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Texas & the Permian Basin · plain-English money guide

Paying for senior care in Texas, in plain English.

The money question is the scariest one. Here's how Texas families actually pay for senior care — private pay, long-term care insurance, VA benefits, and Texas Medicaid, decoded in plain English. Free, local help from Kendall Warren, BCPA·CSA.

The four ways families pay.

Almost every plan is some combination of these four. Most families use more than one — and the mix changes as needs change.

  1. Private pay

    Paying out of pocket — from savings, Social Security, a pension, or the sale or use of home equity. It's the most flexible option (your family chooses any provider) and the most common way care starts. The worry is how long it lasts. A smart plan stretches private pay and lines up the next source before the savings run thin — which is exactly the kind of thing Kendall maps out with families.

  2. Long-term care insurance

    If your parent bought a long-term care policy years ago, it may cover in-home care, assisted living, or nursing care — but only after an “elimination period” and only up to daily or monthly limits. Dig out the policy. Many families don't realize a benefit is sitting there, and the paperwork to activate it trips people up. Bring it to Kendall and she'll help you read what it actually pays.

  3. VA benefits — Aid & Attendance

    If your parent is a wartime veteran (or the surviving spouse of one) and needs help with daily activities, the VA's Aid & Attendance pension can add a meaningful monthly amount on top of a basic VA pension to help pay for care. Kendall's services are veteran-supported — she helps veteran families navigate home-care benefits and can point you to accredited, no-cost filing help.

  4. Texas Medicaid

    For families who can't private-pay indefinitely, Medicaid is the long-term safety net — and Texas has several programs that pay for care at home, not just in a nursing facility. It's also the most misunderstood: Texas Medicaid has income and asset rules, a five-year look-back, and a lot of jargon. The next section decodes it.

What care actually costs in Texas.

These are approximate ranges, not quotes. Every family's situation — hours of care, level of need, exact town — changes the number. Use them to get oriented, then get the real figure from someone local.

  • In-home care (a caregiver comes to the house): roughly $25–$35/hour, billed by the hour; cost depends on how many hours a week your family needs.
  • Adult day care (daytime supervision, meals, activities): roughly $1,500–$2,000/month — often the most affordable option when a caregiver just needs the daytime hours covered.
  • Assisted living (help with daily living, own apartment): roughly $4,500–$6,000/month base rate; extra help with bathing, dressing, or medications can add to it.
  • Memory care (secured setting for Alzheimer's/dementia): meaningfully more per month than standard assisted living.
  • Nursing home (skilled nursing, semi-private room): roughly $5,500–$7,500/month; a private room costs more — this is the highest level of round-the-clock care.

These ranges are drawn from national and Texas cost-of-care surveys (e.g. Genworth / CareScout) and are shown as approximate figures only — they are not a price you'll be charged. Actual costs vary widely by town, by community, and by how much help your mom or dad actually needs. For real Permian Basin numbers, call Kendall at (432) 901-6465 — there's no charge to ask.

Texas Medicaid, decoded.

First, the thing that trips up every family: Texas did not expand Medicaid. That means qualifying is about specific long-term-care programs and strict income and asset limits — not a simple “low income = covered” rule. Here are the programs that actually pay for senior care.

  • STAR+PLUS (HCBS waiver) — Texas's main home & community-based waiver: it pays for care at home or in assisted living so your parent can avoid a nursing facility. It's managed care with limited enrollment, so there can be a waitlist. Getting on the list early matters.
  • CFC (Community First Choice) — personal-care help — bathing, dressing, meals — for those who qualify. Unlike the waiver, CFC is an entitlement (no waitlist if you're eligible), and it includes a self-direction option that can let a family member be the paid caregiver.
  • PHC (Primary Home Care) — non-technical, in-home personal care for adults with a medical need for help with daily activities. A long-standing Texas program that brings a caregiver into the home.
  • DAHS (Day Activity & Health Services) — Texas's Medicaid adult day care: daytime nursing, meals, and activities at a licensed center. A lifeline for a working daughter who can't be home during the day.
  • MFP (Money Follows the Person) — helps a parent who's already in a nursing home move back into the community, with Medicaid services following them home instead of staying tied to the facility.
  • PACE (Program of All-Inclusive Care) — for those 55+ who qualify, PACE combines Medicare and Medicaid into one program — doctors, day center, therapy, and home care coordinated together. Available only in certain Texas areas.

The 2026 numbers that decide who qualifies

These are the long-term-care Medicaid figures families ask about most. Rules and dollar amounts change every year.

  • Income limit — single applicant: ~$2,982/month
  • Asset (resource) limit — applicant: $2,000
  • Community-spouse resource allowance (what the at-home spouse may keep): up to ~$162,660
  • Personal needs allowance (pocket money the resident keeps): ~$75/month
  • Look-back on asset transfers: 5 years (60 months)

These are 2026 figures. Verify current amounts with Texas Health and Human Services at hhs.texas.gov — the numbers are adjusted regularly, and your family's exact situation can shift how they apply. Texas also runs 28 Area Agencies on Aging that offer free benefits counseling.

The five-year look-back — and why planning early matters

When your parent applies for long-term-care Medicaid, Texas reviews the past five years of financial records. If money or property was given away or sold for less than it was worth during that window — even a generous gift to a grandchild — it can trigger a penalty period where Medicaid won't pay, calculated from the amount transferred.

This is why families who wait until the crisis often get caught. Moves that are perfectly legal and smart when done early can backfire if they're done inside the look-back window. It is not too late to plan — but the sooner you understand the rules, the more options your family keeps. When real dollars and a house are on the line, this is the moment to talk with Kendall and a qualified Texas elder-law attorney.

“Can I get paid to care for my parent?”

Yes — honestly, in some situations you can. So many daughters have already left work, or cut back, to care for a mom or dad. There are real programs that can put some money behind that love:

  • Medicaid Community First Choice (CFC), self-direction: for families who qualify, the self-direction option can let your parent choose you as their paid personal-care attendant.
  • Primary Home Care (PHC): another Texas Medicaid path that brings paid in-home personal care into the house.
  • Certain VA programs: some VA benefits, including Aid & Attendance and veteran-directed care options, can help compensate family caregivers of veterans.

The rules on who can be paid, and how, are specific — spouses, for instance, are treated differently under some programs. Kendall helps families navigate these home-care benefits and can point you to the right door.

This maze is exactly what Kendall untangles — free.

You don't have to master waivers, look-backs, and VA forms on your own at 11 p.m. Kendall Warren, BCPA·CSA, has spent 10+ years walking Permian Basin families through the money question — and her guidance is free and independent. When your family needs hands-on help, she connects you directly to trusted local caregivers and communities. You're always free to choose anyone.

Need hands-on help now? Call the 24/7 home-care line at 432-695-6489, or the senior placement line at (432) 994-8088 — Kendall's guidance stays free and independent either way.

Before you make any decisions

This page is general information, not legal or financial advice. It's meant to help you understand your options in plain English — nothing here is tailored to your family's specific situation, and it isn't a substitute for professional guidance.

Medicaid rules, income and asset limits, and program details change regularly. Always verify current amounts and eligibility with Texas Health and Human Services at hhs.texas.gov. Cost ranges shown on this page are approximate figures drawn from national and Texas cost-of-care surveys (e.g. Genworth / CareScout), not quotes.

Before acting on anything involving real money, your parent's home, or a Medicaid application, talk with Kendall — (432) 901-6465 — or a qualified Texas elder-law attorney about your specific situation. And for medical questions, contact your loved one's care team; if anything ever feels like an emergency, call 911.

Questions families ask

Does Medicaid pay for assisted living in Texas?

Sometimes — but not the way people expect. Standard Texas Medicaid does not simply “cover assisted living rent.” What can help is the STAR+PLUS HCBS waiver, which may pay for the care services a person receives in an assisted living facility (not the room-and-board portion). Because the waiver has limited enrollment, there can be a waitlist, so applying early matters. The rules are specific to your parent's income, assets, and level of need. Call Kendall at (432) 901-6465 to walk through whether the waiver could fit your family.

What is the Medicaid five-year look-back?

When your parent applies for long-term-care Medicaid in Texas, the state reviews the previous 60 months (five years) of financial records. If assets were given away or sold for less than fair value during that window — including well-meaning gifts — it can create a penalty period during which Medicaid won't pay for care. That's why moves that are smart when done early can backfire if done during a crisis. It's rarely too late to plan, but the sooner you understand the look-back, the more options your family keeps. For real dollars, involve Kendall and a qualified Texas elder-law attorney.

Can my mom keep her house on Medicaid?

In many cases, yes — a primary home is often treated as an exempt asset while your parent is alive and receiving Medicaid, especially if a spouse still lives there or she intends to return home. So the house usually doesn't have to be sold just to qualify. The part families miss is Medicaid Estate Recovery: after a Medicaid recipient passes away, Texas may seek repayment from the estate, which can include the home. There are exceptions and planning strategies. This is exactly the situation to review with Kendall and an elder-law attorney before making any decision about the house.

How do I get paid to care for my parent?

Honestly — in some situations you can. Texas Medicaid Community First Choice (CFC) includes a self-direction option that can allow your parent to hire a family member as their paid personal-care attendant, and Primary Home Care (PHC) is another in-home path. Certain VA programs can also help compensate family caregivers of veterans. Eligibility rules are specific — and spouses are often treated differently than adult children. Kendall helps families navigate these home-care benefits and can point you to the right program — call her at (432) 901-6465.

Does Medicare pay for long-term care?

Largely, no. This is the single most common — and most expensive — misunderstanding. Medicare is health insurance, not long-term-care insurance. It may cover a short, skilled stay (for example, limited days in a skilled nursing facility after a qualifying hospital stay, or short-term home health after an illness), but it does not pay for ongoing custodial care — the day-to-day help with bathing, dressing, meals, and supervision that most seniors actually need over time. That gap is why families turn to private pay, long-term care insurance, VA benefits, and Medicaid. If you assumed Medicare had this covered, you're not alone — call Kendall at (432) 901-6465 and she'll help you build a plan that does.

You don't have to figure this out alone

You don't have to figure out the money alone.

One phone call with Kendall can save your family months of guessing — and often, real money. It's free, it's local, and there's no obligation.

Call Kendall — (432) 901-6465Start a conversation
24/7 home-care line: 432-695-6489Senior placement line: (432) 994-8088

Kendall's guidance is free and independent — you are always free to choose any provider. We don't accept referral fees.

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