Some family members can be paid for in-home caregiving in Texas through the STAR+PLUS waiver program. Spouses are not eligible for payment, but other relatives can work as paid caregivers, as can friends of beneficiaries. Seniors enrolled in STAR+PLUS may also choose enrolled caregivers or hire help from an approved agency.


STAR+PLUS is the Texas home and community-based Medicaid waiver program, which pays some of the costs for seniors aging in place at home, including caregiver support. The program is open to current Medicaid beneficiaries who are citizens or U.S. residents, live in the state of Texas and have a diagnosed medical or age-related disability that requires in-home assistance to thrive.

Depending on the enrollee’s specific care needs, the program allows a set number of hours each month that it will reimburse a caregiver for, which the beneficiary must sign off on before payment is issued. Because STAR+PLUS is a beneficiary-directed benefit, seniors enrolled in the program may choose their own caregiver.

Who Can Provide Caregiver Services Under STAR+PLUS?

STAR+PLUS enrollees can choose a person to help them out at home from a registry of qualified caregivers the program maintains. They can also designate a state-authorized in-home care agency to send one of its employees to work in the client’s home.

Seniors can also designate a friend or family member to act as their caregiver, provided the person they choose can pass the required background check and meet other program standards, including an in-person orientation. While beneficiaries have the option to choose nearly anyone as their caregiver, STAR+PLUS does not offer compensation for the spouses of program beneficiaries.