In-Home Care in Texas

As of July 2021, Texas had more than 3.8 million residents in the 65+ age group. With everything the state has to offer, it’s no wonder so many seniors call it home. Houston Methodist Hospital is nationally ranked in 10 medical specialties, and Texas residents also have access to high-quality care at Baylor St. Luke’s and UT Southwestern Medical Center. Texas doesn’t impose a tax on personal income, and its major cities have lower costs of living than many other urban centers, which is why so many seniors flock to the state for retirement.

Another reason seniors love Texas is because there are many options for senior care, such as in-home care and home health care. In-home care is the non-clinical care provided by a home health aide, while home health care is clinical care provided by a nurse, physical therapist or other licensed professional. As of 2021, in-home care and home health care cost an average of $4,576 per month in Texas.

This guide provides an overview of what you can expect from in-home care, including costs and coverage through Medicare and Medicaid. It also includes a list of resources to help seniors age in place.

When it comes to in-home care, Texas is one of the most affordable states in the region, with monthly costs averaging $4,576 in 2021, according to the Genworth Cost of Care Survey. To the west, New Mexico is slightly higher at $4,605 per month, while Oklahoma to the north has average monthly costs of $4,862. Louisiana and Arkansas both have lower monthly costs, averaging $3,623 per month and $4,185 per month, respectively. In-home care in Texas is also $381 per month lower than the national average of $4,957.

Within Texas, the average costs of care vary by location. Houston and San Antonio have average monthly costs of $4,576, putting them right in line with the state average. With average monthly costs of $5,196 and $4,862, respectively, Austin and Dallas are the most expensive cities. Amarillo has some of the lowest costs—an average of $4,052 per month in 2021.

In-home care is more affordable than nursing home care, but it can be more expensive than other types of senior care. In Texas, the average cost of nursing home care is $5,125 per month, about $550 per month more than in-home care. Assisted living averages $3,998 per month; although it’s a little less expensive than in-home care, seniors who need assisted living can’t stay in their own homes. Adult day health care is the least expensive option, with average monthly costs coming in at $769. In Texas, the average cost of home health care is the same as the average for in-home care at $4,576 per month.

Traditional Medicaid doesn’t include coverage for non-clinical home care; however, Texas does have a Medicaid waiver program that pays for personal care services and other supports designed to help seniors age in place instead of moving to institutional care settings. This program is known as the STAR+PLUS waiver.

The easiest way to apply for Medicaid is to create an account at Your Texas Benefits and fill out the online application. You can also download an application and mail or fax it to the Texas Health and Human Services Commission.

Fax: (877) 447-2839
P.O. Box 149024
Austin, TX 78714-9024

What Information You Will Need

When you fill out the Medicaid application, you’ll need to provide information about your income and assets. To make the process easier, make sure you have your pay stubs, tax returns and bank statements on hand. If applicable, you may want to gather information about your investments or insurance policies. You should also have your driver’s license or photo identification card, Social Security card and other identity documents in case THHS asks for proof of identity.

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

• Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
• Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
• Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
• Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.