Can't Afford a Nursing Home in Texas? 5 Options for Central Texas

Can't Afford a Nursing Home in Texas? 5 Real Options for Central Texas Families

If your family is facing the question of how to pay for a loved one's care and a nursing home feels financially impossible — you are not alone, and you are not out of options.

Nursing home costs in Texas averaged between $6,000 and $10,965 per month in 2026, depending on whether your loved one needs a semi-private or private room. For most families in Travis, Williamson, Hays, and Bastrop Counties, that cost is simply not sustainable from savings or Social Security alone.

But the nursing home is not the only door. Here are five alternatives that exist right now — some of which may cost your family nothing at all.

Option 1 — Medicaid Home and Community-Based Services (HCBS) Waivers

Medicaid HCBS waivers are state-funded programs designed to keep seniors out of nursing facilities by funding care at home instead. In Texas, the primary program for seniors and people with disabilities is called STAR+PLUS.

STAR+PLUS can cover personal attendant services, adult day care, nursing visits, and other supports — all provided in your loved one's home or the home of a family member.

How to apply in Texas: Visit YourTexasBenefits.com or call 2-1-1. You can also contact your local Area Agency on Aging for navigation support.

The most important thing to know about waivers: waitlists in Texas can run one to three years. Apply now — even if you don't feel you need it yet. The families who plan ahead are the ones who have options when the crisis hits.

Option 2 — PACE (Program of All-Inclusive Care for the Elderly)

PACE is a full wraparound care program that covers medical services, daily support, transportation, meals, prescription drugs, and more — all coordinated through a single care team. It is designed for seniors who would otherwise qualify for nursing facility care but prefer to remain in their community.

For individuals who are Medicaid-eligible, PACE is typically available at no cost. The program operates through PACE centers where participants receive daytime services, while continuing to live at home or with family.

To find a PACE program in Texas, visit npaonline.org or contact your local Medicaid office.

Option 3 — Adult Family Homes and Board and Care

Adult family homes — sometimes called board and care homes or residential care homes — are small, licensed residential settings that provide personal care for a small number of residents, typically four to six people.

A caregiver lives on-site. Meals, assistance with activities of daily living, medication management, and a home-like environment are included. The cost is typically 40 to 60 percent lower than a traditional nursing home.

For seniors with dementia or anxiety who do better in quiet, familiar environments, adult family homes are often a significantly better fit than large institutional facilities — and a fraction of the cost.

Option 4 — Adult Day Programs

Adult day programs provide structured daytime care — meals, activities, socialization, health monitoring, and personal care — while family caregivers work, rest, or tend to their own needs.

In Central Texas, adult day programs typically cost between $75 and $100 per day. Your loved one comes home at night. This option is one of the most underused in senior care, and it consistently delays facility placement by months or even years while improving quality of life for both the senior and the caregiver.

Option 5 — VA Aid and Attendance Pension

If your loved one served in the United States military — even if they have been told they do not qualify for VA benefits because of income — please do not accept that answer without a second opinion.

VA Aid and Attendance is a pension benefit specifically for veterans who need help with daily living activities. Critically, the VA does not use gross income to determine eligibility. They use a calculation called IVAP — Income for VA Purposes — which subtracts unreimbursed medical expenses from gross income before comparing to the income limit.

This means a household that appears to earn too much on paper may qualify comfortably once care costs, prescriptions, and insurance premiums are deducted.

2026 Aid and Attendance maximum rates:

• Veteran alone: up to $2,358 per month
• Veteran with ill spouse: up to $3,261 per month
• Surviving spouse: up to $1,516 per month

How a Senior Placement Advisor Can Help

Navigating these five options simultaneously — understanding eligibility, application timelines, waitlists, and how each program interacts with your loved one's specific situation — is complex. Most families don't know where to start.

I am Stella Williams, founder of Williams Senior Transition Services, a veteran-owned, bilingual senior placement and care navigation business serving Travis, Williamson, Hays, and Bastrop Counties in Central Texas. My consultations are always free to families.

I also wrote a book specifically for families facing these decisions: Before the Crisis covers nursing home alternatives, Medicaid planning, VA benefits, and more across 30 chapters. Available at stellawilliamstx.com for $21 (code BEFORETHECRISIS).

📞 (737) 389-2130 🌐 stellawilliamstx.com | tourseniorliving.org 📍 Serving Austin, Round Rock, Cedar Park, Kyle, Buda, Pflugerville, San Marcos, Schertz and surrounding Central Texas

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