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.

$4576

Texas

$4957

The United States

$4862

Oklahoma

$4605

New Mexico

$4185

Arkansas

$3623

Louisiana

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.

$5196

Austin

$4862

Dallas

$4576

Houston

$4576

San Antonio

$4052

Amarillo

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.

$4576

In-Home Care

$4576

Home Health Care

$5125

Nursing Home Care

$3998

Assisted Living

$769

Adult Day Health Care

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.

Income 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.

Contact
Area Served
Services Provided

(866) 566-8989

Entire State

For 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.

(800) 252-8263

Entire State

THHS 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.

Online Resource

Entire State

TexasLawHelp.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.

Contact
Area Served
Services Provided

(800) 525-0657 for repairs

(888) 606-8889 for weatherization

Entire State

TDHCA 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.

(877) 633-8747

Entire State

The 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.

(800) 252-9240

Entire State

Texas 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.

(877) 399-8939

Entire State

Texas 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.

(800) 252-9121

Entire State

Texas 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.

COVID-19 Rules for In-Home Care Providers in Texas

Unless they qualify for an exemption, all home care workers must be vaccinated against SARS-CoV-2, the virus responsible for the COVID-19 pandemic. This includes in-home care aides and home health care professionals. Although the rule is current as of April 2022, the state or federal government could implement new requirements at any time, so it’s important to check with your local Area on Agency to determine if the rules have changed. Your preferred agency may have more stringent requirements for vaccinations and PPE usage. If you have any questions or concerns, contact an agency representative for more information.

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:

In-Home Care Laws and Regulations in Texas
Scope of Care
PAS 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 Requirements
A 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 Requirements
PAS staff may assist clients with self-administration of doctor-ordered medications.
Staff Screening Requirements
Staff 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 Requirements
Staff must receive training that covers the scope of their assigned duties, and their employer must verify their competency in performing these duties.
Medicaid Coverage
Texas 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 Abuse
Those 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 Much Does In-Home Care Cost in Texas?

According to Genworth Financial’s 2019 Cost of Care Survey, in-home care services cost an average of $3,956 per month in Texas. Home health care services that provide skilled nursing care cost slightly more at an average of $4,004 per month.

Does Texas Medicaid Pay for In-Home Care?

Texas Medicaid currently has three programs available that can cover some or all of the cost of in-home care for eligible seniors. Community First Choice and Community Attendant Services are Medicaid entitlement programs, while STAR+PLUS is a waiver program with a statewide participation cap.

Are There Transportation Assistance Programs in Texas?

The statewide Medical Transportation Program offers free rides so Texas seniors without any other means of transportation can get to nonemergency, health care-related appointments. Area Agencies on Aging also offer transportation programs throughout the state. Seniors may need to meet eligibility guidelines to qualify for these programs.

Does Medicare Pay for In-Home Care?

Medicare pays for specific types of in-home care while an eligible beneficiary is recovering from an illness, injury, hospital stay or surgery and under a doctor’s care. It pays for intermittent skilled nursing care, occupational/physical therapy and home health aide visits. Round-the-clock at-home care, home-delivered meals and homemaker services are not covered.

What Are Activities of Daily Living (ADLs)?

Activities of daily living, or ADLs, are the routine tasks of self-care a person completes each day. They include personal hygiene and grooming, dressing and undressing, continence-related tasks, mobility and eating. ADLs should not be confused with more complex instrumental activities of daily living.

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.

Finding a Home Care Provider Checklist

Find Home Care Agencies Near You

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.

2019, 2020, 2021, 2022

Right at Home Northwest Houston

9538 Huffmeister Rd, Houston, TX, 77095

He really likes the company. He likes that they help to push him to do what he needs to do to take care of himself, such as taking a shower. They stay in good contact and are very flexible with what … (read more)
He really likes the company. He likes that they help to push him to do what he needs to do to take care of himself, such as taking a shower. They stay in good contact and are very flexible with what … (read more)

2017, 2018, 2019, 2021, 2022

Right at Home Galveston

‌1409 39th St, Galveston, TX, 77550

Right at Home could make my life easier by being more flexible with the schedule. I would recommend Right at Home more if they had better communication.
Right at Home could make my life easier by being more flexible with the schedule. I would recommend Right at Home more if they had better communication.

2020, 2021, 2022

At Your Side Home Care – The Woodlands, TX

10200 Grogan’s Mill Rd # 360, The Woodlands, TX, 77380

Our company missions is to Improve the Quality of Life and Level of Independence for every Client and Family receiving our services. Our philosophy is simple – Live Your Best Lift Possible. <p></p> … (read more)
Our company missions is to Improve the Quality of Life and Level of Independence for every Client and Family receiving our services. Our philosophy is simple – Live Your Best Lift Possible. <p></p> … (read more)

2017, 2021, 2022

Life Foundation Home Care

12808 W Airport Blvd, Ste 260L , Sugar Land, TX, 77478

Finding the appropriate home care for your loved ones can be stressful, at Life Foundation Home Care, our award winning team of home care professionals works with the clients to assess their home care … (read more)
Finding the appropriate home care for your loved ones can be stressful, at Life Foundation Home Care, our award winning team of home care professionals works with the clients to assess their home care … (read more)

2017

Right at Home Kingwood

1214 Stonehollow Drive, Suite A, Kingwood, TX, 77339

She is very helpful. They do light cleaning, and she offered to fix meals. They help moving things for me. They work with the VA and got me services quickly.
She is very helpful. They do light cleaning, and she offered to fix meals. They help moving things for me. They work with the VA and got me services quickly.

2022

Home Instead West and Southwest Houston

11201 Richmond Ave, Suite A110, Houston, TX, 77082

Used Home Instead to care for my elderly father after knee replacement surgery. The care giver Carol was great. She was always prompt and entered with a smile. She was very helpful and always asked … (read more)
Used Home Instead to care for my elderly father after knee replacement surgery. The care giver Carol was great. She was always prompt and entered with a smile. She was very helpful and always asked … (read more)

2019, 2020, 2022

Right at Home West Houston and Sugar Land

12808 West Airport Blvd., Suite 316, Sugar Land, TX, 77478

They are very pleasant to be around. The people who come are good.
They are very pleasant to be around. The people who come are good.

2019, 2020, 2022

Home Instead – Houston Northwest, TX

13105 Northwest Fwy, Suite 103, Houston, TX, 77040

The server for "Home Instead" is very punctual and her service is outstanding. She is very attentive to all our needs and requires very little supervision in taking care of us.
The server for "Home Instead" is very punctual and her service is outstanding. She is very attentive to all our needs and requires very little supervision in taking care of us.


Angels Over Us, LLC

8323 Southwest Fwy, Suite 561, Houston, TX, 77074

They have found good people for me. I like that the agency is very friendly.
They have found good people for me. I like that the agency is very friendly.

Home Instead of Houston – Serving Bellaire, Missouri City, and Sugar Land TX

8313 Southwest Fwy, Suite 705 , Houston, TX, 77074

We’ve been using Home Instead of Houston since last year. I like the owner, the staff, and the people they provide. They are very cooperative and very helpful. I just like the way they care. They have … (read more)
We’ve been using Home Instead of Houston since last year. I like the owner, the staff, and the people they provide. They are very cooperative and very helpful. I just like the way they care. They have … (read more)

Kindred at Home – Personal Home Care Assistance – Houston, TX

2600 S. Gessner Road, Suite 320, Houston, TX, 77063

We’re using Kindred at Home. We’re with them for two weeks now. The caregiver’s name is Aileen. She’s been punctual, she keeps Mom very busy, she helps her around the house, and they’ve run errands to … (read more)
We’re using Kindred at Home. We’re with them for two weeks now. The caregiver’s name is Aileen. She’s been punctual, she keeps Mom very busy, she helps her around the house, and they’ve run errands to … (read more)

Always Best Care of Spring & Tomball

20038 Castlegreen Drive, Spring, TX, 77388

Wire hired Always Best Care of Spring &amp; Tomball to help me. They mainly provide assistance with light housekeeping and very minimal help with meal preparation. I hired this agency because they wer … (read more)
Wire hired Always Best Care of Spring &amp; Tomball to help me. They mainly provide assistance with light housekeeping and very minimal help with meal preparation. I hired this agency because they wer … (read more)

Always Best Care of Fort Bend

Three Sugar Creek Center Blvd, Suite 100, Sugar Land, TX, 77478

I hired Always Best Care of Fort Bend because they’re the ones close to me. They’re the ones who responded to me quickly, and they have a good offer. Their work is very good, so my wife is also happy … (read more)
I hired Always Best Care of Fort Bend because they’re the ones close to me. They’re the ones who responded to me quickly, and they have a good offer. Their work is very good, so my wife is also happy … (read more)

Always Best Care of West Houston

9225 Katy Freeway, Suite 112, Houston, TX, 77024

Karena, Roxane and the team of Always Best Care, provide excellent service in a time where quality care is hard to find. I would highly recommend their service if you have a loved one who needs person … (read more)
Karena, Roxane and the team of Always Best Care, provide excellent service in a time where quality care is hard to find. I would highly recommend their service if you have a loved one who needs person … (read more)

SYNERGY HomeCare of Houston

1225 N. Loop West Suite #322, Houston, TX, 77008

Synergy Home Care came to my home to assist with light housekeeping and meal preparation. Brittany was very attentive to all my needs before I moved. The office staff were a joy to deal with.
Synergy Home Care came to my home to assist with light housekeeping and meal preparation. Brittany was very attentive to all my needs before I moved. The office staff were a joy to deal with.

SYNERGY HomeCare North Houston

14425 Torrey Chase Blvd, Houston, TX, 77014

Ms. Margaret and others at Synergy have been most helpful and caring. The caregivers they furnished have been efficient and also caring.
Ms. Margaret and others at Synergy have been most helpful and caring. The caregivers they furnished have been efficient and also caring.

Godly Hearts Home Healthcare Agency

2720 Holly Hall St, Unit C, Houston, TX, 77069

I would like to mention the great service I received from Godly Hearts Home Health Services while recovering from brain surgery. Becky the manager has been always available to speak with me and very … (read more)
I would like to mention the great service I received from Godly Hearts Home Health Services while recovering from brain surgery. Becky the manager has been always available to speak with me and very … (read more)

Platinum Senior Care Solutions – Sugar Land, TX

77 Sugar Creek Center Blvd, Suite 600 , Sugar Land, TX, 77478

I hired Platinum Senior Care for my husband. They come four hours a day and three days a week. No medication help, but they help with bathing, and they help watch him when he is moving around. Staffin … (read more)
I hired Platinum Senior Care for my husband. They come four hours a day and three days a week. No medication help, but they help with bathing, and they help watch him when he is moving around. Staffin … (read more)

Home Instead – Clear Lake and Southeast Houston, TX

14200 Gulf Fwy, Pasadena, TX, 77504

I have no worries with Home Instead. Caregivers are always on time and the office has been very good about sending the right caregivers who meet the needs I request.
I have no worries with Home Instead. Caregivers are always on time and the office has been very good about sending the right caregivers who meet the needs I request.

Home Care Services in Texas (927)