medicaid has no waitlist.
Next Steps
Start by figuring out where your loved one falls: What care do they need now? What can they afford out of pocket? And what programs might they qualify for?
Here's where to go from here:
- Check Medicaid eligibility: Read our guide to Texas Medicaid programs for income and asset limits
- Explore VA benefits: Our VA Aid and Attendance guide covers eligibility and how to apply
- Understand your care options: Compare home care vs home health, assisted living, and nursing homes
- Get paid as a family caregiver: Learn about CDS and other programs
- Find senior care options near you at brevy.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.