Texas's STAR+PLUS Home and Community Based Services waiver can help pay for assisted living, memory care, and in-home care. Here's how Dallas-area families apply and what to expect.
By Sandra Boyd, CSA · February 3, 2026
STAR+PLUS is Texas's Medicaid managed-care program for adults who are older or who have disabilities, and it delivers long-term services and supports through managed care organizations. Layered on top is the STAR+PLUS Home and Community Based Services (HCBS) waiver, which can cover personal care, attendant care, adult day care, and — in a participating assisted living facility — attendant and personal care services, for seniors who meet a nursing-facility level of care and Texas's income and asset limits. Like most state Medicaid waivers, it generally does not pay room and board in an assisted living setting; residents typically apply Social Security income toward rent and meals, with the waiver covering personal care and services on top.
STAR+PLUS is delivered through managed care organizations that hold Texas Medicaid contracts, including Molina Healthcare, UnitedHealthcare Community Plan, Superior HealthPlan (Centene), and Aetna Better Health. Which organizations are available can vary by service area, so Dallas-area families should confirm current plan options with HHSC or their local Area Agency on Aging before assuming a specific plan is available.
Eligibility for the STAR+PLUS HCBS waiver has two tracks: a functional assessment — a medical necessity and level-of-care determination confirming a nursing-facility level of need — and a financial assessment based on income and asset limits set by Texas Medicaid rules. Because the HCBS waiver is a waiver program rather than an entitlement, there can be an interest list (Texas's term for a waiting list), and demand often exceeds available slots, so families should not wait for a crisis to get on the list.
Given the interest list, the single most useful thing a Dallas family can do is start early — ideally well before a crisis forces a decision. Families apply for Medicaid through YourTexasBenefits.com, and HHSC coordinates the medical necessity and level-of-care assessment. Getting on the STAR+PLUS HCBS interest list as soon as a need is anticipated protects a family's place while the financial and functional pieces come together.
The Dallas Area Agency on Aging, operated by The Senior Source, is the primary free resource for Dallas County families navigating STAR+PLUS and the HCBS waiver, functioning as the region's Aging and Disability Resource Center. Families in Collin, Denton, and Rockwall counties can turn to the Area Agency on Aging of North Central Texas, and Tarrant County families (including Arlington) to the Area Agency on Aging of Tarrant County. Anyone in the metro can dial Texas 2-1-1 to reach the HHSC Aging and Disability Resource Center.
A free senior care advisor who works regularly with Dallas-area facilities can also help identify which local assisted living communities currently accept STAR+PLUS managed care organizations, since not every facility participates in every plan. Pairing an Area Agency on Aging screening with an advisor's knowledge of which local communities have Medicaid-approved openings can meaningfully shorten the path from application to placement.
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