El Paso Senior AdvisorBy El Paso Senior Advisor Care Team · October 19, 2026
STAR+PLUS HCBS pays care services in assisted living for eligible members at contracted facilities, but the resident pays room and board from their own income. In 2026 the income limit is $2,982 a month and the asset limit $2,000, and there is often an interest list.
How STAR+PLUS works in assisted living
STAR+PLUS is Texas Medicaid's managed care program for older adults and people with disabilities. Its HCBS waiver pays for people who meet nursing facility level of care to receive services at home or in assisted living instead. In assisted living, the waiver pays the facility for care: help with daily activities, medication supervision and similar services. It does not pay for the room, meals or utilities.
A worked example
Consider an El Paso resident with $1,600 a month from Social Security. Under STAR+PLUS, the facility charges a room-and-board amount that the resident pays from income, and the resident keeps a personal needs allowance. The exact room-and-board figure is set by program rules and the facility's contract, so ask the facility for its Medicaid room-and-board rate in writing.
| Item | Who pays |
|---|---|
| Care services in assisted living | STAR+PLUS health plan |
| Room, meals and utilities | Resident, from income |
| Personal items | Resident's personal needs allowance |
| Medical care | Medicare and Medicaid |
The gap is why some private-pay residents must move when savings run out: the facility may not contract with STAR+PLUS plans, or may limit how many Medicaid residents it serves.
Who qualifies in 2026
An applicant must be 65 or older, or 21 or older with a disability, meet nursing facility level of care, and have income under $2,982 a month and countable assets under $2,000, with the home and one vehicle generally exempt. Spousal protections let a husband or wife at home keep a share of savings and income.
The interest list
People not already on Medicaid usually join an interest list and wait to be released. Call 2-1-1 or apply at YourTexasBenefits.com as soon as you think your parent may need it; getting on the list costs nothing and the wait can be long.
Questions to ask an El Paso facility
Ask whether the facility contracts with STAR+PLUS health plans in the El Paso service area, how many residents use Medicaid now, what its room-and-board rate is for them, and whether a private-pay resident who converts can stay in the same room. Get the answers in writing.
Choosing a health plan in El Paso
STAR+PLUS members choose a managed care health plan available in their service area. Each plan has its own network of facilities, agencies and doctors. Before choosing, ask the assisted living facility or home care agency you prefer which plans it contracts with, and check HHSC's current health plans by service area listing, because contracts change.
The plan assigns a service coordinator who assesses needs and builds the service plan. If the plan does not authorize enough hours or services, members can ask for a review and have appeal rights.
Spouses and couples
When one spouse needs STAR+PLUS and the other lives at home, Texas spousal impoverishment rules protect a share of the couple's savings, between $32,532 and $162,660 in 2026, and some income for the spouse at home. Get advice before moving money, since Texas reviews transfers in the five years before an application.
Estate recovery
Texas may file a claim against the estate of a STAR+PLUS HCBS recipient who was 55 or older, under its Medicaid Estate Recovery Program. Exemptions and hardship waivers exist, including when a spouse or certain children survive. It is a reason to plan, not a reason to avoid care.
Staying at home instead
STAR+PLUS is not only for assisted living. Many El Paso members use it to receive attendant care at home, often combined with an adult day center, which avoids the room-and-board gap entirely because the member keeps living in their own home. For a parent who lives with family, that combination is often the most affordable way to receive daily help.
Documents to gather now
Medicaid applications go faster when the paperwork is ready: proof of identity and citizenship or qualified status, Social Security and pension award letters, bank statements for recent months, information on insurance policies and any property, and the name of the doctor who can complete the medical assessment. Keep copies in one folder, and note the date you joined the interest list.
Getting help with the process
The Rio Grande Area Agency on Aging's benefits counselors and 2-1-1 can explain the steps, and an elder law attorney can advise on spousal protections and income trusts for people slightly over the income limit. Our advisors can tell you which El Paso facilities currently serve STAR+PLUS members.
Alternatives when assisted living will not take Medicaid
If no suitable facility contracts with STAR+PLUS, consider PACE through Bienvivir, STAR+PLUS attendant care at home with an adult day center, or a Medicaid-certified nursing facility, where Medicaid pays the full cost and the resident keeps a $75 personal needs allowance.
Frequently asked questions
Does Texas Medicaid pay for assisted living rent?
No. STAR+PLUS pays care services, not room and board.
What is the STAR+PLUS income limit in 2026?
$2,982 a month for an individual, three times the SSI federal benefit rate.
How do we join the STAR+PLUS interest list?
Call 2-1-1 or apply at YourTexasBenefits.com.
