Texas is one of the most affordable large states for senior care. With a lower cost of living than the national average in most metro areas, families in Texas pay less than their counterparts in California, New York, or the Pacific Northwest — while still having access to a large and competitive market of facilities.
That said, costs are rising. The median price of assisted living in Texas has increased roughly 3–5% annually over the past several years, and major metros like Dallas, Houston, and Austin are approaching national averages. This guide covers what each type of senior care costs in Texas in 2026, what factors drive pricing, how Texas Medicaid can help, and how to stretch your budget further.
Senior care costs in Texas by care type (2026)
These figures are based on the Genworth Cost of Care Survey, Texas Health and Human Services data, and industry sources. Costs vary by metro area and individual care needs.
Assisted living
| Region | Monthly cost (median) | Annual cost |
|---|---|---|
| Texas statewide | $4,500–$5,800 | $54,000–$69,600 |
| Dallas–Fort Worth | $4,800–$6,200 | $57,600–$74,400 |
| Houston | $4,500–$6,000 | $54,000–$72,000 |
| Austin | $5,000–$6,500 | $60,000–$78,000 |
| San Antonio | $4,200–$5,500 | $50,400–$66,000 |
| El Paso | $3,800–$4,800 | $45,600–$57,600 |
The national median for assisted living is approximately $5,350 per month. Most Texas metros fall at or below that figure, with Austin trending higher due to rapid population and cost-of-living growth.
Memory care
Memory care costs 30–50% more than assisted living across Texas due to higher staffing needs, secured environments, and specialized programming.
| Region | Monthly cost (median) | Annual cost |
|---|---|---|
| Texas statewide | $5,800–$7,500 | $69,600–$90,000 |
| Dallas–Fort Worth | $6,200–$8,000 | $74,400–$96,000 |
| Houston | $5,800–$7,800 | $69,600–$93,600 |
| Austin | $6,500–$8,500 | $78,000–$102,000 |
| San Antonio | $5,500–$7,000 | $66,000–$84,000 |
Board and care (residential care homes)
Texas licenses smaller residential care settings as Type A or Type B Assisted Living Facilities. Smaller homes with 4–16 residents typically offer a more intimate, home-like environment at a lower price point.
| Region | Monthly cost (median) | Annual cost |
|---|---|---|
| Texas statewide | $2,800–$4,200 | $33,600–$50,400 |
| Dallas–Fort Worth | $3,200–$4,800 | $38,400–$57,600 |
| Houston | $3,000–$4,500 | $36,000–$54,000 |
| Rural Texas | $2,200–$3,500 | $26,400–$42,000 |
Board and care homes in Texas often include meals, laundry, and personal care assistance in a single rate. For families on a tighter budget, smaller homes in suburban or rural areas can be substantially less expensive.
Skilled nursing facilities (SNFs)
Skilled nursing provides 24-hour licensed nursing oversight and is the most expensive care level.
| Room type | Monthly cost | Daily rate |
|---|---|---|
| Semi-private room | $5,900–$7,500 | $195–$250 |
| Private room | $7,200–$9,500 | $237–$312 |
Texas skilled nursing costs are well below the national median of approximately $8,669/month for a semi-private room, making the state one of the more affordable options for long-term nursing care.
Factors that affect senior care costs in Texas
1. Metro area vs. rural
Austin and Dallas tend to have the highest rates. San Antonio, El Paso, and rural communities can be 15–30% less expensive. Texas's size means there is enormous regional variation.
2. Care level surcharges
Most Texas assisted living and memory care communities use a tiered system. Base rates cover a standard level of assistance. As care needs increase, surcharges of $500–$2,500 per month may apply. Ask for the total cost based on the specific resident's needs, not the base rate.
3. Community fees
One-time move-in costs in Texas typically range from $1,500 to $4,000, including community fees, assessments, and deposits. These are often non-refundable.
4. Medication management
Many Texas facilities charge separately for full medication administration — typically $250–$600 per month. Basic medication reminders may be included in the base rate, but insulin management and complex regimens usually cost extra.
5. Facility size and amenities
Large, resort-style communities with pools, salons, and extensive dining options tend to cost more. Smaller, no-frills assisted living homes often provide comparable care at a significantly lower rate.
Texas Medicaid and Medicare coverage
Texas Medicaid (STAR+PLUS)
Texas administers its Medicaid long-term care services through the STAR+PLUS managed care program. Coverage options include:
- Skilled nursing: Fully covered for individuals who meet financial and medical eligibility requirements (assets below $2,000 for individuals).
- Community-based services: The STAR+PLUS Home and Community-Based Services (HCBS) waiver can cover personal care, adult day care, and some assisted living costs for eligible individuals. This waiver is designed to help people remain in the community rather than entering a nursing facility.
- Assisted living: Texas does not have a broad Medicaid waiver for assisted living. However, some assisted living costs may be covered through STAR+PLUS HCBS for qualifying individuals. Coverage is more limited than in states like California or Washington.
Important: Texas Medicaid has a five-year look-back period for asset transfers. Families should consult an elder law attorney well in advance of needing care to understand planning options.
Medicare
Medicare does not cover long-term custodial care in any state. In Texas, Medicare covers:
- Up to 100 days of skilled nursing following a qualifying 3-day hospital stay
- Part-time skilled home health services
- Hospice care
Veterans benefits
Texas has one of the largest veteran populations in the country. The VA's Aid and Attendance benefit provides up to $2,727/month for a veteran with a spouse, $2,295/month for a single veteran, and $1,432/month for a surviving spouse (2026 rates). Many Texas families are eligible but have not applied.
Tips for finding affordable senior care in Texas
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Explore smaller cities and suburban areas. San Antonio, El Paso, and communities outside the major metros offer significantly lower rates without sacrificing care quality.
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Compare board and care homes. Smaller residential settings in Texas are often $1,500–$2,500 per month less expensive than large assisted living communities, with a more personal care experience.
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Ask about STAR+PLUS HCBS. If your family member may qualify for Medicaid, explore whether the STAR+PLUS waiver can offset some care costs. Start the application process early — eligibility determination can take time.
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Request itemized cost estimates. Ask every facility for a written total monthly cost based on the resident's specific care needs. Do not compare base rates — compare all-in costs.
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Check VA eligibility. Texas has extensive VA resources. Aid and Attendance benefits can contribute $1,400–$2,700 per month toward care costs.
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Avoid commission-based referral services. These services charge facilities $4,000–$13,000 per placement, which gets embedded in the rates families pay. A transparent search platform keeps costs lower across the system.
Key takeaways
- Texas senior care costs range from approximately $2,200/month (board and care in rural areas) to $9,500/month (private-room skilled nursing in major metros).
- Texas is one of the most affordable large states for senior care, with assisted living running 10–20% below the national median in most areas.
- Texas Medicaid (STAR+PLUS) covers skilled nursing and has limited community-based services for assisted living. Medicare does not cover long-term residential care.
- Austin is trending toward national-average pricing. Dallas and Houston remain moderate. San Antonio and El Paso offer the best value among major metros.
- Always request a total monthly cost estimate, not a base rate, when comparing Texas facilities.
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