Assisted Living in Texas

Key Takeaways

• The average monthly cost of assisted living in Texas is lower than the national average, although this can vary widely by city. 
• Medicaid won’t cover the cost of long-term care at an assisted living facility in Texas, but certain Medicaid programs may provide financial assistance for some things, like medical equipment, and help with daily activities. 
• Texas doesn’t have a state income tax, meaning residents can use retirement income from 401(k)s and IRAs to pay for assisted living tax-free. 
• Assisted living facilities in Texas do not have a minimum staff-to-resident ratio.
• Veterans, surviving spouses, and some qualifying residents may receive care for free through one of Texas’s state-run programs. 

They say everything is bigger in Texas, including the state’s long-term care network. With nearly 2,000 registered assisted living communities as of 2024, over 81,000 older adults could comfortably reside in one of the Lone Star State’s many facilities. 

The cost of living index averages the cost of basic living expenses in each state by examining factors like groceries, housing, utilities, health expenses, and more. Texas’s cost of living is approximately 7.1% lower than the average cost of living in the U.S. Other popular retirement destinations, like Florida, for example, are around 2% more expensive than the average. 

Even with lower living costs, Medicare still doesn’t cover long-term care associated with assisted living facilities. Texas does offer state-run Medicaid waivers that may help cover certain assisted living expenses, like medical care or help with daily activities. Read on to learn details and more key information about assisted living in Texas. 

Assisted living in Texas

While all assisted living facilities support older adults who need help with personal care and medical tasks, Texas divides assisted living facilities into two main types as defined by the physical and mental abilities of residents:

• Type A: An assisted living facility for those who don’t need nighttime attendance and can evacuate by themselves or follow staff directions in case of an emergency.
• Type B: A facility for older adults who need nighttime attendance and would require staff help to evacuate the building.

Both types provide built-in support for daily needs like housekeeping and meals. They can also help with other activities of daily living (ADLs), such as bathing or using the bathroom. Many communities even provide group activities or social events. They can range from large, apartment-style buildings to smaller facilities styled like private homes. 

Assisted living scope of care in Texas

Assisted living facilities are state-regulated, meaning the scope of care can vary by state. Texas law defines an assisted living facility as one that: 

• Provides food and shelter for residents 
• Assists with personal care services, such as eating, bathing, or dressing 
• May assist with or supervise the administration of medication

Texas also has guidelines that protect a resident’s privacy. For one, the facility can’t restrict visitors, and every resident has the right to receive guests in a private space. So caregivers, family, and friends can visit whenever they like. 

Residents also have the right to privacy while attending to their personal needs if they want it. 

What are the most common types of care at assisted living facilities in Texas? 

Per the National Center for Assisted Living, the most common tasks that Texas assisted living residents need help with are:

• Bathing (69%) 
• Walking (63%)
• Dressing (62%)
• Toileting (52%) 
• Transferring to the bed (44%) 
• Eating meals (27%)

Cost of assisted living in Texas

According to Genworth, the average assisted living facility in Texas costs around $4,915 per month, approximately 8.1% less than the national average of $5,350. Exactly how much assisted living costs in Texas varies widely by city. For instance, the average monthly cost of assisted living in Corpus Christi is over $7,600, while Amarillo averages around $4,460. 

Costs of assisted living in Texas cities

Assisted living costs in Texas vary by city, as seen in the table below. 

Costs associated with assisted living: What’s included in the fee?

Usually, an assisted living facility’s fee includes basics like a room or apartment, daily meals, and access to amenities like Wi-Fi and social activities. Medical care or assistance with ADLs, like bathing or taking medication, may cost extra, so it is important to clarify pricing and services when touring the facility. 

Some assisted living facilities may offer different pricing tiers based on the level of care that a resident needs. For example, one tier may cover select ADLs once per day, while a higher tier may offer assistance with more ADLs throughout the day, such as during meals or before bed.

Assisted living vs. other long-term care options in Texas

Assisted living isn’t the only care option available to older adults in Texas. You can see how the average cost of assisted living in Texas compares to other forms of long- or short-term care in the chart below. 

Independent living vs. assisted living

Independent living is a type of residential housing development or community exclusive to older adults. It offers many of the same basic features of an assisted living facility, such as daily meals, housekeeping, and social activities, but it doesn’t provide assistance with ADLs or other medical care. 

If a resident of an independent living facility needs help with ADLs, they or their caregivers can hire a third-party service to visit the facility. This could be a more affordable option than a traditional assisted living facility. According to Brookdale, the largest operator of senior housing in the United States, independent living costs between $1,995 and $6,670 in the Southwest. 

Nursing homes vs. assisted living

Nursing homes are care facilities for older adults who need ongoing medical attention or more intensive assistance with their day-to-day activities. Nursing homes typically benefit those with chronic diseases, dementia, or other medical issues that require round-the-clock care. 

For this reason, nursing homes are the most expensive long-term care option in Texas. A shared room in a Texas facility averages $5,323 per month, while a private room can reach $6,692. 

Memory care vs. assisted living

Memory care facilities are similar to assisted living facilities, but they offer specialized care to people with a form of dementia, such as Alzheimer’s disease or Lewy body dementia. For instance, a memory care facility may lock doors to keep residents from wandering. 

Some assisted living facilities may also have dedicated memory care wards on the premises, available for an additional $1,200 per month on average. Memory care in Texas ranges from $4,854 to $7,695 a month. 

In-home care vs. assisted living

In-home care services can provide many of the same services as an assisted living facility, like companionship and assistance with ADLs, but in the comfort of home. Several different types of professionals can provide in-home care, such as certified professional caregivers, certified nursing assistants, or personal care assistants. 

An in-home health aid generally costs around $5,339 in Texas, although the exact amount depends on how much care a person needs. If a person doesn’t need medical care, a non-medical professional could provide care at a more affordable rate, or a loved one or family friend could act as a caregiver. 

Government-subsidized senior living

Older adults with low incomes may qualify for government-subsidized housing through programs administered by the Department of Housing and Urban Development (HUD).

In addition to affordable rents based on income, the Section 202 senior housing program for older adults provides properties with accessibility features such as ramps and non-slip surfaces that help reduce the risk of falls and injuries. Residents won’t receive ADL support as they would in assisted living facilities, but they would have amenities and services that help support health, safety, and social well-being. 

Other alternatives to assisted living

If an assisted living facility isn’t within your budget, some people may turn to other alternatives, such as adult day services. Adult day centers offer supervision and stimulation for older adults who need help during the day, such as those with dementia or cognitive decline. 

Texas is one of the most affordable states in the nation for adult day services, with an average monthly cost of $1,083. 

Paying for assisted living in Texas

While assisted living in Texas is more affordable than in some states, the $58,980 per year cost to reside in an assisted living community could be challenging for some. Thankfully, residents of the Lone Star State who qualify may be able to leverage one of the financial assistance options below to make care more affordable. 

Medicare

Medicare doesn’t pay for long-term care, which includes residence at an assisted living facility. Because Medicare is funded by the federal government, every state follows the same policy, including Texas.

That said, Medicare may cover certain benefits older adults may need while at an assisted living facility, such as outpatient care and the cost of prescription drugs. 

Medicaid

Medicaid is jointly funded by federal and state governments, so its rules vary by state. 

Medicaid by itself doesn’t cover assisted living, but Texas provides special Medicaid waivers and other programs that may cover the cost of long-term care for qualifying residents. Around 8% of Texas assisted living residents rely on Medicaid programs for financial assistance. 

Texas Medicaid: Nursing Home Waiver

Texas can cover the cost of long-term care for qualifying residents via the state’s nursing home Medicaid waiver. To qualify, older adults must require a nursing facility level of care (NFLOC), meaning they need full-time medical care and non-medical supervision that only nursing homes provide. 

In Texas, Nursing Home Medicaid is an entitlement. Eligible Texas residents who apply and are approved are guaranteed by law to receive Nursing Home Medicaid benefits in the setting of their choice. 

Home and Community-Based Service (HCBS) Waivers

Texas’ Home and Community-Based Service (HCBS) Waivers help pay for long-term care services and support for those who require an NFLOC but want to live in the community. Specifically, Texas’ STAR+PLUS Waiver allows applicants to live in their home or an assisted living facility instead of a nursing home. 

While Texas HCBS waivers will cover long-term care services for people in assisted living, they won’t cover the cost of room and board. Also, the program isn’t an entitlement, meaning enrollment slots are limited, and qualifying residents aren’t guaranteed to receive benefits. 

Medicaid for the Elderly and People with Disabilities

Medicaid for the Elderly and People with Disabilities (MEPD) provides Medicaid benefits to Texas residents with limited incomes who are ages 65 and older or disabled. 

MEPD covers health care and personal services for people who live at home, with a loved one, or at an adult foster care house. MEPD is an entitlement, meaning any qualifying Texas resident is guaranteed to receive benefits through one of four programs:

1. Community First Choice: Provides in-home personal care services for qualifying residents who need an NFLOC
2. Primary Home Care: Provides in-home personal care services to residents who don’t require an NFLOC
3. Day Activity and Health Services: Provides weekday supervision for MEPD beneficiaries with chronic health problems at state care health centers 
4. Program for All-Inclusive Care for the Elderly (PACE): Coordinates medical and personal care services for dual-eligible MEPD beneficiaries in select areas of Texas 

Other long-term services and supports in Texas

Texas also offers state-run waivers that can pay for long-term services and support at an assisted living facility or other approved residences for people requiring care. Some of Texas’s state-run waivers for long-term care include:

• Community Living Assistance & Support Services (CLASS): provides in-home and community services for people with qualifying physical and mental conditions 
• Texas Home Living (TxHmL): provides services to people with disabilities who live in their own homes or a loved one’s home 
• Home and Community-based Services (HCS): covers services for people with intellectual disabilities who live at home, with a loved one, or in a group home 
• Deaf Blind with Multiple Disabilities (DBMD): provides services to people who are deaf-blind with other disabilities

Veterans benefits

United States veterans and surviving spouses may be able to receive financial assistance from one of two programs administered by the Department of Veterans Affairs: VA Aid and Attendance or Housebound benefits. These programs won’t cover the cost of room and board, but they may provide other financial benefits to people who live in an assisted living facility. 

Also, the Texas Veterans Land Board provides long-term care services for qualifying veterans, surviving spouses, and Gold Star parents at one of nine homes located across the state. A standard private room for a veteran generally costs between $200 and $260 a day, although some qualifying veterans may be able to live in the homes for free. 

Private pay 

Lastly, many older adults turn to private funds to pay for an assisted living facility, such as personal savings accounts, pensions, Social Security, or 401(k) funds. Since Texas doesn’t have a state income tax, residents have the option to use more of their retirement incomes to pay for assisted living than residents in other states whose earnings are taxed.

According to a 2019 study from the Department of Health and Human Services, around 75% of older adults who need long-term care could pay for two years of home care if they liquidated all their assets.

Certain life insurance policies, like long-term care insurance, can also be used to finance assisted living or other care options, though your coverage will depend on your policy. Review your policy carefully, as some have a waiting period before the benefits payout or a lifetime maximum coverage amount. 
In some cases, people opt to use their home equity, such as proceeds from a home sale or reverse mortgage, to pay for assisted living. It’s important to consult a financial advisor before making any concrete decisions and avoid predatory reverse mortgage scams that target older adults.

Understanding low-income senior housing

If you’re interested in low-cost housing as an alternative to assisted living, it can be helpful to start your search at a national level. HUD provides low-income housing services nationwide, which you can use to find local senior housing options in Texas. Locate a public housing agency (PHA) in Texas to learn more about low-income housing opportunities in your city. 

National programs

Here are a few low-cost national housing programs worth exploring:

• HUD’s Section 202 Affordable Senior Housing: Under Section 202, qualifying adults age 62 or older pay a fixed percentage of their monthly income (usually 25% to 30%) in rent at a HUD-approved housing development. 
• HUD’s Housing Voucher Program: Also called Section 8, these vouchers help subsidize the cost of housing for people with very limited incomes. Section 8 pays a housing subsidy directly to the landlord, which covers a portion of the rent. The participant then pays the difference every month. 
• The Low-Income Housing Tax Credit (LIHTC) Program: This program provides tax credits to builders and owners, giving them an incentive to provide affordable housing for people with low incomes. Participating property owners set aside a certain number of units available for those within a certain income bracket. 

Assisted living laws and regulations in Texas

Standards for assisted living are set state-wide, which means the same rules will apply to all facilities in Texas. A snapshot of Texas’ rules and regulations for assisted living facilities is below, as well as resources you can use to dive deeper into your community. 

How do you qualify for assisted living in Texas?

Texas doesn’t require a person to meet specific conditions to live at an assisted living facility, but the Texas administrative code does advise on the typical characteristics of a resident in a facility:

• Have symptoms of mental or emotional disturbances without being a danger to themselves or others 
• Need self-help devices 
• Need assistance with ADLs, such as movement, bathing, dressing, grooming, or skincare
• Have incontinence without pressure sores or may need reminders to use the toilet to prevent incontinence
• Need a therapeutic diet
• Need assistance with meals or require encouragement or reminders to eat
• Be hearing or speech impaired
• Need supervision or assistance with medication
• Need temporary services by professional personnel

Assisted living staffing requirements in Texas

Texas doesn’t require a minimum staff-to-resident ratio for assisted living facilities—they are only required to have enough staff to properly care for residents and safely evacuate them in the event of an emergency. 

That said, the state requires all staff to complete mandatory training related to their position. For instance, attendants must complete 16 hours of on-the-job training for tasks like assisting with ADLs, first-aid, and behavior management.

Free and low-cost assisted living resources in Texas

The following Texas-based programs and resources are a helpful starting point for those searching for help choosing and financing assisted living. 

Choosing assisted living in Texas

Whether you’re focusing your search in a certain city like Dallas or prioritizing nonprofit communities over corporate ones, you should apply the same criteria during your search. Keep the following factors in mind to ensure you find the right assisted living facility for yourself or your loved one. 

Tips for evaluating and touring facilities 

• Take notes and ask questions: Don’t be afraid to ask staff members questions about the facility, and take detailed notes. Does the staff seem patient and happy to clear up your concerns? 
• Tour several facilities: Visiting multiple communities will help you compare notes and make a more informed decision. Ask trusted family members to visit prospective communities with you so you can reach a consensus on which facility best meets you and your family’s needs. 
• Explore the grounds yourself: After taking a formal tour, ask the staff if you can wander the community areas on your own. This will let you see the facility’s daily operations and observe what a true staff-resident relationship looks like. 
• Talk to residents: If you can, chat with residents one-on-one to get their honest opinion on the facility. Do they enjoy living in the community, and are they getting the care they need? 
• Go with your gut: As you explore the grounds and talk to staff, do you feel confident about allowing a loved one to live here, or does something give you pause? 

Finding an assisted living facility to meet your needs

Other key questions to ask while touring a facility include the following:

Location

• How far away is the facility from family members, friends, or caregivers? 
• Can residents come and go as they please? 
• Are there outdoor areas for residents to enjoy, like patios or terraces?

Finance

• What specific services are not covered by the monthly fee?
• How are payments made?
• Will the monthly fee ever increase, and for what reasons?

Health and safety

• Do all rooms have medical alert systems?
• Are caretakers or managers present 24/7?
• Does the facility provide transportation to doctor appointments?
• What is the staff-resident ratio?
• When is a nurse on duty?
• When is a resident no longer eligible to stay in the assisted living community? 
• What is the procedure if a resident is required to move?

Cleanliness

• Are common areas clean and inviting? 
• Are there any unpleasant smells? 
• Is the kitchen’s health rating visibly posted?

For a more extensive list of considerations, download our assisted living tour checklist. 

Bottom line

Texas residents have many choices when it comes to finding assisted living communities near them. 

The average cost of assisted living in Texas is lower than the national average, and the state’s lack of income tax could make it easier for some to afford it. Qualifying residents may also be able to receive financial aid with state Medicaid waivers or other government-run programs. 

Before making the move, tour several facilities and take detailed notes. Ask questions and interview residents to make the most informed decision for yourself or a loved one. 

Brooke Helton Author

Brooke Helton is a freelance writer passionate about holistic living. She loves creating content that empowers others to take charge of their health.

Kathleen Cameron Reviewer

Kathleen Cameron, BSPharm, MPH, has more than 25 years of experience in the health care field as a pharmacist, researcher, and program director focusing on falls prevention, geriatric pharmacotherapy, mental health, long-term services and supports, and caregiving. Cameron is Senior Director of the NCOA Center for Healthy Aging, where she provides subject matter expertise on health care programmatic and policy related issues and oversees the Modernizing Senior Center Resource Center.