How Long Does Texas Medicaid STAR+PLUS Take?
From applying for Medicaid to a caregiver in your home — a step-by-step look at how long each phase actually takes for Texas STAR+PLUS, and how families can speed things up.
What to expect
If you or a family member is starting the process of getting Texas Medicaid STAR+PLUS to pay for in-home care, you have probably already heard that ‘it takes a while.’ That is true — but most families are surprised by what specifically takes the longest, what they can do to speed things up, and what to expect at each step.
This post walks through a realistic STAR+PLUS application and home-care start timeline based on cases Newport Home Health Agency has handled across DFW, Houston, and San Antonio.
Step 1 — Apply for Medicaid (1–2 months)
If the person who needs care is not already on Medicaid, the first step is applying. In Texas, Medicaid for adults with disabilities and seniors is processed through Texas Health and Human Services (HHSC). Most applications are submitted at YourTexasBenefits.com or by mail.
HHSC typically takes 30–45 days to process a routine application, longer if documents are missing. The fastest path is to gather everything before applying: proof of income for the past 3 months, proof of resources/assets, Social Security card, photo ID, proof of Texas residency, immigration documents (if applicable), and any disability documentation from a physician.
If the person has Medicare and is over 65, they will likely qualify for Medicaid through a different pathway. The same office handles both, but eligibility rules differ.
Step 2 — Get assigned to a STAR+PLUS plan (1–2 weeks)
Once Medicaid is approved, adults qualifying based on age or disability are auto-enrolled in STAR+PLUS — Texas’s managed care program for long-term services and supports. The state assigns the member to one of the participating Managed Care Organizations (MCOs) — Amerigroup/Wellpoint, Superior, Molina, Cigna-HealthSpring, or UnitedHealthcare in most service areas.
The member can change MCOs during their initial enrollment period or once a year afterward. The MCO is what actually authorizes and pays for in-home Personal Assistance Services hours, so this assignment matters.
Step 3 — Schedule the in-home assessment (2–4 weeks)
This is usually the longest part. The MCO assigns a service coordinator who must conduct an in-home assessment to determine how many hours of Personal Assistance Services the member needs. Service coordinators often have heavy caseloads and may schedule the assessment 2–4 weeks out.
If you are calling the MCO and have not heard back within a week, call again. Document the call. If you still don’t get a response, you can request a different service coordinator or escalate to MCO member services.
Step 4 — The assessment itself
The service coordinator visits the home, often spending 60–90 minutes evaluating the member’s ability to perform activities of daily living (bathing, dressing, transferring, toileting, eating, mobility) and instrumental activities (cooking, cleaning, shopping, medication management).
Be honest about the worst days, not the best ones. Many families instinctively put their best face forward and end up with fewer authorized hours than they actually need. The assessment reflects what the member needs, not what the family is currently coping with on willpower.
Step 5 — Hours authorization and agency selection (1–2 weeks)
Based on the assessment, the MCO authorizes a specific number of weekly Personal Assistance Services hours (often 10–40 hours per week for typical cases, more for higher-needs members). The MCO sends the authorization to a contracted home health agency. The member can request a specific in-network agency — and most do, once they know they have a choice.
Newport is in-network with all the major STAR+PLUS MCOs across DFW, Houston, and San Antonio. Members can request Newport directly when speaking with their service coordinator.
Step 6 — Agency intake and first visit (3–7 days)
Once the chosen agency receives the authorization, intake begins. At Newport, an intake coordinator calls the family within one business day to schedule an in-home meeting, gather routine and preference information, and confirm caregiver matching criteria (language, schedule, gender preference if relevant).
The first caregiver visit usually happens within 3–7 days of intake — sometimes the same week if the case is straightforward and a matching caregiver is available.
Total typical timeline
From a brand-new Medicaid application to a Newport caregiver in the home: 2 to 4 months total. If Medicaid is already in place and STAR+PLUS is already assigned, the process compresses to 4 to 8 weeks. If hours are already authorized and the member is just switching agencies, Newport can typically start care within 3 to 7 days.
How to compress the timeline
- Apply for Medicaid before you need it. Start the application as soon as a hospitalization, fall, or new diagnosis suggests home care will be needed.
- Have all documentation ready before submitting the application.
- Call the MCO to follow up if the assessment isn’t scheduled within 2 weeks of MCO assignment.
- During the assessment, describe needs honestly — including the worst days.
- Request your preferred agency by name when authorizations come through.
Questions about your specific situation?
Newport’s intake team can talk through where you are in the process and what to expect next — even if you ultimately use a different agency. Free 30-minute conversation.
