Can Family Caregivers Get Paid in Texas? 2026 Guide

Texas Has Multiple Waiver Programs That May Pay Family Caregivers

If you are caring for a family member at home in Texas, there are Medicaid-funded programs that may allow an approved family caregiver to be paid. Texas runs several waiver and managed care programs, each with different rules about which family relationships are allowed.

This article covers the main Texas programs and what to verify next. It is not an official eligibility determination.

The Main Texas Programs to Know

STAR+PLUS Home and Community-Based Services

STAR+PLUS is Texas's primary Medicaid managed care program for adults with disabilities and people age 65+. The HCBS component provides home-care services that may allow adult children to be paid as caregivers through the Consumer Directed Services (CDS) option.

Under CDS, the participant (or their representative) hires, trains, and supervises their own attendant, which may include a family member.

*Key details to verify:*

• Must be enrolled in Texas Medicaid
• Must meet nursing facility level of care
• Adult children may be eligible as paid attendants through CDS
• Contact: 855-937-2372

Community Living Assistance and Support Services (CLASS)

CLASS serves Texans with related conditions (conditions similar to intellectual disability). It provides home and community-based services where adult children may be eligible as paid caregivers.

*Key details to verify:*

• Must have a qualifying related condition
• Significant interest list (waitlist) may apply
• Contact: 877-438-5658

TX Home and Community-based Services (HCS) Program Waiver

The HCS waiver is one of Texas's largest programs for people with intellectual or developmental disabilities. Adult children may be paid as caregivers through the CDS option.

*Key details to verify:*

• Must have an intellectual or developmental disability
• Budget ranges: $1,200 - $8,400/month depending on assessed needs
• Interest list may apply
• Contact: 855-937-2372

TX Home Living Program Waiver

Home Living is a smaller waiver for individuals with IDD who need less intensive supports. Adult children may serve as paid caregivers.

*Key details to verify:*

• Budget ranges: $800 - $4,500/month
• Contact: 855-937-2372

Deaf-Blind with Multiple Disabilities (DBMD) Waiver

The DBMD waiver serves Texans who are deaf-blind with additional disabilities. Adult children may be eligible as paid caregivers.

*Key details to verify:*

• Must meet deaf-blind and multiple disability criteria
• Contact: 877-438-5658

How to Start Exploring Caregiver Payment in Texas

Step 1: Confirm Medicaid enrollment. Most Texas caregiver-payment programs require the person receiving care to be enrolled in Texas Medicaid.

Step 2: Determine which program fits. STAR+PLUS is the most common pathway for elderly adults and people with physical disabilities. CLASS, HCS, and Home Living serve people with intellectual or developmental disabilities.

Step 3: Request an assessment or join the interest list. For STAR+PLUS, contact your managed care plan. For waiver programs, you may need to join an interest list through the Texas Health and Human Services Commission.

Step 4: Ask about Consumer Directed Services (CDS). Once approved for services, ask whether the CDS option is available and whether your family caregiver relationship qualifies.

Step 5: Complete worker enrollment. Background checks, payroll setup through an FMS provider, and program-specific onboarding are typically required.

Sample Question to Use When You Call

"Hello, I'm calling to ask about the Consumer Directed Services option under STAR+PLUS for my family member. They are enrolled in Medicaid and living at home. I'd like to understand whether a family member can be hired as a paid attendant and what assessment is needed. Can you help me get started?"

The Bottom Line

Texas has multiple pathways for paid family caregiving, with STAR+PLUS being the most common for elderly and physically disabled adults. The key first steps are confirming Medicaid enrollment, identifying the right program, and asking about the CDS self-directed option.