💡 Does Medicaid or Medicare Pay for Assisted Living in Texas? Here’s What Families Should Know

At Psalm 23 Home Care, families often ask us one of the most common questions in senior care:“Does Medicare or Medicaid pay for assisted living in Texas?”

The short answer is not completely, but there are important details to understand that can make a big difference when planning care for your loved one. Below, we’ll break down exactly what these programs cover (and what they don’t), and share how families near Clear Lake, TX can get the help they need.

🏥 What Medicare Covers — and What It Doesn’t

Medicare, the federal health insurance program for adults 65 and older, covers many medical services, but it does not cover most assisted living costs in Texas.

What Medicare does not cover:

• Monthly rent or room and board at an assisted living facility

• Daily personal-care assistance (help with bathing, dressing, eating, medication reminders)

• Non-medical services like housekeeping, meals, or transportation

What Medicare may cover:

• Short-term, medically necessary care such as physical therapy or skilled nursing after a hospital stay

• Certain medical equipment or prescriptions ordered by a doctor

So, if your loved one moves into an assisted living facility primarily for help with daily living activities, Medicare will not cover the cost of their stay.

💙 What Medicaid Covers in Texas

Medicaid is a state- and federally funded program that helps low-income seniors with healthcare and long-term care services. In Texas, Medicaid’s coverage for assisted living is limited but can be very helpful for families who qualify.

What Medicaid generally does not cover:

• The full cost of room and board at an assisted living facility

• Most “private pay” assisted living communities

What Medicaid can cover:Through a special program called STAR+PLUS Home and Community-Based Services (HCBS) Waiver, Medicaid may pay for certain services provided in an assisted living setting.

These may include:

• Help with daily activities (bathing, grooming, dressing, meals)

• Personal-care services

• Medication management

• Health and wellness supports

However, even with Medicaid assistance, residents typically pay their own room and board directly to the facility. Medicaid only covers the care services portion of assisted living — not housing or meals.

📋 Who Qualifies for Medicaid Assistance?

To qualify for the STAR+PLUS Waiver program in Texas, seniors must:

• Meet income and asset requirements

• Require a “nursing home level of care” (verified through assessment)

• Enroll in a managed-care plan under the STAR+PLUS program

Because this program has limited funding, there may be a waiting list. That’s why it’s important to apply early and have a financial plan ready for the transition.

💬 What This Means for Families in Clear Lake and Greater Houston

At Psalm 23 Home Care, we understand that paying for assisted living can be overwhelming. Many families assume Medicare will cover most costs, but in reality, Medicare focuses on medical care, while Medicaid helps with personal-care services — and only for those who qualify.

If your loved one is considering assisted living near Clear Lake, Houston, or League City, here are some tips:

✅ Plan early. Research both private-pay options and Medicaid waivers.✅ Get an assessment. Determine if your loved one qualifies for nursing-home-level care under STAR+PLUS.✅ Ask questions. Every facility has different policies for Medicaid residents and service coordination.✅ Stay proactive. Even if there’s a waiting list, apply early and gather all financial and medical documentation.

🙏 Psalm 23 Home Care Is Here to Help

As a trusted assisted living provider serving Clear Lake and surrounding Texas communities, Psalm 23 Home Care believes families deserve clear, honest answers about care options and costs.

We walk with you every step of the way — helping you understand what programs are available, what they actually cover, and how to find the best care plan for your loved one.

If you have questions about how Medicare or Medicaid works for assisted living in Texas, or need guidance on next steps, reach out to us anytime.

📞 Psalm 23 Home Care Compassion, Care, and Comfort You Can Trust.Serving families across Clear Lake TX, League City, and Greater Houston.