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In-Home Care in Texas

As of July 2021, Texas had more than 3.8 million residents in the 65+ age group. With everything the state has to offer, it’s no wonder so many seniors call it home. Houston Methodist Hospital is nationally ranked in 10 medical specialties, and Texas residents also have access to high-quality care at Baylor St. Luke’s and UT Southwestern Medical Center. Texas doesn’t impose a tax on personal income, and its major cities have lower costs of living than many other urban centers, which is why so many seniors flock to the state for retirement.

Another reason seniors love Texas is because there are many options for senior care, such as in-home care and home health care. In-home care is the non-clinical care provided by a home health aide, while home health care is clinical care provided by a nurse, physical therapist or other licensed professional. As of 2021, in-home care and home health care cost an average of $4,576 per month in Texas.

This guide provides an overview of what you can expect from in-home care, including costs and coverage through Medicare and Medicaid. It also includes a list of resources to help seniors age in place.

The Cost of In-Home Care in Texas

When it comes to in-home care, Texas is one of the most affordable states in the region, with monthly costs averaging $4,576 in 2021, according to the Genworth Cost of Care Survey. To the west, New Mexico is slightly higher at $4,605 per month, while Oklahoma to the north has average monthly costs of $4,862. Louisiana and Arkansas both have lower monthly costs, averaging $3,623 per month and $4,185 per month, respectively. In-home care in Texas is also $381 per month lower than the national average of $4,957.

Texas

$4576

The United States

$4957

Oklahoma

$4862

New Mexico

$4605

Arkansas

$4185

Louisiana

$3623

Within Texas, the average costs of care vary by location. Houston and San Antonio have average monthly costs of $4,576, putting them right in line with the state average. With average monthly costs of $5,196 and $4,862, respectively, Austin and Dallas are the most expensive cities. Amarillo has some of the lowest costs—an average of $4,052 per month in 2021.

Austin

$5196

Dallas

$4862

Houston

$4576

San Antonio

$4576

Amarillo

$4052

In-home care is more affordable than nursing home care, but it can be more expensive than other types of senior care. In Texas, the average cost of nursing home care is $5,125 per month, about $550 per month more than in-home care. Assisted living averages $3,998 per month; although it’s a little less expensive than in-home care, seniors who need assisted living can’t stay in their own homes. Adult day health care is the least expensive option, with average monthly costs coming in at $769. In Texas, the average cost of home health care is the same as the average for in-home care at $4,576 per month.

In-Home Care

$4576

Home Health Care

$4576

Nursing Home Care

$5125

Assisted Living

$3998

Adult Day Health Care

$769

Does Medicaid Cover Home Care in Texas?

Traditional Medicaid doesn’t include coverage for non-clinical home care; however, Texas does have a Medicaid waiver program that pays for personal care services and other supports designed to help seniors age in place instead of moving to institutional care settings. This program is known as the STAR+PLUS waiver.

Home Care Waiver Programs in Texas

STAR+PLUS Waiver

The STAR+PLUS waiver is a managed care program that gives eligible Medicaid enrollees access to services and supports that can help them maintain their independence and improve their overall quality of life. This waiver covers personal assistance, home-delivered meals, respite care and other services that allow beneficiaries to remain in their homes even if they need a little help with activities of daily living.

The STAR+PLUS waiver is available to Texas Medicaid enrollees who are at least 65 years old or have a qualifying disability. To qualify for this waiver, you must work with a service coordinator to determine which supports are a good fit for your needs. If you’re not already enrolled in Medicaid, you can apply by visiting the Your Texas Benefits website.

How to Know if You’re Eligible for Medicaid in Texas

Medicaid eligibility is based on financial need, so an applicant must demonstrate that their income doesn’t exceed a certain level. In Texas, the income limit is $10,092 per year for individual applicants and $15,132 per year for couples. Eligibility is also limited to applicants who are at or below certain asset limits. As of 2022, the asset limit is $2,000 for individuals and $3,000 for married couples.

2022 Basic Medicaid Income Limits for Seniors in Texas

NameIncome limits*Asset limits
Single Person$10,092$2,000
Two-Person Household$15,132$3,000

* per year

Texas Medicaid applicants must also meet the following basic requirements:

  • Residence: Texas resident
  • Citizenship: U.S. citizen, legal alien or lawful immigrant
  • Finances: Low income or very low income

How to Apply for Medicaid in Texas

The easiest way to apply for Medicaid is to create an account at Your Texas Benefits and fill out the online application. You can also download an application and mail or fax it to the Texas Health and Human Services Commission.

Fax: (877) 447-2839
P.O. Box 149024
Austin, TX 78714-9024

What Information You Will Need

When you fill out the Medicaid application, you’ll need to provide information about your income and assets. To make the process easier, make sure you have your pay stubs, tax returns and bank statements on hand. If applicable, you may want to gather information about your investments or insurance policies. You should also have your driver’s license or photo identification card, Social Security card and other identity documents in case THHS asks for proof of identity.

How to Get Help Applying for Medicaid

Medicaid has strict eligibility requirements. If you’re not sure if you qualify, or if you have a question about a submitted or denied application, there are several resources in Texas to help you get the information you need.

ProgramContactAreaServedServices provided
Managed Care Helpline(866) 566-8989Entire StateFor seniors with the STAR+PLUS waiver, the Medicaid Managed Care Helpline provides access to information about eligibility and available benefits. Enrollees can also use the helpline to submit complaints about the managed care companies that participate in STAR+PLUS.
Texas Health and Human Services(800) 252-8263Entire StateTHHS oversees the Medicaid program in Texas, so it's a helpful resource for seniors who have questions about the eligibility criteria or need guidance in completing their Medicaid applications. The agency also oversees the state long-term care ombudsman program and manages other programs for seniors.
TexasLawHelp.orgOnline ResourceEntire StateTexasLawHelp.org offers forms and educational resources to help Texas Residents assert their legal rights. The section on Medicare and Medicaid has articles on what to do if you've been denied Medicaid, how to get covered benefits and other topics related to Medicaid and public benefits in general.

Does Medicare Cover In-Home Care in Texas?

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

  • Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
  • Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
  • Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
  • Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

Other Financial Assistance Options for In-Home Care in Texas

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost Resources for Seniors in Texas

Aging in place has many benefits for seniors, including the opportunity to stay connected to friends, family members and neighbors. Despite these benefits, aging in place also has some challenges, such as difficulty performing household tasks or financial circumstances that prevent seniors from making much-needed home repairs and modifications. Seniors in Texas can get help with these challenges by contacting the organizations below.

ResourceContactAreaServedService
Texas Department of Housing and Community Affairs(800) 525-0657 for repairs (888) 606-8889 for weatherizationEntire StateTDHCA connects eligible residents with local provider organizations that can help with home weatherization and repairs. Weatherization improvements aim to increase energy efficiency, which can help seniors stay safe in extreme weather conditions. Organizations also do non-cosmetic repairs to eliminate existing hazards and make homes safer for their residents.
Medical Transportation Program(877) 633-8747Entire StateThe Medical Transportation Program provides non-emergency medical transportation for Medicaid enrollees. This includes visits to doctors, dentists and other health care providers. Texas residents enrolled in a Medicaid health plan should contact the medical transport number for their plan; otherwise, enrollees can call the general assistance line to arrange for a ride.
Area Agencies on Aging(800) 252-9240Entire StateTexas has 28 Area Agencies on Aging responsible for serving adults aged 60 and older. These agencies provide information and referrals to help seniors and their loved ones navigate the complexities of enrolling in public benefits and getting the help they need to safely age in place. Call the toll-free number to get information on the AAoA serving your area.
Texas Comprehensive Energy Assistance Program(877) 399-8939Entire StateTexas CEAP helps low-income residents cover their immediate utility needs. It may also cover services designed to increase the energy efficiency of a participant's home, leading to lower utility costs over time.
Texas State Comptroller(800) 252-9121Entire StateTexas doesn't have a state property tax, but each municipality is permitted to charge tax based on the value of a home. For seniors living on fixed incomes, rising taxes are a major barrier to aging in place. Fortunately, local tax agencies are required to give seniors a $10,000 homestead exemption. You can contact the Texas State Comptroller if you have questions about this exemption.

In-Home Care Laws and Regulations in Texas

Home and Community Support Services providers that offer personal assistance services to seniors in their own homes are licensed and regulated by the Texas Department of Health and Human Services. Department staff perform an initial survey of each provider 18 months after licensing, as well as follow-up surveys every 36 months to ensure compliance with state regulations. The following table offers an overview of the rules and regulations governing PAS providers in Texas:

TopicRule
Scope of CarePAS staff may complete general household tasks, prepare meals and accompany a patient on appointments. They may also provide assistance with daily living activities, personal care services and complete health-related tasks not normally performed by a professional nurse.
Care Plan RequirementsA provider supervisor must visit the patient's home to discuss their care needs and develop a personalized service plan. This plan must detail the types, frequency and duration of the services a patient receives, and the charges for these services.
Medication Management RequirementsPAS staff may assist clients with self-administration of doctor-ordered medications.
Staff Screening RequirementsStaff must pass a criminal background check as part of the hiring process. The provider must also verify that new hires are not listed on the state Employee Misconduct and Nurse Aide registries.
Staff Training RequirementsStaff must receive training that covers the scope of their assigned duties, and their employer must verify their competency in performing these duties.
Medicaid CoverageTexas Medicaid's Community First Choice, Community Attendant Services and STAR+PLUS waiver programs cover some or all of the cost of in-home care services for eligible individuals.
Reporting AbuseThose with concerns about the abuse, exploitation or neglect of a senior should contact the Texas Department of Family and Protective Services' abuse hotline at 800-252-5400. Alternatively, they may file a report online.

Frequently Asked Questions

How to Find an In-Home Care Provider in Texas

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At Caring.com, we’re here to help – we’ve created a helpful checklist below that can help guide you through the process of both determining your needs and finding a home care agency that will provide the best care possible.

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At Caring.com, we’re here to help – we’ve created a helpful checklist below that can help guide you through the process of both determining your needs and finding a home care agency that will provide the best care possible.

Download
Finding a Home Care Provider Checklist
Finding a Home Care Provider Checklist

Find Home Care Agencies Near You

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Caring.com is a leading online destination for caregivers seeking information and support as they care for aging parents, spouses, and other loved ones. We offer thousands of original articles, helpful tools, advice from more than 50 leading experts, a community of caregivers, and a comprehensive directory of caregiving services.

 

The material on this site is for informational purposes only and is not a substitute for legal, financial, professional, or medical advice or diagnosis or treatment. By using our website, you agree to the Terms of Use and Privacy Policy

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