Texas Medicaid uses state and federal funding to help seniors and the disabled pay for health care services, including in-home and nursing care, as well as assisted living if the individual passes an additional eligibility check.
The core benefits covered by Medicaid include hospitalization, visits to a doctor, drugs, lab fees, dental care, vision and hearing. Some long-term care options are also covered by Medicaid when applying based on age or disability.
STAR+PLUS Medicaid is the managed care program for seniors and the disabled in Texas. This level of coverage includes all the core Medicaid benefits as well as additional care options tailored to seniors that are intended to delay the need for nursing home care.
Medicaid requirements for seniors or the disabled in Texas include:
- Minimum of 65 years of age or disabled based on Social Security definition
- Maximum of $24,731 of countable annual income or $33,482 if applying as a couple
- Maximum of $2,000 in countable assets or $3,000 if applying as a couple
- Resident of Texas and legal U.S. citizen or national or satisfactory immigration status
Recipients of Supplemental Security Income payments
automatically qualify to receive Medicaid in Texas regardless of their age. A full-scope plan that includes all Medicaid services with no share of cost covers these individuals.
Eligible seniors and disabled people in Texas are entitled to care in a nursing facility and some in-home services with no waiting period or limit on participants. Assisted living is not an entitlement under Texas Medicaid and is only covered through the use of the HCBS waiver explained below.
People can apply for Texas Medicaid and the STAR+PLUS program at
Your Texas Benefits. Paper forms to apply by mail are also available, as well as in-person applications at local benefit offices. They can also call (877) 541-7905 for help in the application process.
STAR+PLUS Medicaid HCBS Waiver This waiver is available for eligible Forney residents, and Texans in general, who are receiving health care through the STAR+PLUS Medicaid program.
HCBS waivers are created at the state level so that some of the federal Medicaid restrictions can be removed on a case-by-case basis, which allows for partial coverage of assisted living and a higher degree of in-home care.
Individuals are assessed during the application process to determine whether they need the level of care usually provided in a nursing facility and can live safely in an alternate setting if they receive HCBS services. This opens up the possibility of assisted living and more in-home services if it’s deemed an appropriate choice for the individual.
Applicants for HCBS waiver services must also be approved or eligible for SSI payments and Medicaid and not currently participating in any other waiver program in Texas.
People can apply for HCBS waiver services at
Your Texas Benefits by submitting the forms online or printing and mailing them. They can also call (877) 541-7905 for help with the benefits website or (877) 782-6440 for the STAR+PLUS HCBS helpline.