Does Medicaid Cover Non-Medical Home Care in Texas?
Yes — Texas Medicaid covers non-medical home care, and through more pathways than most families realize. If your loved one needs help with bathing, dressing, meals, or housekeeping (but not nursing care), there are four main Medicaid routes to getting that help paid for — plus a state-funded backup for people who don't qualify for Medicaid at all.
Here's the map.
First, What Counts as "Non-Medical" Home Care?
Non-medical home care (also called personal attendant services or personal care) is hands-on help with daily living:
- Bathing, dressing, grooming, toileting
- Transfers, mobility, and fall prevention
- Meal preparation and feeding
- Light housekeeping and laundry
- Shopping, errands, medication reminders
- Escort to appointments and companionship
It does not include skilled tasks like wound care, injections, or therapy — that's home health care, typically paid by Medicare. The difference matters for who pays: Home Care vs. Home Health Care.
The Four Medicaid Pathways in Texas
1. Primary Home Care (PHC). The classic route for adults with full Medicaid: attendant services up to 50 hours/week, no waiting list, based on a doctor's statement and a functional assessment. Full PHC guide.
2. Community Attendant Services (CAS). The best-kept secret in Texas long-term care: the same attendant services for people whose income is too high for regular Medicaid — up to about $2,982/month in 2026. Any age, no waiting list. Who qualifies for CAS.
3. STAR+PLUS. Most adults on Texas Medicaid (SSI recipients and adults 65+ or with disabilities) are enrolled in a STAR+PLUS managed care plan, and receive personal attendant services through their health plan's service coordinator. For people who need a nursing-facility level of care, the STAR+PLUS HCBS waiver adds a much bigger package — respite, home modifications, emergency response, meals, and more. How STAR+PLUS works.
4. Community First Choice (CFC). A statewide Medicaid entitlement (Texas was the first state to adopt it) for people who need an institutional level of care: personal attendant services, habilitation, emergency response systems, and caregiver support management — with no interest list, ever.
And If Your Loved One Doesn't Qualify for Medicaid?
The Family Care program provides the same kind of attendant care through state Title XX funds for people who don't qualify for any of the Medicaid options. It has an income limit (about $2,982/month in 2026) and a waiting list, so signing up early matters. Family Care explained.
What About Medicare?
This surprises many families: Medicare does not pay for non-medical home care. Medicare explicitly excludes "custodial or personal care" when it's the only care needed, along with homemaker services and 24-hour home care. Medicare pays for home health — intermittent skilled nursing and therapy for homebound patients — but not for the daily personal care most aging adults actually need. In Texas, that gap is filled by Medicaid (the four pathways above), Title XX, VA programs, long-term care insurance, or private pay (which runs around $30/hour in Texas).
Which Pathway Fits Your Family? A Quick Guide
- Loved one has Medicaid/SSI → PHC, or attendant services through their STAR+PLUS plan
- Income too high for Medicaid (under ~$2,982/mo) → CAS — no waiting list
- Needs nursing-home-level care but wants to stay home → STAR+PLUS HCBS waiver or CFC
- Doesn't qualify for Medicaid at all → Family Care (join the interest list now)
- Family member providing the care → in most of these programs, they can be paid for it: How much does Texas pay family caregivers?
How to Apply
For PHC, CAS, or Family Care, call the Texas HHS Community Care Services intake line at 888-241-1570 (or dial 2-1-1). If your loved one is already in STAR+PLUS, call the service coordinator number on their health plan card. And if the paperwork feels overwhelming — that's normal, and it's exactly what we help families with.
Rahma Home Care Agency serves Dallas, Fort Worth, Arlington, Plano, and surrounding North Texas communities. Call (945) 286-4004 and we'll help you find the right program in one conversation.
Program rules and figures current as of 2026 and subject to change. Official sources: hhs.texas.gov and medicare.gov.