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Texas STAR+PLUS HCBS Explained

How the Texas Medicaid STAR+PLUS Home and Community-Based Services program helps seniors get long-term care at home instead of in an institution.

Quick answer: STAR+PLUS HCBS is Texas Medicaid’s managed-care program that can pay for at-home long-term care — personal attendant care, adult day care, respite, and more — for eligible adults 65+ or with a disability.
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STAR+PLUS is the Texas Medicaid managed-care program that provides long-term services and supports to adults who are 65 or older or who have a disability. Its purpose is to help people get the care they need in the most integrated setting possible — ideally at home or in the community rather than in an institution. This page explains, in plain language, how the Home and Community-Based Services (HCBS) portion works for Houston-area families.

What STAR+PLUS HCBS can cover

For members who meet both the financial rules and a functional-need assessment, HCBS can pay for supports that make staying at home realistic. Depending on the person’s assessed needs and their managed care organization, that can include:

  • Personal attendant care — help with bathing, dressing, meals, and medication reminders
  • Adult day care and day activity/health services
  • Respite care to give family caregivers a break
  • Home modifications and adaptive aids (such as ramps or grab bars)
  • Nursing and therapy services in the home
  • In some situations, services delivered in an assisted living or residential care setting

Who is eligible

Eligibility rests on two tests. First, financial: STAR+PLUS follows Medicaid income and asset limits, which change yearly and are set by the state. Second, functional: the state assesses whether the person needs a nursing-facility level of care or otherwise qualifies for waiver services. Because both pieces must line up, many families get help from a benefits counselor before applying.

How it is administered

The Texas Health and Human Services Commission (HHSC) runs STAR+PLUS, and day-to-day services are delivered through managed care organizations (MCOs) that members choose from in their region. Each member is assigned a service coordinator who arranges the approved services in their care plan.

Getting help

Whether STAR+PLUS is the right path — and how it combines with private pay or a VA benefit — depends on your family’s specifics. A free Houston Senior Advisor can help you understand the options and find communities that accept these benefits. Call (346) 385-3815, or read more about STAR+PLUS in Houston and Medicaid and assisted living. For official program details, see the Texas HHS website.

Common questions

What does STAR+PLUS HCBS pay for?
Depending on eligibility and the person’s assessed needs, it can cover personal attendant care, adult day care, respite, home modifications, in-home nursing and therapy, and in some cases residential care.
Who is eligible for STAR+PLUS?
Adults who are 65 or older or who have a disability, who meet Medicaid financial limits and a functional-need assessment. Both the financial and functional tests must be met.
Who runs the program?
The Texas Health and Human Services Commission (HHSC) administers STAR+PLUS, with services delivered through managed care organizations and a member service coordinator.

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