Ways to Pay for Assisted Living in Texas: A Guide for San Antonio Families

Published November 9, 2026 · The William Senior Living · San Antonio, TX

A practical guide to care costs, public benefits, insurance, and local resources for families planning assisted living in San Antonio.

Learning how to pay for assisted living in Texas often starts with two separate questions: what kind of support does a person need, and which resources can realistically pay for it over time? For families in San Antonio and Bexar County, the answer may combine personal income, savings, home equity, insurance, and public benefits. Each source has rules, and none should be assumed to apply until eligibility and policy terms are checked.

The William Senior Living, at 9203 Cinnamon Hill Dr in northwest San Antonio’s 78240 area, offers assisted living and memory care. For a family comparing options in Bexar County, a useful plan separates the price of a setting from the funding sources available, then identifies who will track applications, bills, and changes in care needs.

Start with the cost of care in San Antonio

Local benchmarks make those trade-offs easier to see. The CareScout Cost of Care Survey 2025 reports a San Antonio Area assisted living monthly median of $5,885, or $70,620 annually. The Texas statewide median is $5,666 monthly and $67,992 annually, while the U.S. national median is $6,200 monthly and $74,400 annually. The San Antonio metro figure is $219 higher than the state monthly median and $315 lower than the national monthly median. These are survey medians for the San Antonio Area, not rates for The William Senior Living.

CareScout’s standard in-home estimate uses 44 hours of care per week at $30 per hour. At 20 hours per week, the monthly figure is $2,600; around-the-clock care at 168 hours per week is $21,840 monthly. The 44-hour in-home estimate is $165 lower than the assisted living median. Adult day health care is listed at $90 per day. Annual nursing home figures are $76,468 for a semi-private room and $98,550 for a private room. Fewer hours at home may cost less, but they do not necessarily include housing, meals, home upkeep, or supervision during uncovered hours. Each setting provides a different bundle of services.

Private pay, savings, and home equity

Private pay usually means combining monthly income with assets. Possible sources include Social Security, pensions, retirement account distributions, savings, investments, and contributions from relatives. A home sale can also turn equity into cash, but equity should not be treated as immediately available money. A spouse may still need the home, repairs and transaction costs can affect proceeds, and borrowing against the property creates its own obligations.

Before selling, borrowing, or renting a home, families should consider legal, tax, and financial guidance appropriate to their circumstances. It is also important to leave room in the budget for a spouse’s living expenses, insurance premiums, transportation, and emergencies. A funding plan that works only while every asset performs as expected may be fragile.

A general guide to assisted living in San Antonio can help frame the next conversation, but a community’s written charges and assessment matter more than a regional median. Ask what the base charge includes, which services can add charges, when reassessments occur, and how a temporary absence is handled. Families considering The William Senior Living should call for current rates and ask for a written estimate that separates included services from additional charges.

How to pay for assisted living in Texas with Medicaid

Texas Medicaid’s STAR+PLUS Home and Community Based Services program, often called STAR+PLUS HCBS, can pay for assisted living services for members who meet a nursing facility level of care. The setting must be a licensed assisted living facility contracted with the member’s managed care organization, according to the Texas Health and Human Services STAR+PLUS guidance.

Two limits deserve close attention. Members pay room and board and any applicable copayment, so program approval does not mean every assisted living charge is covered. Interest lists or waitlists may also apply. San Antonio families can call 2-1-1 or contact the local Area Agency on Aging to ask about starting points and current list status. Before relying on this path, verify the individual’s eligibility, the community’s participation, and the expected room-and-board responsibility. Do not assume that a program name on a website establishes a contract with a particular community, and continue other planning while waiting for confirmation.

VA Aid and Attendance for eligible families

Aid and Attendance is an increased monthly amount added to a VA pension for eligible wartime-era Veterans or surviving spouses. VA eligibility guidance includes people who need help with daily activities such as bathing, dressing, or eating, are bedridden, live in a nursing home because of lost abilities, or have limited eyesight. It is not a general benefit for every Veteran, and payment of an assisted living bill is not automatic.

For rates effective December 1, 2025, the VA pension rate tables list a Maximum Annual Pension Rate with Aid and Attendance of $29,093 for a Veteran with no dependents. Divided by 12, that is $2,424 per month if countable income were zero. With one dependent, the annual rate is $34,488, or $2,874 per month on the same zero-income assumption. The pension equals the applicable maximum rate minus countable income, so these figures are not promised monthly payments.

The VA net worth limit from December 1, 2025 through November 30, 2026 is $163,699. VA also reviews asset transfers during the three years before a claim, and a penalty period can last up to five years. Certain unreimbursed medical expenses, which can include care costs, may affect countable income under VA rules. Because transfers and expenses can change a claim, families should seek guidance from VA or an accredited representative before moving assets.

Long-term care insurance and Medicare

Long-term care insurance can pay for services such as assisted living, depending on the policy. The Administration for Community Living’s insurance overview explains that benefits usually begin after an elimination period and when the policyholder needs help with activities of daily living or has cognitive impairment. Ask the insurer to confirm the benefit trigger, elimination period, covered settings, documentation requirements, benefit limits, and claims process. Keep the full policy available rather than relying on a summary or memory of a sales conversation.

Medicare has a different role. Medicare.gov states that Medicare does not cover long-term custodial care when that is the only care needed, and most long-term care is custodial. Ongoing help with daily activities, supervision, room, and board should not be budgeted as though Medicare will pay for them. Coverage for a particular medical service does not, by itself, establish continuing assisted living coverage.

Match the setting and license to the care needs

Texas Health and Human Services licenses assisted living facilities under Texas Administrative Code Title 26, Chapter 553. Its assisted living facility guidance explains that Type A residents can evacuate without help, follow emergency directions, and do not need routine nighttime attendance. Type B residents may need staff help to evacuate, may not follow emergency directions, and may need nighttime attendance. Facilities advertising care for people with Alzheimer’s disease or related disorders must hold an Alzheimer’s certification from HHSC. Families can ask any San Antonio community which license and certification apply.

Memory care should be described plainly as support, supervision, and an environment designed for people who need help with daily life, not as a cure or a promise to stop dementia. Families can review this home’s approach to memory care and ask about routines, supervision, and communication with relatives. For caregivers who are not planning a permanent move, the National Institute on Aging’s respite care explanation describes in-home help, adult day centers, and short residential stays. Availability and payment should be confirmed before respite becomes part of a funding plan.

Free guidance for San Antonio families

San Antonio families do not have to interpret every program alone. The Eldercare Locator, a service of the U.S. Administration for Community Living, connects people with local Area Agencies on Aging at 1-800-677-1116. Ask for the agency serving San Antonio and Bexar County, then request help with benefits, caregiver supports, and STAR+PLUS starting points. For dementia-specific support, the Alzheimer’s Association’s respite care resource explains options, and its 24/7 Helpline is 1-800-272-3900. These resources can clarify next steps, but they do not replace eligibility decisions by VA, Texas Medicaid, or an insurer.

Create a funding plan that can be reviewed

Before choosing a funding mix, place the essential information in one folder:

1. A written description of the daily help and supervision needed now, plus concerns that may change the care plan.
2. A current community estimate showing included services, additional charges, and the family’s remaining responsibilities.
3. A list of income, assets, insurance policies, and plans for any home that will remain occupied or be sold.
4. A record of benefit applications, contacts, requested documents, waitlist status, and dates for follow-up.
5. A scheduled review with the relatives or professionals responsible for monitoring bills and care changes.

For many households, how to pay for assisted living in Texas is not a one-time decision. Care needs, savings, insurance benefits, and program status can change. A workable plan identifies who pays now, which applications are pending, what room and board remains, and when the family will review the numbers again. That clarity is more useful than relying on a single benefit or a regional average.