Page Reviewed / Updated - February 08, 2021
This webpage will help Texans understand the costs associated with assisted living, home care, and adult day throughout the state. It also explores various payment options and financial assistance programs available to assist in caring for the elderly, be that in residential care or for aging in place at home.
Cost of Care Calculator
The average cost of assisted living in Texas, as of 2021, per Genworth’s Cost of Care Survey 2020, is $3,988 / month, which is a few hundred dollars under the national average of $4,300 / month. The areas of Texas with the most expensive assisted living include Houston, McAllen, College Station, Midland, Odessa, and Victoria, where the monthly cost averages between $4,750 and $5,355. The most affordable assisted living in the state can be found in Corpus Christi, El Paso, and Texarkana, where it ranges from $2,600 to $3,260 / month. Other areas with very affordable monthly rates include Sherman ($3,400), Tyler ($3,450), and San Antonio ($3,599). The areas of Waco, Abilene, Longview, and Austin have average monthly rates ($3,750 - $4,250) fairly consistent to the statewide average cost of assisted living.
Memory Care, also referred to as Alzheimer's residential care, is approximately 20% - 30% more costly than is traditional assisted living. This adds approximately $650 - $1,338 to the monthly cost due to the increased level of care provided and the extra safety precautions.
According to the 2020 Genworth Cost of Care Survey, the average hourly rate for home care across Texas in 2021 is $22.00. Texarkana, Brownsville, Wichita Falls, El Paso, and McAllen, have the most affordable home care with the hourly cost between $15.00 and $18.00. Other areas under the statewide average include Beaumont ($19.00), Abilene ($20.00), Corpus Christi ($20.60), and Waco ($21.00). Round Rock / Austin area, Midland, and Dallas are the costliest areas at $23.00 - $24.00 / hour. On par, or close to on par, with the statewide average of $22.00 / hour is San Antonio ($22.50), Houston ($22.50), College Station ($22.00), and Lubbock ($21.73).
Home health care is also available for those who need a slightly higher level of care (medical), and statewide, costs on average the same as regular home care. However, based on the geographic region within the state, the cost may be more. In Killeen, Austin, Beaumont, and Brownsville, the cost is approximately $1.00 more. In Laredo, the additional cost is much higher and averages $6.00 more.
Texas continues to have one of the least expensive average daily rates for adult day care in the nation. The daily cost, per Genworth’s Cost of Care Survey 2020, averages just $32.00 in 2021, and this figure has remained fairly constant the past few years. Amarillo, Dallas, Houston, and Midland are the most expensive areas in Texas for adult day care, and even in these areas, the cost ranges from $53.00 - $73.00 / day. The national average for adult day care is $74.00 /day, so even on the high end, one can find care well below this average. The most affordable adult day care can be found in Laredo, Corpus Christi, El Paso, Lubbock, Brownsville, and Longview at $25.00 - $34.00 / day. Adult day care above the statewide average cost, but still much lower than the approximate nationwide cost, can be found in the areas of San Antonio, Victoria, and Waco. Here, the average daily costs are between $37.00 and $45.00.
Medicaid is health insurance for low-income and disabled individuals and seniors. Medicaid care was originally provided as institutional care (nursing home), and also provided limited personal care. Now states also offer Medicaid waivers, often referred to as Home and Community Based Services Waivers (HCBS). These waivers allow individuals to receive Medicaid care outside of nursing home residences, such as in their home, and in the community.
In 2015, Texas made sweeping changes to its Medicaid programs for the elderly. The STAR+PLUS Waiver, which was rolled out county by county over the last few years, is available statewide. This program provides a range of services (personal care, adult day care, meal delivery, etc.) for the elderly to help them remain living in their homes, in adult foster care homes, or in assisted living communities. Medical and non-medical care is available via this program and is provided through managed care organizations. Read more about STAR+PLUS.
With the statewide rollout of STAR+PLUS, three other Texas Medicaid programs have changed. These include the Community Based Alternatives Waiver (CBA), the Primary Home Care Program (PHC), and Day Activity and Health Services (DAHS). The services that were provided via the CBA program are now available through the STAR+PLUS HCBS Waiver, and the services provided by PHC and DAHS are now available via STAR+PLUS’s state Medicaid plan.
Another program, Community Attendant Services (CAS), provides attendant services or non-medical personal care to individuals in their homes. There is an option for self-direction of care, and friends, as well as some family members, may be hired as a caregiver. Learn more about CAS eligibility and benefits.
There is also a Medicaid entitlement program called Community First Choice (CFC). This program differs from STAR+PLUS significantly in that there are no waiting lists for services. (Being an entitlement program, anyone who is eligible for services is able to receive them). Benefits available via CFC include assistance with activities of daily living, personal emergency response systems, and health maintenance. This program allows for consumer direction, also referred to as self-direction. This means eligible applicants are able to choose the personal care assistant of their preference, including some family members.
To qualify for long-term care Medicaid in Texas, elderly individuals must demonstrate a functional need, as well as have limited financial resources and income. While the eligibility requirements may vary based on if one is applying for the state Medicaid plan, a Medicaid waiver, or institutional care (nursing home), as a general rule of thumb, the monthly income in 2021 for an individual cannot exceed $2,382 / month. For married couples, with both spouses applying for Medicaid services, each spouse is considered as a single applicant. This means each spouse is able to have as much as $2,382 / month in income, or said another way, up to $4,764 / month as a couple. The asset limit is $2,000 for individuals, and $3,000 for couples. One's home (limited to an equity interest of $603,000 if a non-applicant spouse doesn’t live in the home), household items, and vehicle are not included in the asset calculation.
Persons with income and assets over these limits may still become eligible for Medicaid in Texas. By working with a Medicaid planning professional, monthly income in excess of the limit can be allocated to qualified income trusts. Financial assets in excess of the limit can be converted into exempt assets, such as home reparations, additions, and modifications. For individuals that are near the financial limits, or over them, it is strongly recommended they consult with a Medicaid planning professional prior to application to ensure the best possibility of acceptance into Medicaid. Read more.
The State of Texas offers one program that provides assistance to elderly individuals that are not Medicaid qualified. This is the Community Care for Aged/Disabled (CCAD) program, which provides non-medical personal care services and support to nursing home eligible individuals who choose to reside at home instead. Services may also be provided in assisted living residences and foster homes. Read more about CCAD eligibility and benefits.
Please note, two programs, in which one may be familiar, HHS Services to Assist Independent Living (SAIL) and In-Home and Family Support Grants (IFHS), are no longer available. With the abolishment of the Texas Department of Aging and Disability Services in 2017, SAIL is no longer an active program. Similar services may be available through one’s local Area on Agency office. IFHS was also terminated in 2017. This was due to unavailable funding.
In addition to the state specific options that help pay for care, there are many non-profit and federal options. By using our Resource Locator Tool to find other programs that help pay for or reduce the cost of care, you’ll be able to find the most suitable program for your situation. There are also programs that help veterans with assisted living and there are eldercare loans available in Texas.
To help families find affordable care in Texas, we've partnered with several organizations that maintain databases of care providers. These organizations all provide free services that match an individual's specific care needs with care providers in their preferred geographic area. Click here to find affordable care.