In-Home Dementia Care in Texas

Paying for care in Texas: STAR+PLUS Home and Community Based Services

Medicare does not pay for the long-term help dementia requires. In Texas the programme that can is STAR+PLUS HCBS, administered by the Texas Health and Human Services Commission, through managed care organizations that carry out the eligibility determination and coordinate services.

Who qualifies

Assessment for STAR+PLUS HCBS begins only when a person's name reaches the top of the program interest list; the managed care organization then carries out the eligibility determination. The cited page does not describe any dementia-specific eligibility route, so ask the office that administers the programme how a dementia diagnosis is weighed in that assessment.

The financial limits

Single applicant

Not published on the cited eligibility handbook section; set by Texas Medicaid financial eligibility rules

Married couple

Not published on the cited eligibility handbook section; spousal impoverishment rules apply

Look-back period

Not published on the cited eligibility handbook section; standard Medicaid transfer-of-asset rules apply

How to apply

Ask to be placed on the STAR+PLUS HCBS interest list by contacting the HHSC Interest List Management unit, or the managed care organization directly if the person is already enrolled in STAR+PLUS. Nothing else happens until the name reaches the top of that list, so getting on it early is the step that matters.

What is unusual about Texas

Texas runs the programme from an interest list rather than open enrolment, and the wait is the defining feature of applying - families who assume they can apply when care is needed find the assessment cannot even begin until their turn comes.

Rules and figures change. Confirm the current position with the programme itself before making a financial decision.