Private Pay vs Medicaid Assisted Living in Texas

Families weighing how to pay for assisted living often compare private pay with Medicaid. Here is a clear side-by-side.

Private pay

With private pay, the resident or family pays the facility's full monthly rate, which covers both care services and room and board. There is no Medicaid eligibility requirement, and choices are broader, but the cost is entirely out of pocket.

Medicaid (STAR+PLUS HCBS)

With STAR+PLUS HCBS, Medicaid can cover approved care services for eligible members, while the resident still pays room and board. This lowers out-of-pocket cost for care but requires meeting eligibility, including nursing-facility level of care.

What stays the same

In both paths, someone pays for housing and meals. The difference is who pays for the care. Our cost and room and board guide breaks the numbers down further.

Frequently asked questions

Is Medicaid assisted living cheaper than private pay?

For eligible members, Medicaid can significantly reduce out-of-pocket costs for care services through STAR+PLUS HCBS. The resident still pays room and board, so it is not free, but the care portion can be covered.

Can someone switch from private pay to Medicaid later?

Some families start with private pay and transition to Medicaid once eligibility is established. Talk with the facility and your MCO about how that works in your situation.