Also Known As:
Texas Medicaid hospice benefit, STAR+PLUS hospice, Medicaid hospice coverage
Type:
State-administered health insurance program for low-income individuals
Primary Purpose:
To cover hospice services in full for eligible Texas residents.
When It Applies:
When the patient is enrolled in Texas Medicaid or a Medicaid-managed care plan (STAR+PLUS, STAR Kids, etc.) and meets hospice clinical eligibility.
Who Is Involved:
Texas Health and Human Services (HHSC), the patient’s managed-care plan if applicable, the hospice agency, and the patient’s attending physician.
Where It Occurs:
Hospice care is delivered at the patient’s home or facility; Medicaid pays the hospice agency directly.
Duration:
For as long as the patient remains eligible for both hospice and Medicaid coverage.
Coverage:
100%, no co-pays, no deductibles, no out-of-pocket cost for hospice services.
Key Focus:
Same comprehensive hospice care as Medicare, nursing, aide, social worker, chaplain, medications, equipment, and bereavement.
Common Misunderstanding:
Many families don’t realize Medicaid covers hospice on the same terms as Medicare. For dual-eligible patients (both Medicare and Medicaid), Medicaid often covers additional facility room-and-board costs that Medicare does not.
What Texas Medicaid Covers in Hospice
Texas Medicaid covers the same hospice services as Medicare, nursing, aide care, social work, chaplain, all medications related to the terminal diagnosis, durable medical equipment, and bereavement support. There is no out-of-pocket cost to the family for the hospice portion of care.
For patients living in a nursing facility, Medicaid often covers the room-and-board cost in addition to the hospice services. This combination, Medicaid for room and board, Medicare or Medicaid for hospice services, is how many low-income Texas families receive end-of-life care in skilled nursing facilities.
Dual-Eligible (Medicare + Medicaid) Patients
Many Texans qualify for both Medicare and Medicaid. For dual-eligible hospice patients:
- Medicare typically pays for the hospice services (nursing, aide, medications, equipment)
- Medicaid often covers nursing-facility room and board if the patient lives in one
- Neither benefit charges the family a co-pay or deductible for the hospice portion
How to Confirm Coverage
When Lifted’s intake team learns a patient has Medicaid, we verify coverage with Texas HHSC directly, usually within minutes. There is no delay to care while coverage is confirmed; we begin the assessment and admission process in parallel.
If you have questions about Medicaid hospice coverage in Texas, contact our team or call (972) 777-3000.