No. Medicare does not cover the cost of assisted living, memory care, or nursing home custodial care. Medicare covers medically necessary services — physician visits, hospitalizations, home health, and short-term skilled nursing care following hospitalization. Once a person is no longer receiving skilled care, Medicare coverage ends regardless of where they live.

Medicare Part A covers short-term skilled nursing facility care following a qualifying hospital stay — up to 100 days per benefit period, with a daily copay after day 20. It does not cover long-term nursing home care. Once the 100-day benefit or the need for skilled care ends, Medicare stops covering SNF costs and the patient pays privately or through Medicaid if eligible.

Medicaid covers long-term nursing home care for individuals who meet both financial and medical eligibility criteria — they must have limited assets (generally under $2,000 in countable assets for a single person) and require nursing home level of care. Texas Medicaid pays nursing homes directly; the resident contributes their monthly income and Medicaid covers the remainder. Not all nursing homes in Texas accept Medicaid.

Private pay means using personal funds — savings, investment accounts, Social Security, pension, home equity — to pay for care. At $4,000 to $5,000 per month for assisted living, a person with $100,000 in savings will exhaust those funds in roughly two years. Planning for the transition from private pay to public benefits (Medicaid, VA) before funds are depleted is a critical part of elder financial planning.

Long-term care insurance (LTCI) pays a daily or monthly benefit when the insured person cannot perform two or more activities of daily living or has cognitive impairment. Benefits typically apply to assisted living, memory care, nursing home care, and sometimes in-home care. Policy specifics vary widely — benefit amount, benefit period, elimination period (the deductible period), and inflation protection all differ between policies. Review the policy carefully before relying on it.

VA Aid and Attendance is a pension benefit that provides up to $2,727 per month (2026) to veterans who served during a wartime period and need help with activities of daily living. Surviving spouses may receive up to $1,478 per month. This benefit is tax-free and can be used for assisted living, memory care, in-home care, or nursing home care. Approximately 70% of eligible veterans are not receiving this benefit.

Yes. Options include: selling the home and using proceeds for care; a Home Equity Conversion Mortgage (reverse mortgage) that provides monthly income while the homeowner remains at home; or selling a life estate interest. Each strategy has different implications for Medicaid planning. An elder law attorney should be consulted before using home equity to fund care, particularly if Medicaid may be needed in the future.

Medicaid spend-down refers to the process of reducing countable assets to below the Medicaid eligibility threshold by paying legitimate care-related expenses. This can include paying for care privately, purchasing exempt assets, or paying off debts. Improper asset transfers within the five-year look-back period trigger penalty periods. An elder law attorney can develop a legal, ethical spend-down strategy that maximizes the resources available for care.

Texas offers limited state-funded senior care assistance through Medicaid waiver programs (STAR+PLUS) for home and community-based care, the Community Attendant Services program, and some area-specific programs through local Area Agencies on Aging. These programs have eligibility criteria and often have waitlists. The 2-1-1 Texas helpline can help identify local assistance programs.

A Qualified Income Trust (QIT), also called a Miller Trust, is a legal tool that allows seniors whose income exceeds the Medicaid income limit to still qualify for Medicaid nursing home coverage. In Texas, if a person’s monthly income exceeds approximately $2,742 (2026 limit), they can establish a QIT to place excess income, making them eligible for Medicaid. An elder law attorney sets up the trust.

Start planning before care is needed. Identify all potential income sources: Social Security, pension, retirement accounts, home equity, VA benefits, long-term care insurance. Estimate care needs based on health trajectory. If Medicaid may eventually be needed, consult an elder law attorney about Medicaid planning strategies. A Certified Senior Advisor or elder care financial planner can model different scenarios and help the family understand the financial landscape.

Texas has a safety net for people who need nursing home care and have limited resources — Medicaid. If a person qualifies medically and financially, Medicaid will pay for nursing home care. For assisted living, options are more limited but some Medicaid waiver programs exist. Contact your local Area Agency on Aging or call 2-1-1 Texas to identify all available assistance programs in your area.