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My spouse needs more care than I can give

Options that keep a couple together, and the spousal protections Texas Medicaid provides.

Quick answer

Options that keep a couple together, and the spousal protections Texas Medicaid provides.

Home›By Situation›My spouse needs more care than I can give

Caring for a spouse is different from caring for a parent, financially and otherwise. Texas Medicaid has specific protections for the spouse who stays at home.

Short answer

Options that keep a couple together, and the spousal protections Texas Medicaid provides.

What to do, in order

  1. Understand the spousal protections. Texas Medicaid has a Community Spouse Resource Allowance so the spouse at home is not impoverished, reported at $162,660 for 2026, plus a separate monthly income allowance. Confirm current figures with HHSC or an elder law attorney.
  2. Look at communities that keep couples together. Several Austin-area campuses offer different care levels on one site, so a couple can remain close even when needs diverge. Ask specifically how couples are handled and what a second-person fee covers.
  3. Be honest about your own health. Spousal caregivers routinely under-report their own decline. The plan needs to survive you being unwell for a fortnight.
  4. Get an objective assessment. The Capital Area ADRC at 855-937-2372 can assess both of you at no cost, which is more useful than either of you assessing the other.

Questions Austin families ask

Will Texas take my mother's house after she goes on Medicaid?

Texas may file an estate recovery claim after death if she was 55 or older when receiving services and first applied for long-term services on or after March 1, 2005. This covers nursing home care and STAR+PLUS. Texas never recovers more than it paid, and exemptions and hardship waivers exist.

Does Texas have a state program that pays for assisted living?

Not broadly. Texas has no general state-funded assisted living benefit. Two narrow options exist: STAR+PLUS Medicaid waiver assisted living services covering care but not room and board, and the state-funded Residential Care program under Community Care for Aged and Disabled, funded by Title XX block grants with interest lists.

How do I get on the STAR+PLUS waiver list in Austin?

Call 2-1-1 or visit YourTexasBenefits.com to join the interest list, then apply for Medicaid. Next comes a medical necessity assessment, choosing a managed care organization, and building a service plan with a coordinator. The Capital Area ADRC at 855-937-2372 can help you navigate the process.

Not sure where to start?

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