As of 2020, 400,000 Texans are living with Alzheimer's disease and that number is expected to increase 22.5% by 2025, according to the Alzheimer’s Association. The number of people who have died from the disease is up 217.2% since 2000 with 10,101 deaths from Alzheimer’s reported in 2019. These statistics demonstrate a growing need for memory care support throughout Texas.
Memory care facilities provide those living with Alzheimer’s and dementia with care that is tailored to their unique needs. Memory care can take place in its own facility, or as part of a designated wing of another residential care community. Staff members of memory care units or facilities undergo specialized training in caring for those with memory impairment, and the facilities often coordinate social activities and schedules specifically for the needs of those living with Alzheimer’s or dementia.
This guide will cover the cost of memory care in Texas, financial assistance options for paying for memory care, free memory care resources in the state, and a directory of memory care facilities in Texas.
Because of the specialized staff training and resources required to provide high-quality memory care, memory care typically costs more than other types of residential care. On average, memory care will cost 20-30% more than assisted living.
We calculated the cost of memory care in Texas by adding 25% to the cost of assisted living care as reported in the 2021 Genworth Cost of Care Survey.
Averaging $4,998 per month, memory care in Texas is about $600 less than the national average of $5,625. Prices in other neighboring states are generally higher, though most are still below national averages. New Mexico is the exception, with rates about equal to national prices, at $5,623 per month. Louisiana’s rates are lower, at $4,685, and Arkansas’ are similar, at $4,700, still lower than in Texas by about $300 per month. And in Oklahoma, prices are closer to those in Texas, averaging $4,819 per month.
Memory care rates can vary significantly in Texas, depending on where you live. Expensive locations include Austin, which, at $6,681, costs approximately $1,680 more than the statewide average. In Victoria, south of Houston, prices are even higher, at $7,000. Costs in some large cities such as Dallas are lower, at $5,244, and Houston’s prices, at $5,306, are similar. San Antonio, another big city, has even lower rates, at $4,266, and other cities in this price range include the smaller city of Abilene, at $4,311 per month. Some smaller cities have exceptionally low rates for memory care, and these include San Angelo, averaging $3,750 a month, and Waco, where memory care costs $3,500 per month, $1,500 below the state average and $2,125 less than national figures.
Administered through Texas’ Health and Human Services, Medicaid is a program for low-income elderly that pays for health care services, including nursing home care, for those who qualify. This jointly funded state and federal program has specific services that apply to those living in memory care, and these services include assistance with daily living tasks, therapies and transitional assistance services. Specifically, two Medicaid waivers can help cover the costs of living in a memory care residential facility: STAR+PLUS and the Community First Choice Waiver. Recipients of either must meet Medicaid income, asset and physical eligibility requirements to qualify for services.
The STAR+PLUS Medicaid waiver can provide services to seniors 65 and older who meet Medicaid eligibility criteria. The program may cover the cost of assisted living care services in addition to adaptive aids or medical supplies, personal assistant services and occupational, speech or physical therapies.
Community First Choice Waiver
A federal Medicaid program, the Community First Choice Waiver offers services to seniors living at home, in the community or at an assisted living or memory care facility. Daily living activities assistance and personal care attention are provided to those who qualify. Services are designed to help promote the recipient’s independence whenever possible.
In Texas, seniors who wish to obtain Medicaid must have income below specific limits. In 2022, a single applicant can earn no more than $30,276 per calendar year, and they must retain a maximum of $2,000 in assets. The limitations are the same when only one spouse is applying, while income limits increase to $60,552 when both spouses are seeking coverage.
2022 Medicaid Income Limits for Seniors in Texas
|family size||annual income limits||asset limits|
|Two-Person Household (Single Applicant)||$30,276||$2,000 for applicant and $137,400 for non-applicant|
|Two-Person Household (Dual Applicants)||$60,552||$3,000|
In addition to meeting income and asset criteria, applicants must also have a functional need for care that requires a nursing level of care provided in either a nursing home or an assisted living residential facility. Other requirements include:
When applying to Medicaid in Texas, seniors have a number of sources that can help simplify the process by providing general information about eligibility, comparisons with other health care plans and other frequently asked questions.
|Your Texas Benefits||(877) 541-7905||The online Medicaid application portal, Your Texas Benefits, provides information about Medicaid’s benefits, eligibility requirements and support services. Individuals can call the toll-free number or dial 2-1-1 from their phones to get answers to general questions.|
|Texas Area Agencies on Aging||Varies by location||Operating in various counties across the state, Texas Area Agencies on Aging can give families more information about the best long-term care options for their loved ones, including Medicaid services. Referrals are also available to trained benefits counselors at Texas Health Information, Counseling and Advocacy Program, who can help explain the differences between Medicaid and Medicare as well as provide information on eligibility criteria and other Medicaid application guidelines.|
|Benefits.gov||Online||Benefits.gov is a federally funded site providing families with general Medicaid information, including information about how to apply in Texas. The site also offers a tool that gives a quick snapshot of eligibility potential based on answering a short series of questions about income, health and household size.|
Unfortunately, Medicare does not generally cover the cost of Memory Care. Most Memory Care Facilities are considered to be "social settings," so Medicare does not cover the cost incurred in these facilities. The only exception to that is if you are receiving memory care services in a Nursing Home. While this situation is much less common, Medicare would sometimes cover the cost, depending on a number of circumstances.
That being said, Medicare does still cover qualified doctor visits, medications, etc., as it would if you were still at home, but it will not cover the cost of care received at the Memory Care Facility.
In addition to the state programs mentioned above, those looking for resources to finance memory care may consider:
In Texas, assisted living facilities that provide memory care to seniors with Alzheimer’s disease or other forms of dementia are officially classified as Type B assisted living facilities. All ALFs in the state are licensed and regulated by the Health and Human Services Commission.
In Texas, all ALFs and memory care facilities can provide assistance with activities of daily living such as bathing, dressing, and mobility. Assistance with medication administration may be provided, as long as the staff is licensed in medication administration. Limited skilled nursing services may be provided in ALFs and memory care facilities, including care coordination, medication administration/supervision and special care in the event of illness or emergencies.
In Type B ALFs, care may be provided to residents who have been diagnosed with dementia or Alzheimer’s Disease, provided they are not permanently bedridden. Additional services may be provided, including:
Memory care facilities in Texas may not admit residents whose needs can not be met by their staff unless a licensed home health agency is supplementing that resident’s care. Residents of memory care facilities may not be permanently bedridden. If an ALF is classified as Type B, meaning that it’s permitted to provide specialized memory care to residents, it may admit residents who require the assistance of caregivers in emergency situations, including evacuation, and who require mobility assistance.
In all ALFs in Texas, including memory care facilities, licensing requirements state that new residents must be provided with a service plan within 14 days of admission. This service plan must include detailed information regarding nursing services and any special care that the resident receives, including medication administration.
Memory care facility staff in Texas are permitted to provide assistance with medication administration to residents, provided they hold a current Medication Aide license and are acting under the direct supervision of a licensed nurse. Assistance may consist of help with opening packaging, monitoring doses and providing medication reminders. In the event a resident is unable to take medication on their own, licensed staff may provide direct assistance.
In Texas, memory care facilities may not assign more than four residents to a single room and no more than half of the units within a facility may be occupied by more than two residents. Each resident must have a minimum of 80 square feet of personal space in shared rooms, and single rooms must be a minimum of 100 square feet. Restrooms may be communal but must be gender-specific and there must be at least one restroom per every six residents. All restrooms must contain at least one shower, one toilet, and one sink.
In Texas, there is no law that states a required staff to resident ratio in ALFs or memory care facilities; however, all facilities must have at least one manager on duty at all times who is in charge of overseeing staffing and ensuring all residents’ needs are met. Each facility must ensure that it employs enough staff to maintain order, safety and cleanliness within the facility at all times and provide assistance in emergency situations, including evacuation. Additionally, facilities must ensure they keep enough staff on duty at all times to assist residents with their needs, serve meals and provide housekeeping and laundry assistance.
Texas Medicaid provides two waiver programs that may cover the cost of care for eligible seniors — the STAR+PLUS program and the Community First Choice waiver. To receive Medicaid waiver benefits in Texas, seniors must reside in a Type B ALF and require a nursing level of care.
The Texas Department of Family and Protective Services manages a Texas Abuse Hotline, which accepts reports of abuse in nursing homes, assisted living facilities and memory care facilities. The hotline accepts reports between the hours of 7 am and 7 pm Monday through Friday. Reports can be made by calling 800-252-5400. Non-urgent matters can be reported online at the Texas Abuse Hotline website.
A number of valuable resources exist in Texas for those experiencing memory loss and their caregivers. Caregiver support, including respite care and counseling, is available, as is counseling for families to assist them in planning future care. Early detection programs, educational resources and advocacy are some of the additional resources available.
|Alzheimer’s Disease Program||800-242-3399||Part of the Health and Human Services division, the Alzheimer’s Disease Program offers a plethora of informational resources designed to raise awareness about dementia, warning signs and a number of caregiver resources.|
|Alzheimer’s Texas||512-241-0420||Alzheimer’s Texas is a statewide resource providing numerous resources for seniors and their families. The 24-hour helpline can assist families in getting their loved ones an official diagnosis and finding locally available services. Other services include respite care and support groups, as well as classes, ongoing conferences and other educational resources.|
|Alzheimer’s Association Texas Chapter||800-272-3900||Located in southwest Austin, the Alzheimer's Association Texas Chapter connects seniors and family members to support groups, counseling services and individualized counseling to help create personalized plans for future care.|
|Texas Health and Human Services – Aging Department||855-937-2372||The Aging Department of Texas’ Health and Human Services offers a number of services for seniors 65 and older, including respite care, advocacy and guidance regarding long-term care rights. Assistance identifying local memory care services is also provided.|
|AGE of Central Texas||512-451-4611||Providing a variety of services for older adults and their caregivers, AGE of Central Texas also offers Memory Connections, a program of small group interactive activities for those experiencing early symptoms of Alzheimer's.|
|211 Texas||211||A program provided by the Texas Health and Human Services Commission, 211 Texas is a free, anonymous social service hotline that can be reached 24 hours a day. 211 Texas provides information about local community resources, including those for elders experiencing dementia.|