Does Medicare Pay for Assisted Living In Texas?

No - Medicare does not cover the cost of assisted living in Texas. This is one of the most common points of confusion we hear from families.

While Medicare helps with medical care, it doesn’t pay for long-term custodial care - things like help with bathing, dressing, or managing daily routines.

These services make up the core of assisted living, but they’re considered non-medical and fall outside of what Medicare was designed to cover.

There are some situations where Medicare will cover short-term care in a skilled nursing facility after a qualifying hospital stay. But once rehab ends and the focus shifts to personal care or housing, that coverage stops.

That said, you still have options. From Medicaid programs and veterans benefits to long-term care insurance and personal financial strategies, there are several ways Texas families can get help covering assisted living costs.

Let’s walk through what assisted living includes and how to make it more affordable.

What Is Assisted Living?

Assisted living is a type of housing for older adults who need help with daily activities - but don’t require full-time medical care.

It’s not the same as a nursing home, which is more focused on skilled nursing and round-the-clock medical support.

In assisted living, residents typically get help with:

• Bathing and dressing
  
• Taking medications
  
• Preparing meals
  
• Housekeeping
  
• Transportation
  
• Mobility support
  

These are called non-medical or “custodial” services - and that distinction matters when it comes to Medicare coverage.

Think of it this way: assisted living feels like apartment-style living, with added help available when you need it. It’s ideal for people who are mostly independent but need some support to stay safe and comfortable each day.

Understanding that assisted living is not medical care is key to understanding why Medicare doesn’t pay for it - and what other programs might be able to help.

What Medicare Will Pay for (And What It Won’t)

Let’s be clear: Medicare does not cover assisted living costs.

That includes:

• Room and board
  
• Help with daily activities like bathing, dressing, or eating
  
• Medication reminders
  
• Meal preparation
  
• General custodial care
  

These are considered non-medical services, and Medicare wasn’t designed to pay for them.

What Medicare Will Cover

While Medicare doesn’t pay for assisted living itself, it may help cover certain short-term medical services - even if you live in an assisted living facility.

These include:

• Skilled nursing care, if it follows a qualifying hospital stay (at least three days inpatient)
  
• Physical or occupational therapy, when medically necessary
  
• Home health care for specific needs, like wound care or injections
  
• Hospice care, when end-of-life services are required
  

These services are covered under Medicare Part A or Part B, but only when specific medical criteria are met.

Bottom line: Medicare won’t help pay for the “living” part of assisted living - but it may pay for certain health services delivered in that setting.

Knowing the difference can save you a lot of time, frustration, and surprise bills.

How Much Does Assisted Living Cost?

In Texas, assisted living typically costs between $3,500 and $5,000 per month - and that’s just for basic services like housing, meals, and help with daily activities.

If your loved one needs memory care for Alzheimer’s or dementia, expect to add another $1,000 to $1,500 per month to that total. These facilities are more specialized and often require more staffing and secure environments.

These are private-pay costs, meaning they’re paid out of pocket unless another program (like Medicaid or long-term care insurance) steps in.

That can add up quickly - especially over months or years - so it’s important to plan ahead. Many families are caught off guard by just how fast these expenses grow, especially when they realize Medicare doesn’t help cover them.

Payment Options

Paying for assisted living can feel overwhelming, especially when the average monthly costs land in the $3,500–$5,000 range.

Since Medicare won’t cover assisted living, many families in Texas turn to a mix of private funds and programs to help with costs.

Over the years, we’ve seen that families often piece together solutions from several sources.

Here are four of the most practical options we've seen Texans use successfully.

#1. Long-Term Care Insurance

If you bought long-term care insurance in your 50s or early 60s, this is when it really starts to pay off.

These policies were designed specifically to cover services like assisted living, memory care, and in-home personal support.

The exact coverage depends on your policy - but most will start paying out once you need assistance with at least two activities of daily living (like getting dressed or bathing).

Many policies offer a set daily or monthly benefit. Some even adjust over time to keep pace with inflation.

Be sure to check your elimination period too - that's how long you’ll need to pay out-of-pocket before the benefits begin.

We always encourage families to dust off the policy and review it carefully. It may cover more than you think.

#2. VA Aid and Attendance for Veterans

If you’re a wartime veteran or the surviving spouse of one, you may be eligible for a little-known VA benefit that can go a long way.

Aid and Attendance is a supplemental monthly benefit added to a veteran’s pension.

As of 2025, it can add over $2,200/month for qualifying veterans and more than $1,400/month for surviving spouses.

To qualify, you generally need to:

• Have served during a wartime period
• Require help with daily activities
• Meet specific income and asset limits

What’s most surprising is how underused this benefit is - many families don’t realize they qualify, especially if the veteran has passed away.

But the aid can be used toward assisted living or other forms of long-term care.

#3. Supplemental Security Income (SSI) and Texas OSS

For lower-income seniors, Supplemental Security Income (SSI) is a federal program that provides monthly payments to help with basic living expenses.

In Texas, there’s also an Optional State Supplement (OSS) available for those who live in licensed care facilities.

While the payments won’t cover all assisted living expenses, they can help reduce the burden - especially when combined with Social Security or a small pension.

To qualify, you’ll need to meet strict income and asset requirements, and you must reside in a state-licensed facility that participates in the program.

Even if it’s modest, every little bit can help make care more affordable.

#4. Short-Term Financing and Bridge Loans

When families are in transition - maybe selling a home or waiting for VA approval - short-term loans can be a helpful way to cover immediate costs.

Some assisted living communities in Texas partner with lenders to offer bridge loans, rental assistance, or payment plans. Others may allow move-ins with flexible payment arrangements while you finalize benefits or access other funds.

If you’re considering this path, make sure to read the loan terms carefully. Look out for interest rates, fees, and balloon payments. These tools can offer valuable flexibility, but they’re not all created equal.

We’ve found that many families use a combination of these resources to make assisted living affordable.

Whether it’s tapping into an insurance policy, applying for VA benefits, or temporarily financing costs during a transition, the key is planning ahead and knowing your options.

Medicaid in Texas: A Possible but Imperfect Lifeline

If you're looking into Medicaid to help pay for assisted living, it’s important to know what it can (and can’t) do.

In Texas, Medicaid can help cover long-term care, but it doesn’t usually pay for private assisted living facilities the way many families hope.

Texas' Medicaid Long-Term Care Program (SMMC-LTC)

Texas Medicaid offers long-term care benefits through the State of Texas Access Reform (STAR+PLUS) program.

It covers:

• Nursing home-level care in Medicaid-certified facilities
  
• Home and community-based services (HCBS) as an alternative to nursing homes
  (This might include in-home care or adult day programs, but not traditional assisted living rent and services)
  

It doesn't cover:

• Private-pay assisted living communities are typically not covered
  
• Some facilities may accept Medicaid through HCBS waiver programs, but these are limited and often require families to pay out of pocket for housing while Medicaid helps with care services
  

Income and Asset Limits (2025 Estimates)

To qualify for long-term care Medicaid in Texas:

• Individual income limit: Around $2,829/month
  
• Asset limit: $2,000 for a single applicant (some assets, like a primary home and car, may be exempt).
• Married couples applying together have slightly different thresholds
  

These limits change yearly - and Medicaid "spend-down" and planning strategies are sometimes needed to qualify.

Expect a Waitlist

Texas has waitlists for many home and community-based programs under Medicaid, especially for non-nursing home settings.

Planning ahead is crucial - don't wait until you're in crisis.

Where to Get Help

Navigating Medicaid isn’t easy, but there are professionals who can help:

• Area Agencies on Aging – free help with applications and resources
  
• Medicaid planners and elder law attorneys – for legal and financial guidance
  
• Facility caseworkers – some assisted living communities have staff who can help with Medicaid-related paperwork
  

Real-World Payment Scenarios

When it comes to paying for assisted living, every family’s situation is unique.

But over the years, we’ve helped Texans from all walks of life figure out how to make the numbers work - whether through income planning, benefit programs, or using home equity creatively.

Here are three examples based on common scenarios we’ve seen in the field:

Marian, 82 – Fort Worth: Low Monthly Income, But Owns Her Home

Marian lives alone in the home she’s owned for over 30 years, but her only steady income is a small Social Security check.

Her adult son helps with errands, but after a fall, they knew it was time to explore assisted living.

Here’s what worked for Marian:

• She began renting out her house for $1,600/month - handled by a family friend.
• That rental income, combined with her $1,700 Social Security check, allowed her to afford a smaller assisted living community nearby.
• With help from the facility’s admissions coordinator, she applied for a small Optional State Supplement (OSS) payment, which covered incidentals.

By using her home as an income asset instead of selling right away, Marian kept long-term flexibility and made the transition on her terms.

Robert, 79 – El Paso: Korean War-Era Veteran With Modest Savings

After struggling to manage his diabetes and medications alone, Robert’s family stepped in.

He had a VA pension and a little money set aside, but it wasn’t enough for assisted living without help.

Here’s how Robert made it work:

• He applied for the VA Aid and Attendance benefit and qualified for nearly $2,100/month in additional support.
• Combined with his pension and Social Security income, he was able to move into a community that specialized in veteran care.
• The facility helped process the VA paperwork and even offered a short-term payment deferral while the benefit was pending.

Robert’s military service unlocked one of the most valuable - and often overlooked - funding options for seniors.

Denise, 75 – Houston: Planned Ahead With Long-Term Care Insurance

Denise spent her career in education and knew early on she didn’t want to leave her children scrambling for answers later.

At age 62, she purchased a long-term care insurance policy with a generous daily benefit.

Now, at 75, that decision is paying off:

• Her policy provides $4,200/month toward assisted living costs.
• Her personal income (from Social Security and a teacher pension) covers upgrades like memory care and private transportation.
• She avoided waiting lists and was able to choose a community that matched her lifestyle - without compromising quality.

Because Denise planned ahead, she’s not worried about depleting her savings - and she maintains full control over her care.

Key Takeaway

These stories show that there’s no one right way to pay for assisted living in Texas - but with some creative thinking and the right resources, it’s often more achievable than families expect.

Whether you’re starting from scratch or already exploring options, we can help you build a plan that fits your situation.

Your Home = Your Most Powerful Asset

We’ve worked with many Texas families who felt overwhelmed by the cost of assisted living - until they realized their home could be part of the solution.

Whether it’s modest or mortgage-free, your home may hold the key to unlocking the care you need. Let's go over some options.

#1. Renting It Out

This is one of the simplest ways to generate steady monthly income.

• You keep ownership of the home.
  
• Rental income can help pay for assisted living or supplement Social Security.
  
• Many families hire a property manager to make it hassle-free.
  

We’ve seen this work especially well in cities like Austin, Dallas, and Houston, where rental demand is strong.

#2. Selling for a Lump Sum

When the move to assisted living is permanent, selling the home can give you the flexibility to choose a facility that fits your needs.

• The proceeds can cover several years of care.
  
• Downsizing often reduces financial stress on the family.
  

In many cases, families coordinate a home sale while a loved one transitions into care.

#3. Reverse Mortgages

For seniors who want to remain at home a little longer - or need to cover in-home care before moving - a reverse mortgage is worth exploring.

• You access your home equity without monthly payments.
  
• The loan is repaid later, usually when the home is sold.
  

Important: Reverse mortgages come with pros and cons, so speak with a licensed advisor before deciding.

#4. Life Estate or Personal Care Agreements

These legal tools allow families to:

• Transfer the home to a loved one while maintaining certain rights (life estate).
  
• Create written agreements to compensate family caregivers, which can protect Medicaid eligibility.
  

Used correctly, these strategies can help preserve both care access and family assets - but they must be done carefully.

Final Thought: Your home isn’t just where you live - it can also be the financial bridge to the next chapter of care.

If you’re not sure what’s possible, this is exactly where elder law attorneys and Medicaid planners can help.

Bottom Line

Medicare doesn’t pay for assisted living - and that’s a tough reality for many families to hear. ‍

But it doesn’t mean you’re out of options.

From long-term care insurance and veterans benefits to Medicaid planning, creative housing strategies, and private resources, there are real ways to manage the cost. The key is knowing what’s available before you need it.

We’ve helped countless Texas families navigate this exact situation - weighing costs, identifying benefits, and making smart decisions about care.

If you’re planning ahead for a parent or need help now, don’t wait until it feels urgent. The sooner you explore your options, the more control you’ll have over the outcome.