Paying for Home Care in Dallas
Short answer: Most Dallas families pay privately at first. Veterans and surviving spouses may get VA Aid & Attendance. Long-term care insurance often pays for home care. Texans with limited income and assets may qualify for Medicaid STAR+PLUS. Many families combine more than one of these.
VA Aid & Attendance
Short answer: A monthly VA pension add-on for wartime veterans (and surviving spouses) who need help with daily activities. It can be used to pay for home care.
| Situation (effective Dec 1, 2025) | Max annual pension rate (MAPR) |
|---|---|
| Veteran, no dependents, Aid & Attendance | $29,093 |
| Veteran with 1 dependent, Aid & Attendance | $34,488 |
| Two veterans married to each other, both A&A | $46,143 |
| Each additional dependent | +$2,984 |
| Net worth limit (Dec 1, 2025 – Nov 30, 2026) | $163,699 |
Source: VA – Current pension rates for Veterans. The VA pays the difference between your countable income and the MAPR. Unreimbursed medical expenses above 5% of your MAPR (such as paid home care) can lower your countable income. The VA also looks back 3 years at asset transfers. See also VA Aid & Attendance.
Surviving spouses (Survivors Pension with Aid & Attendance)
| Situation (effective Dec 1, 2025) | MAPR |
|---|---|
| Surviving spouse, no dependent child, A&A | $18,697 |
| Surviving spouse with 1 dependent child, A&A | $22,304 |
| Each additional child | +$2,984 |
| Net worth limit | $163,699 |
Source: VA – Current Survivors Pension benefit rates. Medical expenses count only above 5% of the MAPR ($584 for a surviving spouse with no child).
Long-term care insurance
Short answer: Many policies pay toward in-home care once you need help with daily activities, up to a daily or monthly limit. Read your policy for the elimination (waiting) period and whether it requires a licensed agency.
Typical Texas policy benefit amounts: TBD. They vary by policy, so call your insurer. Several of the Dallas agencies we list say they accept long-term care insurance or help with claims, including Amada (files claims for free), Granny NANNIES, Care Mountain, and ComForCare.
Texas Medicaid: STAR+PLUS
Short answer: STAR+PLUS is Texas Medicaid's managed-care program for adults with disabilities and people 65 and older. It can cover personal attendant services (help with bathing, dressing, meals) at home.
- The STAR+PLUS HCBS program requires being 21 or older, living in Texas, being financially eligible for Medicaid, and needing a nursing-facility level of care, with a service plan that stays within cost limits (Texas HHS handbook §1200; 1 TAC §353.1153).
- Attendant hours are set using a needs assessment (Form H2060).
- 2026 limits (effective Jan. 1, 2026), per the STAR+PLUS Handbook, Appendix VIII and MEPD Handbook G-1300:These are the basic limits only. Some assets don't count, and other rules (such as protections for a spouse who stays at home) may apply, so ask Texas HHS. Eligibility details: STAR+PLUS Handbook §3200.
Limit Individual Couple Monthly income limit, waiver/institutional (300% of SSI) $2,982 $5,964 Monthly income limit, SSI-based programs $994 $1,491 Resources (assets), waiver/CAS/institutional $2,000 $3,000 - Apply through Your Texas Benefits or by calling 2-1-1, the Texas HHS help line.
- You must use an attendant agency in your STAR+PLUS health plan's network. Ask the plan's Member Services for its list of in-network agencies.
Private pay
Short answer: Paying out of pocket is the most common way to start. At the Texas median of $30/hour (CareScout 2025), 20 hours a week comes to about $2,600 a month (our arithmetic). Some families use savings, help from relatives, or home equity.
How the options fit together
Short answer: Many families layer these options: private pay or insurance covers the first hours, and VA benefits help with what's left. Medicaid is generally for people with limited income and assets.
- Check for long-term care insurance and look up the waiting period.
- If the person is a wartime veteran or surviving spouse, apply for Aid & Attendance. Paid home care can count as a medical expense that lowers countable income.
- If income and assets are limited, ask Texas HHS about STAR+PLUS.
- Pay privately for any hours the other options don't cover.
Free local help: Dallas Area Agency on Aging (run by Community Council of Greater Dallas): 214-871-5065 or 800-252-9240, per the Texas HHS Area Agencies on Aging directory. Office listed by the agency: 1341 W. Mockingbird Lane, Suite 1000W, Dallas, TX 75247 (ccadvance.org). The HHS directory shows a different address (3910 Harry Hines Blvd), so call ahead before visiting.
Frequently asked questions
How much is VA Aid and Attendance in 2026?
It depends on your income. The VA pays the difference between your countable income and a yearly maximum (MAPR). From December 1, 2025, the maximum is $29,093 for a veteran with no dependents, $34,488 with one dependent, and $46,143 when two married veterans both qualify (va.gov).
Does Texas Medicaid pay for home care?
It can. Through STAR+PLUS, eligible Texans can get personal attendant services. The STAR+PLUS home and community-based services (HCBS) program requires being 21 or older, meeting Medicaid financial rules, and needing a nursing-facility level of care (Texas HHS).
Can I combine VA benefits and long-term care insurance?
Often yes, but check with the VA and your insurer. Out-of-pocket home care costs that aren't reimbursed can count as medical expenses that lower your income for VA purposes. If insurance reimburses those costs, they may not count.
How much is Aid and Attendance for a surviving spouse?
From December 1, 2025, the yearly maximum (MAPR) for a surviving spouse with Aid and Attendance is $18,697 with no dependent child, or $22,304 with one child (va.gov).
What are the 2026 Texas Medicaid limits for home care?
For STAR+PLUS waiver services, the 2026 monthly income limit is $2,982 for an individual and the resource limit is $2,000 (Texas HHS STAR+PLUS Handbook, Appendix VIII).
What is the VA net worth limit?
$163,699 from December 1, 2025 to November 30, 2026. Your primary home and car are not counted (va.gov).
Sources
- VA.gov, VA Aid and Attendance benefits and Housebound allowance
- VA.gov, Veterans Pension rates
- VA.gov, Survivors Pension rates
- Texas HHS, STAR+PLUS Handbook §3200 Eligibility
- Texas HHS, STAR+PLUS Handbook Appendix VIII, Monthly Income/Resource Limits
- Texas HHS, Medicaid for the Elderly and People with Disabilities Handbook G-1300, Income Limits
- Texas HHS, Form H2060 Needs Assessment Questionnaire
- Your Texas Benefits (apply for Medicaid)
- CareScout (Genworth) Cost of Care Survey 2025 (PDF)
- Texas HHS, Area Agencies on Aging directory
- Community Council of Greater Dallas, Dallas Area Agency on Aging
Please note: This guide is general information for families, not medical, legal, or financial advice. Prices, ratings, and program rules change; confirm directly with agencies, the VA, and Texas HHS. We are brand-neutral and do not accept payment for placement.