Free senior care guidance for Austin-area families. No cost to you, ever.
Call (737) 273-3575
Austin Senior AdvisorPeople • Places • Possibilities

Texas Medicaid STAR+PLUS and Assisted Living

What the STAR+PLUS waiver covers, what it does not, and how Austin families get on the interest list.

HomeCosts & PayingTexas Medicaid STAR+PLUS and Assisted Living
Short answer

STAR+PLUS is Texas Medicaid managed care with long-term services and supports. Its home and community based services waiver covers assisted living care services but explicitly not room and board, requires nursing facility level of care, and runs on an interest list.

What the waiver actually pays for

Personal attendant and personal care services, adult day care, respite, nursing services, adaptive aids, minor home modifications, personal emergency response systems, and assisted living services delivered in a licensed facility.

The gap families discover late: The waiver does not cover room and board in assisted living. Medicaid treats the room, meals, and utilities portion as the resident's responsibility, paid from their own Social Security or pension income less the personal needs allowance.

Two separate gates

Families tend to think of Medicaid eligibility as one test. It is two, and clearing one says nothing about the other.

  1. Financial. Income under $2,982 per month and countable assets under $2,000 for a single applicant, with the home and one vehicle generally exempt.
  2. Functional. A Nursing Facility Level of Care determination. A person can qualify financially and fail medical necessity, which is a common and demoralising surprise.

The third gate nobody mentions

Even with both cleared, the community itself must contract with your managed care organisation. A meaningful share of Austin-area assisted living does not participate at all. This is why the question to ask any community you are seriously considering is not just whether they accept Medicaid, but how many current residents are on STAR+PLUS.

Getting on the interest list

Call 2-1-1 or apply at YourTexasBenefits.com to join the interest list, then complete a Medicaid application, a medical necessity assessment, managed care plan selection, and a service plan with a service coordinator.

Join the list early, even while paying privately and expecting to for some time. Nothing is lost by being on it, and the timeline does not compress because your circumstances became urgent.

Managed care plan availability in the Travis service delivery area has changed since 2024. Confirm which plans currently serve your county on the HHSC health plans by service area listing before choosing. HHSC health plans by service area

How Austin families pay for care. Medicare does not cover assisted living. Texas has no broad state assisted living benefit. The main routes are private funds, Medicaid STAR+PLUS, and VA Aid and Attendance. Read the full explanation →

Questions Austin families ask

Which Austin hospitals handle serious senior emergencies?

Dell Seton Medical Center at The University of Texas, 1500 Red River Street, is the region's Level I trauma center and Dell Medical School teaching hospital. Other major systems are Ascension Seton, St. David's HealthCare with more than 180 sites, and Baylor Scott and White, all with campuses across the metro.

Why is there so much senior housing in Georgetown and Round Rock?

Williamson County skews older than Travis, 13.7 percent aged 65-plus versus 11.6 percent, and grew 23.6 percent since 2020. Sun City Texas in Georgetown, a Del Webb 55-plus community of roughly 7,500 to 8,500 homes on about 5,000 acres, anchors that demand.

How many seniors live in the Austin area?

Approximately 305,000 people aged 65 and older live across Travis, Williamson, and Hays counties, based on Census population estimates combined with survey age percentages. That's roughly 161,000 in Travis, 103,000 in Williamson, and 41,000 in Hays. Hays and Williamson are growing fastest.

What's the difference between Type A and Type B assisted living in Texas?

Texas licenses assisted living by residents' ability to evacuate. Type A residents must evacuate without physical staff assistance, follow emergency directions, and not need nighttime attendance. Type B residents may need staff help evacuating, nighttime attendance, and help transferring from a wheelchair, but cannot be permanently bedfast.

Is memory care a separate license in Texas?

No. Memory care isn't a license type. Under Texas rule 26 TAC 553.27, any community advertising specialized Alzheimer's or dementia care must hold an Alzheimer's certification, and it must be licensed as Type B to qualify. Always ask to see the Alzheimer's certificate, not just the license.

Not sure where to start?

Answer five questions and a local advisor will come back with senior care options in the Austin area that actually fit your situation and budget. It is free, and there is no obligation.

Find care options
Find senior care — free