Financial Assistance for Assisted Living in Texas

Texas Medicaid STAR+PLUS HCBS Waiver

Phone Number: (877) 782-6440
Website: https://hhs.texas.gov/services/health/medicaid-chip/medicaid -chip-members/starplus

In Texas, recipients of Medicaid who are aged 65 and over receive services through the STAR+PLUS managed care program. The long-term support services available in this program are intended to help keep the senior population outside of nursing facilities. This may include an assisted living facility if eligible for the additional home and community-based services (HCBS) available with this waiver program. Seniors who receive the HCBS waiver are covered for a wide range of care and services, although there are waiting lists for some services.

Applicants for the HCBS waiver must be aged 65+ or disabled, and it must be determined that the services available are necessary to avoid nursing home placement. They must also be eligible for Medicaid and within the income and asset limits. As of 2020, the income limit is $2,349, which is 300% of the federal benefit rate, and the asset limit is $2,000.

Community First Choice (CFC)

Phone Number: (877) 541-7905
Website: https://hhs.texas.gov/doing-business-hhs/provider-portals/long-term-care-providers/resources/community-first-choice-cfc

This program provides many of the same services available via the HCBS waiver. However, the Community First Choice program is a Medicaid entitlement, which means eligible Texans receive services immediately, and the eligibility requirements are slightly easier to navigate. Residents of assisted living facilities are covered for personal care received, such as assistance from caregivers and with some health-related tasks. The CFC program doesn’t cover room and board.

Applicants for Community First Choice must be receiving, or be eligible for, Medicaid. They must also be assessed on their need for the available services. The need for services is largely based on the number of everyday tasks the applicant needs help with, and it must be determined that CFC services will prevent nursing home placement.

Community Care for Aged and Disabled (CCAD)

Phone Number: (877) 541-7905
Website: https://hhs.texas.gov/laws-regulations/handbooks/case-worker-community-care-aged-disabled-handbook

CCAD provides eligible residents with a similar set of personal care and community-based services as the HCBSCFC waiver and program. However, the main difference is that Community Care for Aged and Disabled is a non-Medicaid program and is instead the responsibility of Texas Health and Human Services. Personal care received in certain assisted living facilities is covered.

There is no age requirement for CCAD. As of 2020, the income limit for an individual is $2,349, or $4,698 for a couple. There is also a limit of $5,000 in non-exempt assets for an individual or $6,000 for a couple. Eligibility for each service is determined individually based on the functional impairments and the need for assistance.

Source: https://www.senioradvice.com/assisted-living/texas

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