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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 family members to be hired as paid attendants. Administered by managed care organizations under HHSC.

STAR+PLUS HCBS provides an extended service array beyond basic personal care: adult day health care, home health aide, nursing, respite (up to 35 days/year for live-in caregivers), supported employment, day activity and health services (DAHS), and financial management. Under the CDS option, participants can hire and manage their own attendants, including family members. Pays attendants $10–$18/hr depending on managed care organization. Waitlists are common; apply as early as possible. Medicaid financial eligibility under Texas MEPD special-income rules and nursing-facility level of care are required; 2026 screening uses $2,982/month for an individual and $5,964/month for a couple.

Some details for this program are still being verified. Check the official source for the most current information.

Eligibility

  • Care recipient must have a qualifying disability
  • Care recipient age: at least 21
  • Relationship: spouse, parent, child, sibling, grandparent, other relative, non relative

Services

STAR+PLUS HCBS provides an extended service array beyond basic personal care: adult day health care, home health aide, nursing, respite (up to 35 days/year for live-in caregivers), supported employment, day activity and health services (DAHS), and financial management. Under the CDS option, participants can hire and manage their own attendants, including family members. Pays attendants $10–$18/hr depending on managed care organization. Waitlists are common; apply as early as possible. Medicaid financial eligibility under Texas MEPD special-income rules and nursing-facility level of care are required; 2026 screening uses $2,982/month for an individual and $5,964/month for a couple.

How to apply

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