Azucena's Primary Home Care
This is the most common misconception we see: 'Medicare should cover my mom's caregiver.' Understanding the difference between these two programs can save your family thousands of dollars and weeks of confusion.
Medicare does NOT pay for long-term personal care (bathing, dressing, meal prep, medication reminders). Medicaid — specifically STAR+PLUS in Texas — does. These two programs are fundamentally different in what they were designed to cover.
Medicare is federal health insurance for people 65 and older (and some younger people with disabilities). It covers medical care: doctor visits, hospital stays, skilled nursing (limited), home health services (limited), and hospice. The key word is 'skilled' — Medicare pays for a nurse to come assess a wound, or a physical therapist to help after a hip replacement. Once the skilled need ends, Medicare coverage ends. It does not pay for an ongoing caregiver to help with daily activities.
Medicaid is a state-federal program for people with low income and assets. In Texas, STAR+PLUS Medicaid covers Personal Assistance Services (PAS) — the daily help that Medicare specifically excludes: bathing, dressing, grooming, transfers, meal preparation, medication reminders, light housekeeping, and companion care. For people who meet the nursing facility level of care standard, the STAR+PLUS HCBS Waiver also covers respite care, adaptive aids, and more — often for many hours per week or per day.
A family member has a stroke or hip replacement. Medicare pays for the hospital stay and a short-term home health rehab period (maybe 20–30 visits from a skilled nurse or therapist). Once the patient is 'stable,' Medicare stops. But the patient still needs daily help — they can't bathe alone, can't cook, can't transfer safely. This is when families realize Medicare wasn't designed for this — and start looking for alternatives.
The fastest way is to call us at (956) 594-8188. We help families in Cameron County navigate these programs every day, at no cost. Tell us your loved one's situation, their insurance status, and their care needs — we'll guide you to the right program and help you start the application process. There's no commitment and no fee for the guidance.