What's the same as everywhere — and what's specific to Texas, from the waiver interest lists to the community-property funding trap.
In Texas, the special needs trust follows federal rules — but the Texas system has its own programs, its own notoriously long waitlists, and a few Texas-only wrinkles. Medicaid for adults with disabilities runs largely through STAR+PLUS, developmental-disability services come through a set of waivers with massive interest lists, Texas is an income-cap state, the state ABLE plan is Texas ABLE, and the Arc of Texas runs the main pooled trust. One thing matters more than all the rest: getting on the waiver interest lists immediately.
As everywhere, a third-party special needs trust holds assets without breaking the $2,000 SSI and Medicaid limit and avoids payback. See what a special needs trust is for the mechanics.
This is the single most important step for a Texas family, and it's the one most often missed. Texas runs several Medicaid waivers for people with disabilities — HCS (Home and Community-based Services), TxHmL, CLASS, DBMD, and MDCP — each with its own "interest list." More than 170,000 Texans are waiting, and the wait for HCS can run 5 to 15 years or longer. You can be on multiple lists at once. Sign up through your Local IDD Authority (LIDDA) as early as possible; a child placed on the list at 16 may not reach the top until their thirties.
For adults with disabilities, much of Texas Medicaid's long-term care is delivered through STAR+PLUS, a managed-care program providing both health coverage and long-term services and supports in the home or community.
Yes. Texas caps income for Medicaid long-term care (the 2026 cap is $2,982/month for an individual), and someone over the limit may need a Qualified Income (Miller) Trust — a separate income tool, not a substitute for a special needs trust.
Texas is a community-property state, which creates a trap when funding a trust from joint savings. If those funds are later treated as community property in a divorce, a portion of the trust could be exposed. A Texas attorney can prepare a marital-property partition agreement to convert the funds to separate property before they go into the trust.
Texas uses the term guardianship (not conservatorship) and was the first state to authorize supported decision-making agreements in 2015, along with limited guardianship. The state ABLE plan is Texas ABLE, and the Arc of Texas Master Pooled Trust is the established pooled option. Draft the trust with a Texas-licensed special needs attorney; Special Legacy partners with them on the funding side.
If you do one thing in Texas, do this: get your loved one on the waiver interest lists today. The trust and the funding can be built over time — the waitlist clock can't be turned back.
Our free Care Cost Calculator estimates your loved one's lifetime care costs and shows the funding gap — a clear, no-pressure place to begin.
Estimate Care CostsThis article is for educational purposes only and is not legal, tax, or financial advice. Eligibility rules and dollar figures change frequently and vary by program. The figures here reflect 2026 and should be confirmed with your state Medicaid agency and a special needs attorney licensed in your state.