How to Qualify for Medicaid Home Care in Texas

What Is Texas Medicaid Home Care?

Texas Medicaid offers several programs that pay for in-home personal care services — meaning a trained caregiver can come to your home and assist with daily tasks at little or no cost to you. These programs are designed for elderly individuals, people with disabilities, and children with special needs who qualify based on medical and financial criteria.

Wellness Home Health LLC is authorized to provide services under multiple Texas Medicaid programs including PAS, Star Plus Waiver (SPW), Starkids (SK), Family Care (FC), Community Attendant Services (CAS), Community First Choice (CFC), and Personal Care Services (PCS).

Who Qualifies for Texas Medicaid Home Care?

To qualify for Medicaid-funded home care in Texas, you generally need to meet both medical and financial eligibility criteria:

• Medical eligibility: You or your loved one must have a documented need for personal care assistance — such as difficulty with bathing, dressing, meal preparation, or medication management due to age, illness, or disability.
• Financial eligibility: Income and asset limits apply. In 2024, individuals generally must have income at or below 100–300% of the Federal Poverty Level depending on the specific program.
• Texas residency: You must be a Texas resident and U.S. citizen or qualified immigrant.
• Age: Most programs serve adults 65+ or adults with disabilities 18+. The Starkids program serves children with disabilities.

Step-by-Step: How to Get Started

Step 1 — Apply for Medicaid

If your loved one is not already on Texas Medicaid, apply through Texas Health and Human Services (HHSC) at yourtexasbenefits.com or by calling 2-1-1. You will need to provide proof of income, residency, and identity.

Step 2 — Request a Needs Assessment

Once enrolled in Medicaid, HHSC will conduct a functional needs assessment — either by phone or in person — to determine what level of care is needed and which program you qualify for.

Step 3 — Choose an Authorized Provider

After your care level is determined, you choose a licensed home care provider like Wellness Home Health LLC. We are authorized under multiple Texas Medicaid managed care plans including Molina Healthcare, Superior Healthplan, and United Healthcare.

Step 4 — Begin Care

Once matched with a caregiver, services begin — typically within a few days to a week. Your care plan is reviewed regularly to ensure it continues to meet your needs.

Which Medicaid Program Is Right for You?

Texas has multiple Medicaid home care programs, each serving a slightly different population. Here is a quick overview of the most common ones:

• PAS (Personal Assistance Services): The most common program, covering help with daily activities for adults who qualify medically and financially.
• CFC (Community First Choice): A federally-funded program that often has less restrictive eligibility and covers a broad range of personal care services.
• CAS (Community Attendant Services): For low-income adults who need personal care but do not yet meet the nursing home level of care.
• Star Plus Waiver (SPW): For adults 21+ who qualify for nursing home care but choose to receive services at home instead.
• Starkids (SK): For children with disabilities under 21 who need complex medical care.
• Family Care (FC): For individuals who do not qualify for other Medicaid programs but still need in-home assistance.

Does Medicaid Cover All Home Care Costs?

For most qualifying individuals, Texas Medicaid covers the full cost of authorized home care services with no out-of-pocket expense. Some programs may have small co-pays depending on income level. Private Pay and supplemental insurance options are also available for those who do not qualify for Medicaid.