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STAR+PLUS HCBS vs. Nursing Home Medicaid

Both use similar Texas financial eligibility tests, but they pay for completely different settings -- and only one is a capacity-limited waiver.

HomeComparisonsSTAR+PLUS HCBS vs. Nursing Home Medicaid
Short answer

Texas's 2026 nursing facility Medicaid limits: $2,901/month special income limit, $2,000 asset limit for a single applicant. STAR+PLUS HCBS uses a similar financial test but pays for care services in an assisted living facility or at home instead of a nursing home.

Nursing home Medicaid functions as an entitlement -- if you qualify, coverage is available. STAR+PLUS HCBS waiver capacity for assisted-living-style placement is not guaranteed the same way; a facility can hold a provider agreement without having current openings for waiver residents. Confirm capacity directly with any specific community rather than assuming the waiver functions like an entitlement the way nursing home Medicaid does.

Questions families ask

Is the Area Agency on Aging different in Tarrant County than the rest of the metro?

Yes. Tarrant County runs its own dedicated Area Agency on Aging through United Way of Tarrant County, separate from the 16-county North Central Texas Council of Governments (NCTCOG) region that covers Parker, Johnson, Denton, Wise and the rest of the outlying metro.

Can the ombudsman help if I disagree with how a Fort Worth facility handled my parent's care?

Yes, that is exactly the kind of situation the ombudsman program exists for. Contact the Area Agency on Aging of Tarrant County's ombudsman program at 817-258-8000, describe the situation, and a trained advocate -- often a volunteer -- will work with your family and the resident.

Where can family caregivers in Fort Worth get free support?

The Area Agency on Aging of Tarrant County offers caregiver support programs and care coordination at no cost. The Alzheimer's Association's North Central Texas Chapter helpline (800-272-3900) is also free and available 24/7 for dementia-specific caregiver questions.

What happens at an ombudsman-attended care conference?

An ombudsman advocate can sit in alongside the resident and family during a facility care plan meeting, help the family understand what's being proposed, and advocate for the resident's stated preferences if there's a disagreement with the facility's plan.

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