Assisted Living Cost in Texas: 2025 Medians and STAR+PLUS HCBS

Assisted Living Cost in Texas: 2025 Medians and STAR+PLUS HCBS

Key takeaways

• CareScout 2025 Texas median assisted living: $5,666/month ($67,992/year), near the national $6,200/month median.[1][2]

• Medicare does not pay for most custodial AL.[3]

• For many adults 21+, Texas STAR+PLUS Home and Community-Based Services (HCBS) can include assisted living services in HHSC-licensed personal care facilities contracted with the member’s MCO. Members remain responsible for room and board (and sometimes a copayment).[4]

• We do not determine STAR+PLUS eligibility. Confirm with Texas Health and Human Services / your MCO.

• Related: Assisted living and memory care costs (hub)

• Related: Long-term care options

• Related: Medicaid eligibility

• Related: Long-term care insurance and costs

• Related: Family caregiver guide

• Related: Aging in place: home modifications

• Related: How to find SHIP/SHIBA

Texas cost range (CareScout 2025)

Survey July–November 2025; CareScout state median tables opened.[1][2]

Memory care: No dedicated CareScout 2025 memory-care median in tables we opened—request written quotes.

Medicare reminder

Medicare.gov: long-term custodial care is generally Not Covered; you pay non-covered costs unless Medicaid or private LTC insurance helps.[3]

Texas SHIP: how to find SHIP/SHIBA.

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STAR+PLUS HCBS assisted living — what HHSC’s handbook says

HHSC’s STAR+PLUS Handbook §7200 (opened this review) describes assisted living under the STAR+PLUS HCBS program as a 24-hour living arrangement in personal care facilities licensed by HHSC when independent living at home is no longer workable.[4]

Key consumer points from that handbook section (verify current handbook text before relying on them):[4]

• Services are provided in HHSC-licensed personal care / AL facilities that are contracted with the member’s MCO.
• Members are responsible for room and board costs and, if applicable, a copayment.
• Room and board is framed around the SSI federal benefit rate minus a personal needs allowance (handbook cites an $85 personal needs allowance; amounts can change—confirm current figures).
• SSI recipients generally do not owe the AL copayment; members whose financial eligibility used special institutional criteria may owe a copayment.
• Refusal to pay required room and board / copayment can lead to service termination under program rules.

Start with Texas HHS consumer pages and your MCO service coordinator—not facility marketing flyers. Broader Medicaid concepts: Medicaid eligibility. Optional screen:

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Eldercare Locator: eldercare.acl.gov / 1-800-677-1116.

Practical checklist for Texas families

1. Get two written quotes (base rate + care levels + move-in fees).
2. Ask: Are you contracted for STAR+PLUS HCBS AL with major MCOs in this county?
3. Ask what monthly room and board a STAR+PLUS member would still pay.
4. Call Area Agency on Aging / ADRC via Eldercare Locator about Medicaid LTC pathways.
5. Weigh home supports: aging in place.
6. Caregiver load: family caregiver guide.

FAQ

If we get STAR+PLUS HCBS, is assisted living free?
No. HHSC’s handbook states members pay room and board and may owe a copayment.[4]

Does STAR+PLUS cover memory care automatically?
Coverage depends on program eligibility, the service plan, and whether the facility/setting is contracted and appropriate. Confirm with the MCO—do not assume “memory care” is a separate automatic benefit.

Sources

1. CareScout. Cost of Care Report. https://www.carescout.com/cost-of-care. Survey July–November 2025. Accessed October 30, 2026.
2. CareScout. Cost of Care Survey 2025 median tables (PDF). https://assets.carescout.com/x/8fcb50422f/282102.pdf. Accessed October 30, 2026.
3. Medicare.gov. Long-term care. https://www.medicare.gov/coverage/long-term-care. Accessed October 30, 2026.
4. Texas Health and Human Services. STAR+PLUS Handbook §7200 Assisted Living Services. https://www.hhs.texas.gov/handbooks/starplus-handbook/7200-assisted-living-services. Accessed October 30, 2026.

Disclaimer

This article is for general education only and is not medical, legal, or financial advice. We do not sell facilities, insurance, or cost PDFs. Only Texas HHS, Medicaid eligibility workers, and your MCO determine STAR+PLUS HCBS eligibility and cost sharing. Talk with those agencies, a licensed attorney, or a SHIP counselor. In an emergency, call 911.

Attribution

Portions of this page are adapted from "HowToLiveBetter" (高性价比人生指南) by eternity4719, https://github.com/eternity4719/HowToLiveBetter, licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Changes: adapted and rewritten for the U.S. context (not a direct translation), and re-sourced to U.S. research and official guidance.