Short answer: in Texas, Medicaid pays for ongoing caregivers at home; Medicare does not. Medicare covers short-term skilled care after a doctor orders it. Families mix these two programs up constantly – and the mix-up costs them months of help they were entitled to. Here is the difference in plain English.
Medicaid (STAR+PLUS): the long-term caregiver program
Texas Medicaid’s STAR+PLUS program is built for exactly the situation most families are in: an older adult or adult with a disability who needs help with daily living, week after week. After the health plan assesses needs, it authorizes weekly hours of personal assistance services – bathing, dressing, meals, errands, supervision – at no cost to the member. A qualified family member can often be the paid caregiver. Eligibility is based on age or disability plus income; see who qualifies.
Medicare: short-term, medical, doctor-ordered
Medicare covers skilled nursing and therapy at home when a physician orders it and the person is homebound – typically for weeks, after a hospital stay or new diagnosis. It can include a bath aide during that episode, but when the skilled need ends, the aide ends. Medicare never pays for a long-term daily caregiver, no matter how much the family needs one.
Have both? That’s the best case
Many Texans 65+ with limited income are dual-eligible: Medicare handles doctors, hospitals, and short-term skilled care, while Medicaid STAR+PLUS covers the ongoing caregiver. If your loved one has both cards, they may be leaving the caregiver benefit unused – ask their STAR+PLUS plan for an assessment, or call us and we will help you request one.
What to do next
- Loved one needs ongoing daily help → pursue STAR+PLUS (we can help you start)
- Just discharged with doctor-ordered nursing or therapy → Medicare home health
- Both → use both – and read our full coverage guide
Talk to a real person: call Newport Home Health at 972-602-3500. We serve Dallas–Fort Worth, Houston, and San Antonio, and the consultation is free.