Houston families typically pay for dementia care through private funds, Texas Medicaid STAR+PLUS, long-term care insurance, and veterans benefits, often blending more than one source over time. This page explains how those options usually work for in-home support. For a broader look at local aging resources, visit our Houston care hub.
How Houston Families Typically Pay for Dementia Care
Most Houston families start with private pay and then add public or insurance benefits if the person with dementia qualifies and a waiting list or claims process allows. Private savings, pensions, and Social Security commonly cover companion care and personal care at first. When hours increase, families may look to STAR+PLUS Medicaid, a long-term care policy, or VA aid if a veteran is involved.
Alzheimer's disease is the most common type of dementia. Dementia is a general term for impaired memory, thinking, or decision-making that interferes with everyday activities, as described by the Centers for Disease Control and Prevention. Those functional needs are what drive paid help, but they do not create a single automatic payment program. Houston households still choose among the funding routes below.
Private Pay for Dementia Care at Home
Private pay means the family covers care from income, savings, retirement accounts, or proceeds from selling assets, without waiting for a public program to approve hours. Many Houston households use this route first because it can start quickly and can fund the mix of companionship, hands-on help, and memory care at home that a person actually needs.
Private pay also lets families set the schedule, including evenings, weekends, or 24-hour live-in care when wandering or overnight safety becomes a concern. Respite care for family caregivers can be purchased the same way. There is no asset test and no interest list, but the household bears the full cost until another payer is in place.
After a hospital stay, some families use short-term hospital discharge care paid privately or through a policy while they arrange longer-term dementia support. Private pay can later sit alongside Medicaid, insurance, or VA benefits rather than replacing them entirely.
Texas Medicaid STAR+PLUS Waiver Coverage
Texas Medicaid can help pay for in-home dementia care through STAR+PLUS Home and Community-Based Services (HCBS), a waiver program administered by private managed care organizations under contract with Texas Health and Human Services. STAR+PLUS is meant to support people who meet a nursing facility level of care while they remain at home.
Texas does not automatically lower the eligibility bar for a dementia diagnosis alone. Dementia-related behaviors such as wandering are factored into the standard Nursing Facility Level of Care assessment. A diagnosis matters only to the extent it shows up in that functional review.
For a single applicant, countable assets are generally limited to $2,000. For couples, the limit varies with spousal allowance rules that can protect some resources for a spouse still living in the community. Texas also applies a 60-month asset transfer look-back period, so gifts or below-market transfers during that window can delay eligibility.
Texas caps STAR+PLUS HCBS services at 202% of what nursing facility care would otherwise cost, and the program offers a Consumer Directed Services option so eligible members can have more say over who provides care. Applicants join the STAR+PLUS HCBS interest list, and once reached, an assigned managed care organization completes the eligibility determination.
These points are a high-level snapshot of how the program is structured and can change. You can learn more about STAR+PLUS from Medicaid Planning Assistance. Texas Health and Human Services also publishes STAR+PLUS HCBS program eligibility materials.