Caregiving in Texas— the questions adult children actually ask.

No on both counts. Texas has no state estate tax and no state inheritance tax — and no state income tax. The federal estate-tax exemption ($13.99M per person in 2025) applies, but most Texas families face no estate tax. The lack of state-level death taxes is one of the structural reasons Texas attracts retirees with substantial assets from higher-tax states.

For long-term-care Medicaid (administered through STAR+PLUS managed care), the asset limit is $2,000 for a single applicant — the SSI baseline. The home is exempt up to $752,000 of equity, one vehicle is exempt, and a community spouse can retain up to $157,920. Texas's unlimited constitutional homestead protection means the home equity is protected from non-Medicaid creditors at any level during life — but the federal Medicaid home-equity cap still applies for eligibility purposes.

Yes, through the STAR+PLUS HCBS waiver. Once your parent qualifies for Texas Medicaid LTC and is enrolled in a STAR+PLUS managed-care plan (Amerigroup, Cigna-HealthSpring, Molina, Superior HealthPlan, or UnitedHealthcare), the plan can authorize Consumer Directed Services (CDS) — allowing the recipient to hire and pay a caregiver, including an adult child. Spouses cannot be paid; otherwise the relationship is broadly permissive. Rates vary by region and plan but typically run $10–$15/hour.

A Qualified Income Trust (QIT), also called a Miller trust, is required when a Texas Medicaid LTC applicant's gross monthly income exceeds the $2,901 income cap (2026 figure). The QIT diverts income above the cap into a separate trust account so it's not counted for eligibility. Setup is paperwork-heavy but not difficult — a Texas elder-law attorney charges $500–$1,500 for a standalone QIT. Most retirees with even a modest pension or IRA distribution above Social Security need one.

Call the Texas Adult Protective Services hotline at 1-800-252-5400, operated 24/7 by the Texas Department of Family and Protective Services under Texas Human Resources Code Chapter 48. Reports can also be filed online at txabusehotline.org. For abuse in licensed long-term care facilities, contact the Long-Term Care Ombudsman through HHSC at 1-800-252-2412. For immediate danger, call 911 first.

Texas Estates Code Chapter 114 authorizes a Transfer-on-Death Deed (TODD) — a recorded document naming a beneficiary who automatically receives the home at the owner's death, bypassing probate entirely. The owner retains full control during life and can revoke the deed at any time. Recording costs typically run $25–$75 at the county clerk. For Texas families whose primary asset is the home (which is most of them), the TODD is the simplest and cheapest probate-avoidance tool available, and far less expensive than a revocable living trust.

Texas has the strongest homestead protection in the United States: under the Texas Constitution (Art. XVI §§50–51), an unlimited home value is protected from forced sale by most creditors, on up to 10 acres urban or 100–200 acres rural depending on classification. The exemption applies during life and does not have a dollar cap (unlike most states which cap protection at $150,000–$600,000). It does not protect against mortgage holders, tax liens, mechanic's liens for work on the property, or federal tax liens. For Medicaid purposes, the federal home-equity ceiling ($752,000 in 2026) is a separate analysis.

No. Texas does not have a state Paid Family Leave program and does not require private employers to provide paid leave for caregiving. Federal FMLA (12 weeks of unpaid, job-protected leave for caregivers of seriously ill family members, including parents, at employers with 50+ employees) is the primary protection available. Some Texas employers offer paid leave voluntarily, and federal employees have access to the federal Paid Parental Leave program (which doesn't cover parent caregiving). Texas caregivers often rely on the contractor-economy advantage instead — the larger share of self-employed and contract workers means more workers control their schedules.

Texas nursing home costs are among the lowest in our six launch states. The 2024 Genworth state median for a semi-private room is approximately $5,400/month (~$65,000/year) and for a private room is approximately $7,500/month (~$90,000/year). Major metros (Houston, Dallas-Fort Worth, Austin) run $1,000–$2,000/month above the state median; rural Texas runs below. Medicaid pays the semi-private rate at the state-negotiated reimbursement; private-pay families bear the spread.

Texas licenses assisted living in two categories under Health and Safety Code Chapter 247. Type A facilities serve residents who can evacuate independently in an emergency, or with minimal assistance. Type B facilities serve residents who require more assistance to evacuate, including some non-ambulatory residents and some residents with cognitive impairment. The licensure tier matters for memory-care eligibility — most facilities marketing themselves as memory care in Texas are Type B. Confirm the license type before signing an admission contract; some Type A facilities have been challenged for serving residents who should be in Type B settings.