Paying for it
Who pays for home modifications in Texas
Families ask this before anything else. The short version: Medicare does not pay. The VA, several Texas Medicaid waiver programs, workers’ compensation and a state barrier-removal grant may, each with its own rules. Here is what each one does, in plain language.
Medicare: no
Original Medicare does not pay for ramps, stairlifts, grab bars, walk-in showers or any other home modification. It covers durable medical equipment such as walkers, wheelchairs and patient lifts, not the structural work to install them. Medicare’s own policy says home modifications are not covered.
Some Medicare Advantage plans include a small home-safety allowance as an extra benefit. Check your plan’s Evidence of Coverage or call the number on your card.
Veterans: the VA
The VA HISA benefit can pay up to $6,800 (service-connected, or non-service-connected with a 50 percent or higher rating) or $2,000 (other non-service-connected) over a lifetime toward prescribed home changes. Veterans with certain severe service-connected disabilities may qualify for the much larger SAH and SHA grants. Details, forms and what we do to help are on our VA grants page.
Texas Medicaid waiver programs
Texas runs several Medicaid waiver programs that can pay toward minor home modifications: ramps, grab bars, roll-in showers, wider doorways and related work. Each has a lifetime cap for home modifications, a separate yearly allowance for adaptive aids, and its own rules on who qualifies. The program decides medical necessity and the amount.
CLASS (disability that began before age 22, such as cerebral palsy, spina bifida, muscular dystrophy, epilepsy or head injury; all ages): minor home modifications up to $10,000 lifetime, then $300 per plan period for repairs. Adaptive aids up to $10,000 per plan period, shared with dental. Work is arranged by your Direct Services Agency, which gets bids and sends the request to your case manager. There is a waiting list; call 877-438-5658 and ask for the CLASS interest list.
STAR+PLUS HCBS (adults 21 and over with a disability, or 65 and over): minor home modifications up to $7,500 lifetime, then $300 a year for repairs. Adaptive aids up to $10,000 a year. Elevators are excluded. Your managed care plan’s service coordinator assesses and authorizes, and the plan pays its contracted provider.
STAR Kids / MDCP (children and young adults up to 20 who are medically dependent): minor home modifications up to $7,500 lifetime, limited to ramps, doorway widening, bathroom changes and directly related work. Adaptive aids up to $4,000 a year; a stairlift counts as an adaptive aid here, not a home modification. Run by the child’s STAR Kids plan.
HCS and TxHmL (intellectual and developmental disability): minor home modifications up to $7,500 lifetime, $300 a year for repairs after that, adaptive aids up to $10,000 a year. Service coordination is through your Local IDD Authority.
DBMD (deaf-blind with multiple disabilities): minor home modifications up to $10,000 lifetime, adaptive aids up to $10,000 a year. Its list includes security fencing for a person with a cognitive impairment.
You may hear “$10,000 a year.” That is the adaptive-aids allowance in most adult waivers. Home modification caps are lifetime amounts. We will tell you which applies during the visit.
Managed care plans by city
STAR+PLUS and STAR Kids are run by private managed care organizations. Your plan’s service coordinator is the person who authorizes home modifications. As of early 2026, the plans in our markets are:
Houston (Harris County): STAR+PLUS: Community Health Choice, Molina, UnitedHealthcare. STAR Kids: ask your plan.
Austin (Travis County): STAR+PLUS: Superior, UnitedHealthcare. STAR Kids: Blue Cross and Blue Shield of Texas, Superior.
San Antonio (Bexar County): STAR+PLUS: Community First, Molina, UnitedHealthcare. STAR Kids: Community First, Superior.
Plans must document the need, get written landlord approval where it applies, and complete an approved STAR+PLUS home modification within 90 business days. We provide the written specifications, itemized bid and before-and-after photos a service coordinator asks for.
Workers’ compensation
If you were hurt at work in Texas and your employer carries workers’ compensation, the insurance carrier pays for all health care reasonably required by the injury, as and when needed. There is no dollar cap and no end date, and that liability cannot be limited by agreement or settlement (Texas Labor Code §408.021). After a serious injury, that care can include changes to your home if your treating doctor prescribes them.
How it works: your treating doctor recommends the work, the carrier’s adjuster preauthorizes it, and the carrier pays the provider. You are not billed. We provide the assessment and itemized estimate your adjuster or nurse case manager needs, and we bill the carrier after the work is done. Questions about your claim: Texas DWC, 800-252-7031, option 1.
TWC Vocational Rehabilitation
If you are working with a Texas Workforce Commission Vocational Rehabilitation counselor toward a job goal, VR may fund a home modification that lets you live independently and work. Ask your counselor whether it applies to your plan.
Amy Young Barrier Removal Program
This Texas Department of Housing and Community Affairs program gives one-time grants of up to $22,500 to households with a person with a disability, for renters or owners, when household income is at or below 80 percent of the area median family income. You apply through a local nonprofit or city administrator, not the state, and funding is limited and opens in rounds. We can be the contractor on an administrator’s project.
Other sources
Long-term care insurance. Some policies pay toward home modifications. Ask your carrier about the policy’s home-modification provision before scheduling work.
Area Agency on Aging. Your local agency (800-252-9240) may have limited funds for minor repairs and safety changes for people 60 and older, and can point you to other programs.
VA Aid & Attendance. A monthly cash add-on to a VA pension, not a home-modification grant. Some families budget it toward accessibility work.
Paying privately, and financing
Most of our projects are paid for by the family. A written proposal from us is a firm price, not an allowance that grows later, and we break larger projects into phases when that helps. Financing is available through a third-party lender for those who qualify; ask us on the visit and we will explain the terms in writing before you decide anything.
How to start
Book a free in-home visit. We measure, listen, and tell you honestly which programs might apply to your situation.
We write what your caseworker needs. Itemized specifications and estimate, before photos, and our license and insurance documents, in the form your program, plan or adjuster asks for.
You or your coordinator submit. We answer questions about the estimate. We do not start until the program authorizes the work.
We build. Our own licensed crews in Houston, Austin and San Antonio.
Book a free in-home visit. Veterans, start on our VA grants page. Therapists and case managers, see how we work with you.
Talk to a person
Free in-home assessment. We write the itemized estimate your caseworker, adjuster or VA office needs.