If you are researching the Star Plus program Texas offers for seniors and adults with disabilities, the short version is this: STAR+PLUS is a Texas Medicaid managed care program that gives members free health coverage plus help at home, all through one health plan they choose. For many families it is the difference between a loved one staying home and moving into a nursing facility.
Our guide on qualifying for Medicaid home care in Texas covers the financial rules in depth. This one explains the program itself, who it is for, and how to get in.
What is the STAR+PLUS program in Texas?
STAR+PLUS is a Texas Medicaid managed care program for adults age 65 and older and adults with disabilities. It bundles two things together under one health plan: regular medical coverage, like doctor visits, hospital stays, and prescriptions, and long term services and supports, which is the part that pays for help at home.
The program started in Harris County in 1998 and now covers the entire state. Rather than the state paying providers directly, care runs through private managed care organizations, or MCOs, that contract with Texas Health and Human Services. Members pick a plan, and that plan becomes responsible for both their medical care and their long term services. Every member can also be paired with a service coordinator who builds their care plan.
Star Plus program Texas eligibility: who qualifies
You can be enrolled in STAR+PLUS if you have Texas Medicaid and you are:
- Age 65 or older
- Age 21 or older with a disability, which usually means you receive Supplemental Security Income or qualify for Medicaid based on a disability
- A woman in the Medicaid for Breast and Cervical Cancer program
- Living in a nursing facility and covered by Medicaid
Most people come into STAR+PLUS automatically once they are approved for SSI, since SSI brings Texas Medicaid with it. People who earn too much for SSI can still qualify through the STAR+PLUS HCBS waiver, which has its own higher income limit, covered below.
STAR and STAR+PLUS are two different programs
People searching "who is eligible for the STAR program in Texas" often mean STAR+PLUS. STAR is a separate Medicaid managed care program that mainly covers children, pregnant women, and some low income families. STAR+PLUS is the one for seniors and adults with disabilities, and it is the only one of the two that includes long term care at home.
STAR+PLUS waiver income limits for 2026
The STAR+PLUS HCBS waiver, often just called the STAR+PLUS waiver, uses a higher income limit than regular Medicaid. That is what lets people with a pension or a larger Social Security check get help at home.
| Requirement | STAR+PLUS HCBS waiver (2026) |
|---|---|
| Monthly income | $2,982 per applicant, three times the SSI benefit rate |
| Countable assets | $2,000 for an individual; the home is generally exempt |
| Age or disability | 65 or older, or 21 and older with a disability |
| Medical need | Must meet a nursing facility level of care |
If your income is over the limit, a Qualified Income Trust, sometimes called a Miller Trust, can still make you eligible. Talk to an elder law attorney before setting one up.
Three ways STAR+PLUS pays for help at home
This is the part that confuses most families. Inside STAR+PLUS there are three different levels of home care support, and which one you get depends on your Medicaid status and how much help you need.
Personal Attendant Services (PAS)
Any STAR+PLUS member with full Medicaid and a documented need for help with daily activities can get attendant care through PAS. There is no waiting list. PAS is the service formerly known as Primary Home Care, and it is what most of our Pasadena families receive.
Community First Choice (CFC)
Community First Choice is for members with full Medicaid who meet an institutional level of care, meaning they would otherwise qualify for a nursing facility or similar setting. There is no waiting list, and it adds services like habilitation and emergency response on top of attendant care.
The STAR+PLUS HCBS waiver
The waiver is for people who need a nursing facility level of care but are not already on SSI Medicaid, using the higher income limit above. It covers the widest range of services, including care in an assisted living setting, but it has limited slots and often an interest list.
| Path | Who it is for | Waiting list |
|---|---|---|
| Personal Attendant Services | Members with full Medicaid who need help with daily activities | None |
| Community First Choice | Members with full Medicaid who meet an institutional level of care | None |
| STAR+PLUS HCBS waiver | People with income up to $2,982 a month who meet a nursing facility level of care | Often yes |
What benefits do seniors get through STAR+PLUS?
On top of regular Medicaid medical coverage, the long term services side of STAR+PLUS can include:
- Personal attendant services, including bathing, dressing, grooming, meals, and mobility help
- Skilled nursing visits and physical, occupational, or speech therapy
- Respite care, giving family caregivers a scheduled break
- Adult day programs with supervision and activities
- Assisted living services, for members in the HCBS waiver
- Home modifications such as grab bars and wheelchair ramps
- Adaptive aids and durable medical equipment
- Nonemergency medical transportation to appointments
- An emergency response device for members living alone
Health plans also offer their own extra benefits, called value added services, which can include things like additional dental or vision coverage. Exactly which services a member receives, and how many hours, is decided individually by their service coordinator based on a needs assessment.
The STAR+PLUS waiver waiting list
The STAR+PLUS HCBS waiver is not an entitlement. The state funds a set number of slots, and when they are full, new applicants go on what Texas calls an interest list. Names are released first come, first served as slots open, and the wait can run from months to years.
Two things are worth knowing. First, get on the list as early as possible, even before you think you need it, because your place is based on the date you asked. Second, you have to confirm each year that you are still interested, so keep your contact information current. If the state cannot reach you, your name can be removed.
If you already have full Medicaid through SSI, you may not need the waiver at all. PAS and Community First Choice have no waiting list.
How to apply for the STAR+PLUS waiver in Texas
- Get on the interest list. If you are not in STAR+PLUS yet, call Texas Health and Human Services at (877) 438-5658. If you are already a STAR+PLUS member, call your health plan and ask about the HCBS program instead.
- Apply for Medicaid when your name comes up. Apply at YourTexasBenefits.com, by phone at 211, by mail, or in person at a local office.
- Choose a health plan. You pick from the STAR+PLUS plans that serve your county.
- Complete the level of care assessment. Your plan assesses whether you meet a nursing facility level of care.
- Build your care plan. Your service coordinator sets your services and hours, and you choose agency directed care or Consumer Directed Services.
If you already receive SSI and just need help at home, skip the interest list. Call your STAR+PLUS health plan, ask for a service coordinator, and request an assessment for attendant care.
Not sure which path fits your family?
Our care coordinators help Pasadena area families figure out if PAS, Community First Choice, or the waiver applies, and get services started.
Star Plus program Texas phone numbers
- (877) 438-5658HHSC line to join the STAR+PLUS HCBS interest list
- (877) 782-6440STAR+PLUS program helpline
- (800) 964-2777Texas Medicaid enrollment broker, to choose or switch a health plan
- 211Texas information line for Medicaid applications and general help
- (281) 201-5872New Dimensions Caregivers, for help with home care in Pasadena and Southeast Houston
Choosing a STAR+PLUS health plan in the Houston area
Texas splits the state into 13 STAR+PLUS service areas, and each one has two or three health plans to choose from. The current contracts took effect in September 2024, and plans serving Harris County have included Community Health Choice and UnitedHealthcare Community Plan. Lineups change as contracts are renewed, so confirm your options with the enrollment broker at (800) 964-2777 before you choose. Members can switch plans if the first choice is not working.
If you have both Medicare and Medicaid
Texas ended its Medicare Medicaid Plan demonstration on December 31, 2025. Members in Harris County who were in one of those plans were moved into STAR+PLUS health plans on January 1, 2026. If that applies to your loved one, check which plan they are now in and confirm their home care authorization carried over.
Agency directed care or Consumer Directed Services
Once services are approved, members choose how care is actually delivered. Agency directed care means a licensed home care agency, like New Dimensions Caregivers, employs and manages the caregiver on the member's behalf. Consumer Directed Services, often called CDS, lets the member hire and manage their own caregiver directly, which in many cases can include a family member or someone the member already knows and trusts.
Neither option is universally better. Agency directed care includes built in backup coverage, supervision, and liability protection. CDS offers more control over exactly who provides care, which matters to some families more than the administrative support an agency provides. Our guide to choosing a PAS provider in Texas walks through what to look for in an agency.
Member rights and filing a complaint
Members have the right to a member handbook explaining their benefits, the right to request a fair hearing if a service is denied or reduced, and the right to file a complaint about their plan or a provider. If a problem comes up, the first step is contacting the health plan directly using the number on the member ID card. If it is not resolved, members can escalate to Texas Health and Human Services or call 211 for guidance on next steps.