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What Happens When the Money Runs Out

Spend-down, Medicaid transitions, and why you should ask a community about this before you move in.

Home›Costs & Paying›What Happens When the Money Runs Out
Short answer

If private funds run out, the options are the Medicaid STAR+PLUS waiver for assisted living care services, Medicaid nursing facility coverage, or moving to a community that accepts Medicaid. Many Austin-area assisted living communities do not contract with Medicaid managed care at all.

Ask before you move in, not after

This is the single most consequential question families skip. A community that does not contract with Medicaid managed care will ask your parent to leave when private funds are exhausted — often with thirty days' notice, at the point when moving is hardest.

Ask directly: do you accept STAR+PLUS, and how many current residents are on it? The second half of that question matters. A community can technically hold a contract and still have no Medicaid beds available.

The waiting problem

STAR+PLUS assisted living services are interest-list driven. Getting on the list takes a phone call; getting through it can take considerably longer. Families who wait until funds are nearly gone discover the timeline does not bend for them. If Medicaid is a realistic eventual path, join the interest list early, even while paying privately.

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 →
The Austin-area long-term care ombudsman. Free, confidential and independent of Texas HHS. Capital Area covers Travis, Williamson and Hays at 512-916-6054. Read the full explanation →

Questions Austin families ask

How much is VA Aid and Attendance in 2026?

For 2026, maximum annual pension rates are $29,093 for a veteran with no dependents, roughly $2,424 monthly, $34,488 with one dependent, and $18,697 for a surviving spouse, about $1,558 monthly. VA pays the difference between countable income and that maximum, not a flat check.

Can Aid and Attendance help pay for assisted living in Austin?

Yes, indirectly and often substantially. VA subtracts unreimbursed medical expenses, including assisted living and home care costs, from countable income. A veteran with significant care bills can therefore qualify despite moderate income. The 2026 net worth limit is $163,699, with a three-year look-back on asset transfers.

What does long-term care actually cost in Texas?

Per the 2025 CareScout Cost of Care Survey, published March 2026, Texas medians are $5,666 monthly for assisted living, $7,604 for a private nursing home room, $30 an hour for a non-medical caregiver, and $90 a day for adult day health care.

Is senior care more expensive in Austin than the rest of Texas?

Generally yes. CareScout publishes Texas statewide medians, $5,666 monthly for assisted living, but does not publish separate Austin figures. Austin's rapid growth, competitive labor market, and newer inventory push local pricing above the state median. Ask each Austin community directly for a current all-in monthly quote.

How much does in-home care cost per hour in Austin?

The 2025 CareScout survey puts the Texas median for a non-medical caregiver at $30 an hour, roughly $5,720 monthly at 44 hours a week. Skilled private duty nursing at home runs about $90 an hour or $150 a visit. Austin rates typically run above statewide medians.

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