Assisted Living Costs in Texas: What Families Are Paying in 2026
Texas is one of the more affordable states for assisted living in the country — which is a meaningful fact if you're the adult child sitting across from an admissions coordinator trying to figure out how much longer your parent's savings will last.
The Texas median for assisted living is below the national average, and it has been for several years. But "below the national average" covers an enormous range inside the state. What you'll pay in Austin is a different conversation than what you'll pay in Waco or Amarillo, and what's included in that monthly fee varies from facility to facility in ways that aren't always obvious upfront.
This guide covers what Texas families are actually paying in 2026, what to watch for in the pricing, how the state's Medicaid waiver program works, and how Texas regulates the facilities your parent might move into.
Texas vs. National: How the Costs Compare
According to the Genworth Cost of Care Survey, the national median cost of assisted living in 2024 was approximately $5,511 per month. Texas comes in meaningfully lower.
Based on 2024–2025 data from Genworth and PayingForSeniorCare.com, the Texas median for assisted living runs roughly $3,800 to $4,200 per month for a standard one-bedroom or semi-private unit. That's a savings of roughly $1,300–$1,700 per month compared to the national median — or $15,600–$20,400 per year.
That gap matters. For a family estimating how long a parent's savings will support care, that's a meaningful difference in runway.
Cost by City: The Variation Inside Texas
Texas is a large state with significant variation in cost of living, and assisted living prices track that variation closely.
| City / Region | Estimated Monthly Range (2025–2026) | Notes |
|---|---|---|
| Austin | $4,500 – $7,500+ | Highest costs in state; strong demand, high real estate costs |
| Dallas / Fort Worth | $4,000 – $7,000+ | Wide range; suburbs often lower than city core |
| Houston | $3,500 – $6,500 | Large market; broad range from basic to luxury |
| San Antonio | $3,200 – $5,500 | Generally below Dallas/Austin averages |
| El Paso | $2,800 – $4,500 | Among the more affordable major cities |
| Lubbock / Amarillo | $2,500 – $4,200 | West Texas markets tend to run lower |
| East Texas / Rural | $2,200 – $3,800 | Lowest costs but fewer facility options |
Sources: Genworth Cost of Care Survey 2024, PayingForSeniorCare.com Texas data, facility surveys. 2026 estimates reflect an approximate 3–5% annual cost increase applied to 2024 data.
A few things to note about these ranges:
The low end of any range is often for a semi-private room (shared with a roommate) and minimal care needs. The high end reflects private suites, higher care levels, or premium communities with resort-style amenities.
Memory care costs more. A secured memory care unit typically runs $1,000–$2,000/month more than standard assisted living in the same facility, because staffing ratios are higher and programming is more intensive.
Geography matters more than city. In large metros like Houston and Dallas, a community 30 minutes outside the city center can cost $500–$1,000/month less than one in a high-demand suburb like The Woodlands or Frisco.
What's Included — and What's Not
One of the most common surprises Texas families encounter is that the base monthly rate quoted in an admissions tour doesn't tell the whole story.
Typically included in Texas assisted living base rates:
- Private or semi-private room (varies by community)
- Three meals per day plus snacks
- Weekly or bi-weekly housekeeping and laundry
- 24-hour supervision and safety monitoring
- Some level of personal care assistance (usually 1–2 hours/day of staff time for basic needs)
- Activities and social programming
Commonly charged as add-ons (read the contract carefully):
- Incontinence supplies and assistance
- Medication management (often $200–$500/month additional)
- Escort to meals or activities
- Higher levels of personal care (dementia-related supervision, two-person transfers)
- Transportation to medical appointments
- Beauty salon / barber services
- Private phone or cable TV
Watch for tiered care pricing. Many Texas assisted living facilities use a "points" or "levels of care" system where residents are assessed on how much staff time they require, and the fee goes up as care needs increase. Ask upfront how this works: what triggers a level change, how much each level costs, and how often residents are reassessed. Some families are surprised when a parent's monthly bill jumps significantly after a health change.
How Texas Regulates Assisted Living
Texas regulates assisted living facilities through the Texas Health and Human Services Commission (HHSC). All facilities must be licensed, and HHSC conducts inspections on a regular cycle.
Two license types you need to understand:
Type A facilities serve residents who are mobile, can follow directions, and can evacuate themselves in an emergency without staff assistance. Think of Type A as appropriate for relatively independent seniors who need some help with meals, medications, or light personal care.
Type B facilities can serve residents who are non-ambulatory, who need staff assistance to evacuate, or who require more intensive supervision. Memory care units must be licensed as Type B or operate as a separate secured unit within a Type B facility. If your parent has dementia or significant mobility impairment, you want a Type B facility.
How to verify licensing: HHSC maintains a public online search tool at hhs.texas.gov where you can look up any licensed assisted living facility in Texas, confirm their current license status, and access inspection history. Any facility with a current enforcement action against its license should be able to explain it directly — if they can't or won't, that's a concern.
Paying for Texas Assisted Living: The Options
Private pay is how most residents begin. This means using savings, investments, pension income, Social Security, or the proceeds from selling a home to pay monthly fees.
Long-term care insurance (if your parent has a policy) typically covers assisted living as part of its benefit. Confirm with the policy that the specific facility and care type are covered before making a move.
Veterans benefits. Eligible veterans and surviving spouses may qualify for the Aid and Attendance benefit, which can provide $800–$2,400/month toward assisted living costs. This benefit is underused and worth exploring through the VA or a VA-accredited claims agent.
STAR+PLUS Medicaid Waiver. This is Texas's main Medicaid managed care program for long-term care, and it can cover assisted living costs for seniors who qualify. Here's how it works:
- Financial eligibility: The applicant must meet Medicaid income and asset limits. For an individual, countable assets generally cannot exceed $2,000.
- Medical eligibility: The applicant must require a nursing-facility level of care — determined through a Medicaid assessment, not just the facility's own evaluation.
- Facility participation: Not every Texas assisted living facility accepts STAR+PLUS. Facilities must be enrolled as a STAR+PLUS provider and have available capacity.
- Waiting lists: There are often waiting lists for waiver slots, and the wait can range from months to years depending on the region.
If Medicaid planning is relevant for your situation, consulting with an elder law attorney in Texas before making care decisions can protect your family from costly mistakes. Medicaid rules are complex and the spend-down process has legitimate legal strategies that can protect some assets for a spouse.
What Questions to Ask on an Assisted Living Tour in Texas
Before you sign anything, make sure you have direct, written answers to these:
- What is the base monthly rate, and what exactly does it include?
- What triggers a care level increase, and what does each level cost?
- Is this facility licensed as Type A or Type B?
- What is your most recent HHSC inspection result?
- Do you accept STAR+PLUS Medicaid? If so, are there currently open slots?
- What is your staff-to-resident ratio during the day and at night?
- What happens if my parent's care needs increase significantly — can they stay, or would they need to transfer?
- What is the 30-day written notice period, and what are the terms for fee changes?
For more on what to look for on a tour and what to expect day-to-day in assisted living, see our full guide to assisted living.
How to Find the Right Community
Texas has hundreds of licensed assisted living facilities ranging from small owner-operated homes (Residential Care Facilities licensed for 4–16 residents) to large corporate communities with 150+ residents. What's right for your parent depends on their personality, care needs, location preferences, and budget.
Small residential homes (often called "board and care" homes or "personal care homes") tend to have higher staff-to-resident ratios and a more homelike atmosphere. Larger communities typically offer more programming, amenity-rich environments, and more on-site clinical support.
Neither format is universally better — but it's worth visiting both types if you're still exploring.
Ready to start comparing assisted living communities in Texas? Search the DigitalCare60 directory to find licensed facilities near you, filtered by city, care type, and budget.