In-Home Care Costs in Texas: 2026 State Guide

What Texas Families Should Know

Texas is one of the more affordable states for in-home care in 2026. Statewide agency rates for personal care run approximately $21 to $30/hr, meaningfully below the national median of around $34/hr.
Costs vary significantly across the state’s vast geography: Austin and Dallas-Fort Worth run highest; the Rio Grande Valley, El Paso, and rural East Texas are among the most affordable markets.
Texas’s primary Medicaid program for home care is the STAR+PLUS HCBS Waiver, administered by the Texas Health and Human Services Commission (HHSC), with a 2026 income limit of $2,982/month for a single applicant.
One critical planning note: STAR+PLUS HCBS has an interest list. Many Texas families are waiting for available slots. Getting on the list early — well before care is urgently needed — is the single most important step Texas families can take.
Texas uses Qualified Income Trusts (Miller Trusts) for applicants who exceed the income limit, rather than a spend-down process like some states.
Consumer-directed services are available through STAR+PLUS, allowing eligible families to hire and pay a trusted caregiver (including some family members) directly through Medicaid.
Texas has no state income tax, which may improve the financial picture for families funding care from retirement income or Social Security. Consult a tax professional about your specific situation.

Planning for in-home care costs in Texas means reckoning with scale. Texas is the second-largest state in the country, and its home care market reflects that size, with sharp differences between major metros, mid-sized cities, the border region, and the rural communities that cover much of the state’s geography. This guide gives Texas families accurate, city-by-city cost estimates, a plain-English explanation of the STAR+PLUS Waiver, and the local resources needed to find and fund care.

What Does In-Home Care Cost in Texas in 2026?

Texas runs below the national median on home care costs, making it one of the more manageable states for families planning ahead. For a broader look at what different types of care typically include, see Senioridy’s complete guide to in-home care services. Statewide, families can expect to pay:

Non-Medical / Companion / Homemaker Care

Typical hourly range: $19–$26/hr
Best for: help with meals, light housekeeping, errands, medication reminders, and companionship

Personal Care Aide (Non-Medical)

Typical hourly range: $21–$30/hr
Best for: bathing, dressing, grooming, toileting assistance, and mobility support

Home Health Aide (Limited Medical Supervision)

Typical hourly range: $23–$32/hr
Best for: post-hospital recovery, vital sign monitoring, and medication management support under nursing supervision

Skilled Nursing (RN / LPN Home Visits)

Typical hourly range: $60–$95/hr
Best for: wound care, IV therapy, and clinical assessments ordered by a physician; may be partially covered by Medicare when medically necessary

Monthly Cost Estimates

The number of hours per week is the largest driver of monthly cost:

Part-time care (20 hrs/week): approximately $1,700–$2,600/month
Full-time care (44 hrs/week): approximately $3,800–$5,800/month
24/7 live-in care: $9,000–$15,000+/month depending on city, staffing model, and care complexity

These are 2026 estimates based on regional agency market benchmarks. Rates vary by location, care type, agency, and individual care plan. Hiring a private caregiver directly typically costs 20–30% less than agency rates, but families take on responsibility for background screening, payroll taxes, backup coverage, and supervision.

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How Costs Vary Across Texas

Texas is one of the most geographically and economically diverse states in the country, and its home care market reflects that. The difference between what a family pays in Austin or Plano versus what they pay in McAllen or Texarkana is substantial. It’s worth understanding regional variation before comparing agencies.

Dallas–Fort Worth Metroplex

DFW is one of Texas’s most developed home care markets and among the state’s higher-cost regions. The sprawling metro (Dallas, Fort Worth, Plano, Frisco, Arlington, and surrounding suburbs) has strong provider density and competitive agency options, particularly in the northern suburbs.

Agency rates: $24–$32/hr for personal care
The Plano, Frisco, and North Dallas corridor tends to run at the upper end of the DFW range, reflecting higher household incomes and professional caregiver wages
Fort Worth and the western suburbs offer a somewhat more moderate price point than North Dallas
DFW’s sheer size means provider selection varies meaningfully by ZIP code. Worth asking agencies about their specific service area and typical response times.

Houston and the Greater Gulf Coast

Houston is home to the Texas Medical Center — the world’s largest medical complex, which gives the city a particularly strong skilled home health infrastructure. Overall agency rates are close to the state median, making Houston a reasonably accessible market for most families.

Agency rates: $22–$30/hr for personal care
The Woodlands, Sugar Land, and Katy tend to run slightly above Houston proper; communities southeast toward Galveston are more moderate
The Texas Medical Center’s presence means families managing post-surgical recovery, complex diagnoses, or dementia will find strong specialized agency options
Houston’s large veteran community makes VA Aid & Attendance worth exploring early. The Houston VA Regional Office and multiple VSO offices are available to help with applications.

Austin and the Central Texas Corridor

Austin consistently ranks as the highest-cost major Texas home care market, driven by the city’s rapid population growth, a tight labor market, and one of the state’s higher overall costs of living. Families in Austin, Cedar Park, Round Rock, Georgetown, and the surrounding Hill Country should budget toward the upper end of the state range.

Agency rates: $26–$34/hr for personal care, the highest range among Texas’s major metros
The Austin market has seen consistent upward pressure on caregiver wages over the past several years, and agencies in the area reflect that
Provider availability is generally strong within the city and close-in suburbs; rural Hill Country communities west and north of Austin have fewer agency options
The University of Texas at Austin and a large state government employer base mean many households have long-term care insurance, worth reviewing when planning private-pay options.

San Antonio and South-Central Texas

San Antonio is one of Texas’s more affordable major metro markets for home care, with rates meaningfully below Austin and DFW. The city has a robust provider network and a very large military and veteran population. Joint Base San Antonio is one of the largest military installations in the country.

Agency rates: $21–$28/hr for personal care
New Braunfels and Seguin are within reasonable service range of San Antonio agencies; more rural communities to the south and west have thinner provider options
San Antonio’s enormous veteran population makes VA Aid & Attendance a critical resource. The Texas Veterans Commission has offices in San Antonio and can help with applications at no charge
The large multi-generational household traditions in San Antonio mean many families combine paid care with informal family caregiving, a pattern the STAR+PLUS consumer-directed model is designed to support.

The Rio Grande Valley — McAllen, Brownsville, Laredo, Harlingen

The Rio Grande Valley and South Texas border communities are among the most affordable home care markets in the state, though formal agency networks are thinner and many families rely more heavily on informal caregiving and Medicaid waiver services.

Agency rates: $16–$22/hr for personal care, among the lowest in the state
Licensed agency availability is more limited than in major metros; families may have fewer choices and longer scheduling lead times
STAR+PLUS Medicaid services are especially important in this region. The Rio Grande Valley has a high proportion of Medicaid-eligible seniors relative to the state as a whole.
Families may want to contact their local Area Agency on Aging or call 2-1-1 early to understand what local options and waiver services are available

El Paso and West Texas

El Paso has a mid-range home care market, with costs below Austin and DFW but somewhat above the Rio Grande Valley. The city has a significant military presence (Fort Bliss) and a large veteran population, making VA benefits an important funding consideration.

Agency rates: $18–$25/hr for personal care
El Paso has a reasonable provider network for a city its size. Rural West Texas communities (Midland, Odessa, Alpine, and the vast stretches between) have much more limited options.
For families in rural West Texas, STAR+PLUS consumer-directed services and family-directed care through waiver programs may be the most practical home care pathway

East Texas — Tyler, Beaumont, Texarkana, Lufkin

East Texas markets are generally affordable and moderately served, with Tyler having the strongest provider network in the region. Beaumont and Port Arthur have access to a Gulf Coast-influenced labor market; more rural communities in the Piney Woods are more limited.

Agency rates: $19–$26/hr for personal care
Tyler and Longview have more established agency options; Texarkana and Lufkin are more limited
Rural East Texas families are among the most dependent on Medicaid waiver programs and Area Agency on Aging services for home care access

Texas Medicaid Programs for In-Home Care

Texas Medicaid is administered by the Texas Health and Human Services Commission (HHSC). For seniors and adults with disabilities who need home-based care, the primary pathway is the STAR+PLUS HCBS Waiver.

STAR+PLUS HCBS Waiver — Texas’s Primary Home Care Medicaid Program

STAR+PLUS is Texas Medicaid’s managed care program for adults with disabilities and seniors who need long-term services and supports. The HCBS (Home and Community-Based Services) component — informally called the STAR+PLUS Waiver — covers services delivered at home rather than in a nursing facility. It is one of the most important financial resources available to qualifying Texas families.

Services covered under STAR+PLUS HCBS can include:

Personal attendant services: bathing, dressing, grooming, feeding, and mobility support
Respite care for family caregivers
Adult day health care: structured day programs with nursing supervision
Home modifications to increase accessibility: ramps, grab bars, and widened doorways
Skilled nursing and therapy services in the home
Specialized medical equipment and supplies
Care management and service coordination through a Managed Care Organization (MCO)

2026 STAR+PLUS HCBS Eligibility Guidelines:

Applicants are generally age 65 or older, or age 21–64 with a qualifying disability
A Nursing Facility Level of Care (determined through a functional assessment by HHSC) is typically required
Income limit: $2,982/month for a single applicant (300% of the SSI Federal Benefit Rate, updated annually in January)
Asset limit: $2,000 in countable assets for a single applicant; the primary home, one vehicle, and personal belongings are generally excluded
Texas Medicaid enrollment and Texas residency are generally required

Income above the limit — Qualified Income Trusts (Miller Trusts): Unlike some states that use a spend-down process, Texas uses a Qualified Income Trust (informally called a Miller Trust) for applicants whose income exceeds $2,982/month. Families in this situation may want to consult a Certified Medicaid Planner or elder law attorney, as the trust must be properly structured to meet program requirements.

The interest list — the most important planning step for Texas families: STAR+PLUS HCBS has an interest list, and the number of Texans waiting for available slots is significant. Getting on the list early — well before a care crisis — is the single most useful step a family can take. Getting on the interest list does not require a Medicaid determination first. Families can request to be added by calling HHSC toll-free at 1-855-937-2372 or through YourTexasBenefits.com. Current wait time information is available directly from HHSC.

Applying: Applications for Texas Medicaid can be submitted through YourTexasBenefits.com or at your local HHSC benefits office. The process from application to approved services typically takes 30–90 days once a slot is available, which is another reason to start early.

Consumer-Directed Services — A Key Option for Texas Families

One of the most valuable features of STAR+PLUS HCBS is the consumer-directed services (CDS) model. Under this option, the person receiving care acts as the employer of their own attendant, with support from a Service Coordinator. This means:

Families can hire someone they already know and trust: a neighbor, a family friend, or in some cases, a family member
Adult children, siblings, and close friends may be eligible to be paid as caregivers through the program in many cases (spouses and legal guardians are typically excluded)
CDS workers generally need to be at least 18 years old and pass a background check
The MCO handles payroll and administrative functions through a Fiscal Management Services Agency (FMSA)

More information on consumer-directed services in Texas is available at hhs.texas.gov or by calling 2-1-1.

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Other Payment Options Texas Families Should Know

Medicare — What It Does and Doesn’t Cover

Medicare does not cover ongoing custodial in-home care (companion care, personal care, or home health aide services for daily living assistance). What Medicare does cover is skilled home health services when specific conditions are met:

A physician orders the care following a hospitalization or for a homebound patient with an active medical need
Services include skilled nursing visits, physical therapy, occupational therapy, or speech therapy
Coverage is time-limited and tied to measurable medical improvement

For families unsure what Medicare covers in a specific situation, Texas’s free SHIP counselors are available at no cost in every county at shiphelp.org.

VA Aid & Attendance

Texas has one of the largest veteran populations in the country, particularly concentrated in San Antonio, DFW, Houston, El Paso, and Killeen (near Fort Cavazos). For veterans and their surviving spouses who need help with daily activities, VA Aid & Attendance is one of the most important and underutilized resources available. It is not a loan and does not need to be repaid. 2026 maximum monthly benefit rates:

Single veteran: up to $2,300/month
Veteran with a dependent spouse: up to $2,727/month
Surviving spouse of a veteran: up to $1,478/month

Aid & Attendance is not counted toward Medicaid income eligibility. Families can learn more at VA.gov or through the Texas Veterans Commission, which has benefits counselors in offices across the state and can assist with applications at no charge.

Long-Term Care Insurance

Families who purchased long-term care insurance policies in earlier years may want to review them carefully. Many policies cover in-home care once the policyholder cannot perform two or more activities of daily living. Key things to verify:

The policy’s daily or monthly benefit maximum
The elimination period: how many days of care are paid out of pocket before benefits begin
Whether the policy covers agency-directed care, consumer-directed care, or both
Any inflation protection riders that may have increased the benefit amount since the policy was purchased

Senioridy’s guide to long-term care insurance and in-home care offers a broader overview of how these policies typically work.

Private Pay

Most Texas families begin with private pay, drawing on savings, retirement income, or proceeds from the sale of a home. Texas has no state income tax; families may want to consult a tax professional about how that affects their specific retirement income picture when budgeting for care. Families who anticipate eventually applying for Medicaid may find it helpful to speak with a Certified Medicaid Planner or elder law attorney early in the planning process, as Texas has a look-back period for STAR+PLUS HCBS applications during which asset transfers are reviewed. Early guidance can help families understand how their situation fits within program rules.

Texas Resources for Families

Texas Health and Human Services Commission (HHSC)

HHSC administers Texas Medicaid and the STAR+PLUS program. Families can apply for Medicaid, get on the STAR+PLUS HCBS interest list, and find local resources through YourTexasBenefits.com or by calling 2-1-1. For interest list inquiries specifically, HHSC can be reached at 1-855-937-2372. Program details are also available at hhs.texas.gov.

Texas Area Agencies on Aging

Texas has 28 Area Agencies on Aging covering all regions of the state. AAAs provide information, case management, caregiver support, adult day programs, and help connecting families to Medicaid and other funding options. Families can find their local AAA through the Eldercare Locator at eldercare.acl.gov or by calling 1-800-677-1116.

Texas Veterans Commission (TVC)

For veterans and surviving spouses exploring VA Aid & Attendance and other benefits, the Texas Veterans Commission has benefits counselors in offices statewide and can help families understand eligibility and navigate the application process at no charge. Particularly valuable for families in San Antonio, DFW, Houston, El Paso, and Killeen.

Texas SHIP — Free Medicare Counseling

Free, unbiased guidance on Medicare, Medicare Advantage, and how coverage intersects with home care costs, available in every Texas county at no cost. Find a local counselor at shiphelp.org.

2-1-1 Texas

Dialing 2-1-1 connects Texas residents to a statewide referral service for health and human services, including help navigating the STAR+PLUS interest list, finding local home care agencies, locating caregiver support programs, and accessing emergency assistance. Available 24/7 and in multiple languages. Also accessible at 211texas.org.

Neighboring State Cost Guides

For families comparing Texas to nearby states, or caring for a parent across a state line, Senioridy’s in-home care cost guides for neighboring states can be helpful:

Finding In-Home Care in Texas

Understanding the cost range is the first step. Finding the right agency or caregiver for your family’s specific situation is the next one. If you’re still weighing whether in-home care or a nursing facility is the right fit, Senioridy’s guide to in-home care vs. nursing home walks through the decision in detail. Texas has a large and varied home care market, from national franchise agencies to smaller locally owned operators.

Senioridy’s Texas in-home care directory can help you compare local agencies, understand your options, and start the conversation with providers in your area. For families who may need skilled medical home care following a hospitalization or procedure, see Senioridy’s Texas home health medical directory.

For a broader look at all payment options, see our guide to how to pay for in-home care.

This article is for informational purposes only and does not constitute legal, financial, tax, or medical advice. Cost figures are 2026 estimates based on regional agency market benchmarks and publicly available rate data and are subject to change. Rates vary by location, care type, agency, and individual care plan. STAR+PLUS HCBS eligibility guidelines reflect program rules as of early 2026 and are updated annually; confirm current income and asset limits, interest list procedures, and wait time estimates with HHSC at hhs.texas.gov or by calling 2-1-1. Tax treatment of retirement income varies by individual situation; consult a qualified tax professional for guidance specific to your circumstances. For free, personalized Medicare guidance, contact your State Health Insurance Assistance Program (SHIP) counselor at shiphelp.org, available in every Texas county at no cost. For guidance on Medicaid eligibility and planning, consulting a Certified Medicaid Planner or licensed elder law attorney is generally advisable.