STAR+PLUS: how Texas Medicaid pays for long-term care in the Valley

What is STAR+PLUS?

STAR+PLUS is Texas Medicaid's managed care program for adults 65 and older and adults with disabilities, and its Home and Community Based Services (HCBS) part pays for care at home, in adult day centers and in contracted assisted living for people who meet nursing facility level of care.

Members choose a health plan, which assigns a service coordinator to assess needs and build a service plan. The plan then authorizes services such as personal attendant hours, adult day (DAHS) attendance, respite, nursing, minor home modifications, adaptive aids and emergency response systems.

Who qualifies for STAR+PLUS HCBS in 2026?

An applicant must be a Texas resident, 65 or older or 21 or older with a disability, meet nursing facility medical necessity, and have income up to $2,982 a month (three times the 2026 SSI rate of $994) with countable assets of $2,000 or less; the home and one vehicle generally do not count.

• Texas resident, U.S. citizen or qualified non-citizen
• Age 65 or older, or 21 or older with a disability
• Meets nursing facility medical necessity (level of care) for HCBS
• Income up to $2,982 a month in 2026 under the special income limit (three times the $994 SSI federal benefit rate)
• Countable assets of $2,000 or less for one person; the home and one vehicle generally do not count

Income over the cap does not always end the conversation; an elder law attorney can explain whether a qualified income trust applies. Apply at YourTexasBenefits.com or through 2-1-1, option 2.

Which STAR+PLUS health plans serve Hidalgo County?

HHSC's plan-code table for the Hidalgo service area, Revision 25-5 effective December 17, 2025, lists three STAR+PLUS plans: Molina Healthcare of Texas, Superior HealthPlan and UnitedHealthcare Community Plan, which joined on September 1, 2024.

Source: HHSC STAR+PLUS Program Support Unit Operational Procedures Handbook, Appendix XXIX, Revision 25-5 (effective December 17, 2025).

Cigna-HealthSpring served the area until the end of 2021. Plan line-ups change with state procurements, so confirm the current list with the Texas Medicaid enrollment broker at 1-800-964-2777 before choosing. The plan you pick decides which agencies, adult day centers and assisted living facilities are in network.

Does STAR+PLUS pay for assisted living in McAllen?

STAR+PLUS can pay the care portion of assisted living in a facility that contracts with the member's health plan, but never the rent and meals, and none of Hidalgo County's licensed assisted living facilities reports accepting Medicaid in its TULIP record.

That makes STAR+PLUS in the Valley mainly a home-and-day program: attendant care at home and DAHS attendance on weekdays. A family hoping to use Medicaid in a residential setting usually ends up with a Medicaid-certified nursing home, or with a facility outside the county that contracts with a plan. Ask any assisted living facility directly; contracts change.

Does Texas take back STAR+PLUS costs after death?

Texas's Medicaid Estate Recovery Program can file a claim against the estate of a recipient who was 55 or older and first applied for long-term services on or after March 1, 2005, including STAR+PLUS HCBS, but it never recovers more than the state paid and allows exemptions and hardship waivers.

Exemptions include a surviving spouse, a child under 21, and a child of any age who is blind or disabled, among others. Families worried about a home should talk with an elder law attorney before applying, not after.