When a family first calls us about memory care, the second question is almost always about money. It is a fair question, and it deserves a straight answer: in Texas, most families pay for Alzheimer’s and memory care through a combination of sources rather than a single one. This guide walks through the options families most often use, what each one realistically covers, and the questions worth asking before you commit to anything.
One note before we start: programs, eligibility rules and benefit amounts change. Treat this as a map, not a rulebook, and confirm the details with each program directly — we link to the official sources throughout.
Private pay is the most common starting point
Most Texas families begin by paying for memory care from income and savings — a pension, Social Security, retirement accounts, or the proceeds of selling a home. Communities typically charge a monthly rate, and what that rate includes varies widely: some communities price room, board and care separately, while others bundle them. When you tour a community — ours included — ask exactly what the monthly rate covers, what triggers a rate change, and how often rates are reviewed. A community that answers those questions plainly is telling you something important about how it operates.
Long-term care insurance
If your loved one bought a long-term care policy years ago, it may be one of the most valuable assets they own. Most policies pay a daily or monthly benefit toward assisted living and memory care once the policyholder can no longer manage a set number of activities of daily living, or has a cognitive impairment diagnosis. Two practical points: there is usually an elimination period (a stretch of days you pay out of pocket before benefits begin), and claims require documentation from a physician. Find the policy documents early and call the insurer before you need to move — knowing the benefit amount changes which communities are realistic.
VA benefits: Aid and Attendance
Wartime veterans and their surviving spouses may qualify for the VA’s Aid and Attendance benefit — a monthly addition to the VA pension for people who need help with daily activities. For a qualifying veteran or spouse, it can meaningfully offset memory care costs. Eligibility depends on service dates, income and assets, and medical need, and applications take time, so start early. The official details live at VA.gov, and Texas veterans can get free application help from their county Veterans Service Office.
What Medicare does — and does not — cover
This is the misunderstanding that costs families the most planning time: Medicare does not pay for long-term custodial care, which is what residential memory care is. Medicare covers hospital stays, doctor visits, limited short-term skilled nursing after a qualifying hospital stay, and hospice — but not months or years of help with bathing, dressing, meals and supervision. Budget as though Medicare will contribute nothing to the monthly memory care bill, and let anything it does cover be a bonus. The coverage rules are at Medicare.gov.
Medicaid in Texas: STAR+PLUS
Texas Medicaid can help pay for long-term care for people who meet both medical and financial criteria, largely through the STAR+PLUS program and its Home and Community Based Services. Some — not all — assisted living and memory care communities participate, and demand for waiver services can exceed capacity, so there may be a waiting period. If Medicaid is likely to matter for your family, two early steps help: ask every community you tour whether they accept STAR+PLUS residents, and talk to Texas Health and Human Services or your local Area Agency on Aging about eligibility before savings run down completely. Official information is at hhs.texas.gov.
Life insurance you already own
A life insurance policy can sometimes help pay for care while the policyholder is still living. Depending on the policy, that might mean an accelerated death benefit rider for chronic or terminal illness, a loan against cash value, or selling the policy in a life settlement. Each route has real trade-offs — reduced death benefit, tax questions, and offers that may be well below face value — so this is a decision to make with a financial professional who is not the buyer.
Where to get free, unbiased help in Texas
You do not have to untangle this alone, and you should not have to pay someone just to understand your options. Your local Area Agency on Aging offers benefits counseling, and the Alzheimer’s Association publishes practical financial and legal planning guidance for dementia specifically. If you are earlier in the process, our own guide to financial planning for memory care expenses covers the budgeting side of the same conversation.
Questions to ask any memory care community about money
- What exactly does the monthly rate include, and what is billed separately?
- Which payment sources do you accept — and do you participate in STAR+PLUS?
- What happens if our funds run low after moving in?
- How much notice is given before a rate change?
- Is there a community fee or deposit, and is any of it refundable?
Ask us these questions too. We would rather a family understand the numbers clearly at the first visit than be surprised later. If you are exploring Alzheimer’s care in San Antonio, you can schedule a visit at any of our communities, and bring every financial question you have — including the hard ones.
