STAR+PLUS HCBS is Texas's main home-and-community-based alternative to nursing-facility placement, operating under the state's Section 1115 waiver authority and administered within the broader STAR+PLUS managed-care system (HHSC STAR+PLUS handbook).
To qualify, HHSC requires an applicant to be at least 21 years old, meet full Medicaid financial eligibility, be a Texas resident and U.S. citizen, have a documented nursing-facility medical-necessity determination, show an unmet care need, have an individual service plan that fits within the program's cost limit, and be in an appropriate living situation (HHSC STAR+PLUS HCBS eligibility policy). Community First Choice runs as a separate State Plan option alongside STAR+PLUS HCBS, giving Texas two distinct paths into in-home support with different eligibility rules and different realities around interest lists.