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Texas STAR+PLUS Home and Community Based Services (HCBS) Waiver

The Texas STAR+PLUS HCBS waiver (1915(c)) provides home and community-based services to Medicaid-eligible adults 21 and older who have physical disabilities or are age 65+ and require a nursing facility level of care. Unlike the CFC entitlement program, STAR+PLUS HCBS provides an expanded service array including personal attendant care, home health, adult day health, day activity and health services, supported employment, financial management services, and emergency response. The Consumer Directed Services (CDS) option allows eligible relatives, friends, and other workers to be hired within program rules, but spouses and STAR+PLUS HCBS primary caregivers are excluded. Administered by managed care organizations under HHSC.

STAR+PLUS HCBS provides an extended service array beyond basic personal care, including personal assistance services, nursing, respite, supported employment, day activity and health services, financial management, adaptive aids, minor home modifications, emergency response, home-delivered meals, therapies, assisted living, adult foster care, and transition assistance. Under the CDS option, a member or legally authorized representative can hire and manage eligible service providers, including eligible family members and friends, through a required financial management services agency. HHSC rules exclude spouses from paid CDS employment except in CMPAS, and STAR+PLUS HCBS excludes the person's primary caregiver from being the CDS employee. CDS wages are set within the authorized service-plan budget and allowable limits rather than a single public hourly wage. STAR+PLUS HCBS eligibility requires age 21+, Texas residency, U.S. citizenship, full Medicaid financial eligibility, nursing-facility level of care, an individual service plan within cost limits, an unmet need for at least one STAR+PLUS HCBS service, and an appropriate living arrangement. The 2026 MEPD special income limit for institutional or HCBS waiver services is $2,982/month for an individual and $5,964/month for a couple; countable resources are $2,000 for an individual and $3,000 for a couple. Married waiver applicants use spousal impoverishment resource policy, and a qualified income trust can overcome the special income limit for HCBS waiver eligibility. Interest-list releases are part of the access process.

Eligibility

  • U.S. citizenship or qualified immigrant status required
  • Care recipient must have a qualifying disability
  • Care recipient age: at least 21
  • Relationship: parent, child, sibling, grandparent, other relative, non relative

Questions to ask the program

These are questions to ask the program, not a verdict on your eligibility. Confirm the current rules directly with the program.

  • Does the person receiving care live in Texas? — Residency is usually the first thing a program checks.
  • Does your relationship to the person — parent, child, sibling, grandparent, other relative, or non relative — count for this program?
  • What are the current income and asset limits, and whose income counts? — Our record lists gross monthly limit around $2,982 for a household of one — limits change, so confirm the current figures.
  • Is the person receiving care in the covered age range (21 or older)?
  • What counts as a qualifying disability or level of care need, and what documentation shows it?
  • Which citizenship or immigration statuses does the program accept, and which documents show it?
  • Is there a caregiver-specific department, coordinator, or support line? Ask for it by name. — Many agencies have one that isn’t advertised on the website.
  • What documents do you need from us to start an application?
  • Is there a waitlist right now, and how long is it?

Services

STAR+PLUS HCBS provides an extended service array beyond basic personal care, including personal assistance services, nursing, respite, supported employment, day activity and health services, financial management, adaptive aids, minor home modifications, emergency response, home-delivered meals, therapies, assisted living, adult foster care, and transition assistance. Under the CDS option, a member or legally authorized representative can hire and manage eligible service providers, including eligible family members and friends, through a required financial management services agency. HHSC rules exclude spouses from paid CDS employment except in CMPAS, and STAR+PLUS HCBS excludes the person's primary caregiver from being the CDS employee. CDS wages are set within the authorized service-plan budget and allowable limits rather than a single public hourly wage. STAR+PLUS HCBS eligibility requires age 21+, Texas residency, U.S. citizenship, full Medicaid financial eligibility, nursing-facility level of care, an individual service plan within cost limits, an unmet need for at least one STAR+PLUS HCBS service, and an appropriate living arrangement. The 2026 MEPD special income limit for institutional or HCBS waiver services is $2,982/month for an individual and $5,964/month for a couple; countable resources are $2,000 for an individual and $3,000 for a couple. Married waiver applicants use spousal impoverishment resource policy, and a qualified income trust can overcome the special income limit for HCBS waiver eligibility. Interest-list releases are part of the access process.

How to apply

  • Request an application (mailed within two working days); submit online through YourTexasBenefits.com, in the local office, or by mail, fax, or phone (2-1-1). Intake for the waiver itself is through HHSC or an HHSC-contracted provider, which determines the waiver component and helps with the financial Medicaid component. Enrollment is limited; a person may be on more than one interest list but can enroll in only one waiver at a time.

Use the official program page for application details: official program page.

  • tx-consumer-directed (companion): CDS is the self-direction option within STAR+PLUS; CFC (tx-consumer-directed) is a separate entitlement