STAR+PLUS and Home Care in Texas: What Families Need to Know

If your loved one is an adult on Texas Medicaid, chances are their home care doesn't come from a state office — it comes through STAR+PLUS, the Medicaid managed care program for seniors and adults with disabilities. Understanding how STAR+PLUS works is the key to unlocking help at home for most Texas families.

What Is STAR+PLUS?

STAR+PLUS is Texas Medicaid delivered through private health plans (managed care organizations, or MCOs). Adults who get SSI, adults 65 and older on Medicaid, and adults with disabilities are generally enrolled in a STAR+PLUS plan, which covers both their medical care and their long-term services and supports — including non-medical home care.

In the Dallas and Tarrant County service areas, plans include Molina, UnitedHealthcare Community Plan, Superior HealthPlan, and Wellpoint — availability depends on the county.

Every STAR+PLUS member gets a service coordinator — and this person is the most important phone number on your loved one's health plan card. The service coordinator assesses needs, builds the service plan, and authorizes home care hours.

Home Care Through Regular STAR+PLUS

You do not need a "waiver" for basic help at home. Standard STAR+PLUS benefits include personal attendant services — bathing, dressing, meals, housekeeping, errands — authorized by the plan based on assessed need. This is the managed-care version of the state's Primary Home Care program, and it's how most members receive care.

If your loved one is on STAR+PLUS and struggling at home, the first step is one phone call: ask the health plan for a service coordination assessment for personal attendant services.

What the STAR+PLUS HCBS Waiver Adds

For people whose needs have grown to a nursing-facility level of care, the STAR+PLUS Home and Community Based Services (HCBS) waiver funds a much larger package so they can stay home instead of entering a facility:

• Personal attendant services (including the option to pay family caregivers)
• In-home and out-of-home respite for family caregivers
• Nursing visits and therapies (PT/OT/speech)
• Home-delivered meals and emergency response systems
• Minor home modifications (grab bars, ramps) and adaptive aids
• Day activity programs, adult foster care, or assisted living as alternatives

Financial eligibility (2026): income up to about $2,982/month and countable assets under $2,000 for an individual, with significant protections for a spouse still living at home. The family home is generally exempt.

The Two Ways Into the Waiver

1. The interest list. Texans not yet on Medicaid can join the STAR+PLUS HCBS interest list by calling 844-438-5658. Be warned: the wait is measured in years, so join early — the sign-up date holds your place.
2. The "waiver upgrade" — often much faster. If your loved one is already a STAR+PLUS member and their needs now meet a nursing-facility level of care, the health plan's service coordinator can request an upgrade assessment directly — no interest list involved.

Also worth knowing: Community First Choice (CFC) provides attendant services, habilitation, and emergency response to Medicaid members who meet an institutional level of care as an entitlement — no interest list — and can cover much of what families need while waiting on the waiver.

Can Family Members Be Paid Caregivers Under STAR+PLUS?

Yes — through the agency option or the Consumer Directed Services (CDS) option, most relatives (adult children, siblings, and others, though not spouses) can be hired and paid to provide the authorized care. Current pay figures: How Much Does Texas Pay Family Caregivers?

How Rahma Home Care Agency Fits In

Once STAR+PLUS authorizes attendant services, the family chooses a licensed agency to deliver them. Rahma Home Care Agency works with families across Dallas, Fort Worth, Arlington, Plano, and surrounding communities — providing trusted attendants, helping navigate service coordinators, and hiring family caregivers where the rules allow.

Call (945) 286-4004 and we'll help you take the next step with your loved one's plan.

Program details current as of 2026 and subject to change. Official source: hhs.texas.gov (STAR+PLUS).