STAR+PLUS Medicaid in Dallas | Home Care Options for Families

If your family is exploring Medicaid-funded home care in the Dallas area, every path leads through the same program: STAR+PLUS. It’s the Medicaid managed care system that serves adults with disabilities and those 65 and older in Texas, and it’s the program that makes paid family caregiving possible for thousands of Dallas families.
Understanding how STAR+PLUS works in your specific service area — which MCOs operate here, what services are available, and how to activate the family caregiver option — is the foundation for everything that comes next.

What STAR+PLUS Is and Who It Serves

STAR+PLUS is Texas’s Medicaid managed care program for individuals who are 21 or older and have a disability, or who are 65 or older. It combines acute care (doctor visits, hospital stays, prescriptions) with long-term services and supports (home care, attendant services, nursing facility care) under a single managed care plan.
For Dallas families, the long-term services piece is what matters most. Within STAR+PLUS, participants who need help with daily activities — bathing, dressing, eating, mobility, medication management, housekeeping — can qualify for Home and Community-Based Services (HCBS). These are the services that fund home care and keep your loved one out of a nursing facility. HCBS under STAR+PLUS includes personal attendant services, homemaker services like meal preparation and light housekeeping, adaptive aids and medical supplies, minor home modifications, emergency response services, and respite care for primary caregivers.

The critical piece for families: STAR+PLUS HCBS includes the Consumer Directed Services(CDS) option, which allows participants to hire their own caregiver — including a qualifying family member — and pay them through a Financial Management Services Agency.

The MCOs Serving Dallas

STAR+PLUS is administered by Managed Care Organizations, and the MCO your loved one is enrolled with controls the service authorization process, care coordination, and provider network. In the Dallas service area, four MCOs currently operate.

Superior HealthPlan is one of the largest Medicaid managed care companies in Texas, part of the Centene Corporation. Superior has a broad provider network across the DFW metroplex and significant experience administering STAR+PLUS HCBS. Many Dallas families are enrolled with Superior, and their service coordination teams handle a high volume of home care cases.

Molina Healthcare of Texas has a strong presence in the Dallas market and serves a large Medicaid population across the state. Molina’s approach tends to emphasize care coordination and member engagement, and they have service coordinators familiar with the specific needs of Dallas-area communities, including the large Hispanic population in areas like Oak Cliff and Irving.

Amerigroup Texas is part of Elevance Health (formerly Anthem) and operates one of the larger STAR+PLUS networks in the state. Amerigroup has invested in community health initiatives across the DFW area and has dedicated teams for long-term services and supports.

UnitedHealthcare Community Plan brings the resources of the largest health insurer in the country to the STAR+PLUS program. United’s network is extensive, and their technology platforms for care management are among the most developed.

When your loved one enrolls in STAR+PLUS, they will either be assigned to one of these MCOs or given the opportunity to choose. Unlike some states where the MCO choice feels meaningless, in Texas the differences can be real — particularly around how quickly a service coordinator is assigned, how responsive member services is, and how smoothly the CDS enrollment process runs.

How to Qualify for HCBS in Dallas

Your loved one may qualify for STAR+PLUS HCBS if they meet both financial and functional criteria.
Financial eligibility follows Texas Medicaid guidelines. Individuals receiving SSI are generally automatically eligible. Others must meet income and asset limits, which can be verified through a Medicaid application at YourTexasBenefits.com or by calling 2-1-1. Texas has not expanded Medicaid under the ACA, so eligibility categories are more limited than in some other states —but the aged, blind, and disabled pathways serve the STAR+PLUS population.

Functional eligibility means your loved one needs a nursing-facility level of care. A service coordinator from the MCO conducts an in-home assessment that evaluates how much help your loved one needs with activities of daily living. The assessment isn’t looking for someone who’s bedridden — it’s looking for someone who needs regular, ongoing assistance with daily tasks that they can’t safely perform independently.

If the assessment determines your loved one meets the threshold, HCBS is authorized and a care plan is developed specifying the services and hours approved.

Activating Consumer Directed Services

During the care planning process, your loved one (or their Legally Authorized Representative)should request the
Consumer Directed Services delivery model. This is the step that opens the door to hiring a family member.
Under CDS, the participant becomes the employer of record. They choose who to hire, set the schedule, and direct the care. A Financial Management Services Agency handles payroll, taxes, workers’ compensation, and compliance. The family member who provides the care is the attendant — they submit timesheets through the FMSA and receive regular paychecks.

Two rules to remember: the employer of record and the paid attendant must be different people, and spouses cannot serve as paid attendants under STAR+PLUS.

If your loved one is already receiving STAR+PLUS HCBS through a traditional agency and wants to switch to CDS, they can request the change through their service coordinator. It’s not a one-time-only choice — participants can move between service delivery models.

What Dallas Families Should Know About STAR+PLUS Timing

One of the advantages STAR+PLUS has over some other Texas waiver programs is that
HCBS does not typically have a waitlist. Programs like CLASS and MDCP can have waitlists stretching months or years, but STAR+PLUS is generally accessible once eligibility is established. For Dallas families who need services relatively quickly, this makes STAR+PLUS the most practical pathway.

That said, the process still takes time. From Medicaid application through MCO enrollment, functional assessment, care plan development, and CDS setup, families should plan for approximately six to ten weeks before the first paycheck arrives. Starting early — before a crisis forces the issue — gives your family the best chance of a smooth experience.

Local Resources in Dallas

The Dallas Area Agency on Aging provides information, referrals, and assistance navigating long-term care options in the Dallas area. They can help connect your family with the right starting point, whether that’s a Medicaid application, an MCO inquiry, or a community resource.

The Texas Health and Human Services Commission (HHSC) local offices in Dallas County handle Medicaid eligibility determinations. You can also reach HHSC through 2-1-1, the statewide helpline for health and human services.

How CareChoice Supports Dallas Families Through STAR+PLUS

CareChoice serves Dallas-area families navigating STAR+PLUS every day. We understand which MCOs operate here, how the CDS enrollment process works with each one, and how to connect families with the right FMSA to get the payroll infrastructure in place.

Whether you’re starting from scratch with a Medicaid application or you’re already enrolled in STAR+PLUS and want to switch to Consumer Directed Services so a family member can become the paid caregiver, CareChoice walks you through each step.

Talk to our Dallas team →Contact CareChoice

STAR+PLUS Medicaid in Dallas: Home Care Options for Your Family