Primary Home Care provides in home attendant services to eligible Texans who need help with daily activities like bathing, dressing, eating, and light housekeeping. It has existed for decades as one of the state's core personal care programs. What confuses a lot of families searching for it today is that the name has largely been replaced. Current Texas Health and Human Services guidance describes today's PAS, or Personal Attendant Services, as the program formerly known as Primary Home Care. In practice, they are the same service under two names, with PHC still used specifically in certain transitional situations.
Who Primary Home Care serves
PHC is available to Texas residents age 21 or older who receive Supplemental Security Income, which automatically enrolls them in Texas Regular Medicaid. Eligibility also requires a documented medical need, meaning a health care practitioner has confirmed the person's condition causes a genuine limitation in performing at least one activity of daily living.
Because eligibility is tied to SSI rather than the separate income test used for the STAR+PLUS HCBS waiver, the income limits are lower. For 2026, an individual must have income under roughly $994 per month, and a married couple's combined income must stay under approximately $1,491 per month. The asset limit follows regular Medicaid rules, $2,000 for a single applicant and $3,000 for a couple, with a primary home generally exempt.
How PHC compares to the STAR+PLUS HCBS waiver
These two programs get confused constantly, and the differences actually matter quite a bit for a family trying to plan ahead.
| Feature | Primary Home Care | STAR+PLUS HCBS waiver |
|---|---|---|
| Eligibility basis | Tied to SSI and regular Medicaid | Separate income and asset test |
| 2026 income limit | About $994 single, $1,491 couple | $2,982 per applicant |
| Waiting list | None, guaranteed entitlement | Often yes, varies by region |
| Setting | Own home or a loved one's home only | Broader home and community settings |
The entitlement detail matters
Because PHC is a Medicaid entitlement rather than a waiver, anyone who meets the eligibility requirements is guaranteed services, without being placed on an interest list. Families who assume every Texas home care program has a long wait are often relieved to learn this particular path does not.
What Primary Home Care actually covers
PHC provides nontechnical, medically related personal care tasks delivered by a trained attendant, including help with bathing, grooming, toileting, eating, and mobility, along with housekeeping tasks needed to keep the home clean and safe. It does not include skilled nursing care. Participants must live in their own home or the home of a loved one. PHC does not cover care provided in an assisted living facility or an adult foster care home.
How care is delivered
Like the broader PAS program discussed in our guide to choosing a PAS provider, PHC offers both an agency option, where a licensed provider hires and supervises the attendant, and a participant directed option, where the individual manages their own attendant with support from the state.
Provider licensing requirements
Providers delivering PHC services must be licensed as a Home and Community Support Services Agency, within a category covering licensed home health services or personal assistance services, and must hold a direct contract with Texas Health and Human Services specifically to provide PHC. This licensing and contracting structure is set out in the Texas Administrative Code, and it is worth asking any provider you are considering to explain clearly how they meet it.
Trying to figure out which program applies to you?
Our care coordinators can help you understand how PHC, PAS, and the STAR+PLUS waiver relate to your specific situation.