In Texas, the state coordinates care for approximately 700,000 dual-eligibles, based on June 2025 enrollment data, through a mix of programs including STAR+PLUS, STAR Kids, Dual-Eligible Special Needs Plans (D-SNPs), and, for some individuals, fee-for-service Medicaid or IDD waivers like Home and Community-based Services (HCS) and Texas Home Living (TxHmL). These programs provide different pathways for dual-eligibles to receive medical, behavioral health, and long-term support services, depending on their age, eligibility, support needs, location, and Medicare coverage choices.

Our latest Texas Dual-Eligible HQ State Report, published in October 2026, takes a deep dive into how dual eligibility is structured and delivered in Texas. It includes the most current information available on eligibility, program design, delivery models, and enrollment figures. Whether you’re a policymaker, provider, or researcher, this report serves as a go-to resource for understanding how dual eligibility in Texas works.

In the Texas Dual-Eligible HQ State Report, you’ll find answers to questions like:

• How is Texas’s Medicaid program organized, and how does managed care operate through STAR+PLUS and STAR Kids?
• What role do D-SNPs play in delivering care to dual-eligibles in Texas?
• Who qualifies as a dual-eligible in Texas, and what types of services do they receive?
• How does Texas coordinate long-term services and supports (LTSS), behavioral health, and IDD services for dual-eligibles?
• What is the function of Texas’s IDD waivers and how do they work alongside Medicare and Medicaid coverage?
• How are behavioral health services funded and coordinated between Medicare and Medicaid for duals?
• Who oversees Texas’s Medicaid managed care and D-SNP integration efforts?
• What are the most recent dual-eligible enrollment numbers in Texas?
• How do value-based payments factor into Medicaid managed care under Texas’s Medical Pay-for-Quality program?

Want to get a full picture of dual eligibility in Texas? Click below to access the comprehensive Texas Dual-Eligible HQ State Report.