Texas · HHSC · LIDDA · HCS · TxHmL · STAR+PLUS

Texas Medicaid waiver guide

Texas operates five major home- and community-based services (HCBS) waivers across two pathways: LIDDAs (Local Intellectual and Developmental Disability Authorities) for HCS and TxHmL; CLASS provider agencies for CLASS; and Medicaid managed care organizations (MCOs) for STAR+PLUS LTSS and MDCP. The HCS interest list is one of the largest in the country — your LIDDA contact date is your documented place. WaiverPath helps you track the right track, your interest list registration date, and every document and deadline along the way.

WaiverPath is not a government agency, law firm, Medicaid provider, or benefits advisor. We help you organize information, documents, and follow-up tasks. Always verify requirements with the official agency or a qualified professional.

HCS Waiver (Home and Community-based Services)

Texas's most comprehensive I/DD waiver, serving individuals with intellectual or developmental disabilities of any age who need intensive community support. Administered by HHSC through Local Intellectual and Developmental Disability Authorities (LIDDAs). The HCS interest list has tens of thousands of Texans waiting — your LIDDA contact date establishes your place. Confirm current eligibility criteria and interest list procedures with your local LIDDA.

TxHmL Waiver (Texas Home Living)

A less intensive I/DD waiver for individuals who need community supports but do not require the full HCS level of service. Also administered by HHSC through LIDDAs. Entry point and interest list registration process is the same as HCS — contact your local LIDDA. Confirm current waiver level eligibility and interest list procedures with your LIDDA — waiver level determination is made by HHSC based on assessed support needs.

CLASS Waiver (Community Living Assistance and Support Services)

For individuals with related conditions — conditions other than intellectual disability that cause substantial functional limitations and had onset before age 22. Administered by HHSC through CLASS providers. Contact HHSC or a CLASS provider agency to begin the eligibility and interest list process. Confirm current CLASS provider availability in your area and intake timelines directly with HHSC.

STAR+PLUS LTSS

Long-term services and supports (LTSS) for adults 21 and older who are aged or have physical disabilities and require a nursing-facility level of care, delivered through HHSC Medicaid managed care organizations (MCOs). Enrollment and services go through your STAR+PLUS MCO. Confirm current eligibility criteria and your MCO's enrollment process with HHSC or your plan directly.

MDCP (Medically Dependent Children Program)

For children and youth under age 21 who are medically dependent — requiring ongoing nursing care — who would otherwise require a nursing facility level of care. Administered through HHSC and STAR Kids managed care organizations (MCOs). Contact your STAR Kids MCO or HHSC to begin the enrollment and assessment process. Confirm current MDCP eligibility criteria and any enrollment procedures with HHSC or your STAR Kids plan.

How Texas waiver applications work in 2026

1
Identify your waiver track
Determine which Texas waiver applies: HCS or TxHmL through a LIDDA for I/DD (intellectual or developmental disability) of any age; CLASS through HHSC or a CLASS provider agency for related conditions with onset before age 22; STAR+PLUS LTSS through your Medicaid MCO for adults 21+ with physical disabilities or aging needs; or MDCP through your STAR Kids MCO for medically dependent children under 21. Confirm the right track with your LIDDA, CLASS provider agency, MCO, or HHSC.
2
Confirm Texas Medicaid enrollment
All Texas HCBS waivers require active Texas Medicaid enrollment. Apply through Your Texas Benefits (yourtexasbenefits.com), by calling 2-1-1, or at your local benefits office. Keep your Texas Medicaid ID and application confirmation number for your records.
3
Contact your LIDDA or MCO for intake
For HCS and TxHmL: contact your local LIDDA (hhs.texas.gov/lidda) to request an eligibility determination and interest list placement. For CLASS: contact HHSC or a CLASS provider agency to begin the eligibility and interest list process. For STAR+PLUS LTSS: contact your Medicaid MCO directly to begin enrollment and assessment. For MDCP: contact your STAR Kids MCO or HHSC. Record the date, person contacted, and outcome of every contact.
4
Complete eligibility determination and get on the interest list
For HCS and TxHmL, the LIDDA completes an eligibility determination and, if eligible, places the individual on the HHSC HCS interest list. Request written confirmation of your interest list registration date from your LIDDA — that date is your documented priority position. For STAR+PLUS and MDCP, eligibility and enrollment run through the MCO assessment process.
5
Assemble required documents
For HCS and TxHmL, gather: a psychological evaluation with IQ and adaptive behavior scores (onset before age 22 for I/DD), supporting medical records, school or IEP records, Texas Medicaid enrollment confirmation, and identity documents. For STAR+PLUS and MDCP, the document set differs — confirm with your MCO or HHSC before your assessment appointment.
6
Keep contact information current and monitor status
HHSC and LIDDAs contact families when a waiver slot becomes available — missing that call or letter can mean losing your place. Keep your address, phone, and email current with your LIDDA at all times. Record the date and outcome of every status update. For STAR+PLUS and MDCP, confirm status-check intervals and follow-up steps with your MCO.

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The HCS interest list reality

The HHSC HCS interest list is one of the largest in the United States. Wait times vary significantly by region and individual circumstances — some families wait a decade or longer. There is no single statewide published count. Your LIDDA interest list registration date is your documented position; earlier dates have priority when slots open. Contact your local LIDDA (hhs.texas.gov/lidda) as soon as possible to begin eligibility determination and get on the list. When HHSC contacts you about an available slot, respond immediately — a missed contact can mean losing your place. Keep your contact information current with your LIDDA at all times. Confirm current wait estimates directly with your LIDDA.

Texas Medicaid waiver FAQ

Which Texas Medicaid waiver is right for my family?

It depends on the person's disability type, age, and level of need. For intellectual or developmental disabilities (I/DD), HCS (comprehensive) or TxHmL (less intensive) through a LIDDA are the primary tracks — both require active Texas Medicaid. For related conditions with onset before age 22 (not I/DD), CLASS may apply. For adults 21+ with physical disabilities or aging needs, STAR+PLUS LTSS through a Medicaid MCO is generally the path. For medically dependent children under 21, MDCP through your STAR Kids MCO. Confirm the right track with your LIDDA, CLASS provider agency, MCO, or HHSC.

How do I apply for a Texas Medicaid waiver?

For HCS and TxHmL: contact your local LIDDA (Local Intellectual and Developmental Disability Authority) — find your LIDDA at hhs.texas.gov/lidda. The LIDDA completes eligibility determination and places eligible individuals on the HHSC interest list. For CLASS: contact HHSC or a CLASS provider agency directly — find CLASS providers through HHSC at hhs.texas.gov or by calling 2-1-1. For STAR+PLUS LTSS: contact your Medicaid managed care organization (MCO) directly to begin the enrollment and assessment process. For MDCP: contact your STAR Kids MCO or HHSC. All Texas waivers require active Texas Medicaid enrollment — apply through Your Texas Benefits (yourtexasbenefits.com) or by calling 2-1-1. Confirm current application procedures and agency contacts with your LIDDA, CLASS provider agency, MCO, or HHSC before initiating any intake process.

How long is the Texas waiver waitlist?

The HCS interest list is among the largest in the country — tens of thousands of Texans are waiting, and wait times can range from several years to over a decade depending on the region and individual circumstances. TxHmL and CLASS interest lists are shorter but still substantial in many areas. There is no single published statewide wait time. Your HHSC interest list registration date determines your position. Confirm current wait estimates with your local LIDDA. Apply early — your date is your place.

What is a LIDDA and how do I find mine?

A LIDDA (Local Intellectual and Developmental Disability Authority) is the regional public authority in Texas that provides the entry point for I/DD waiver services — HCS and TxHmL. (CLASS uses a separate pathway through HHSC and CLASS provider agencies — see the CLASS card above.) LIDDAs complete eligibility determinations, maintain local interest lists, and coordinate service planning. Find your local LIDDA at hhs.texas.gov/lidda. Confirm all eligibility and interest list information directly with your LIDDA.

What documents do I need for a Texas waiver application?

For HCS, TxHmL, and CLASS, the core documents typically include: a psychological evaluation with IQ and adaptive behavior scores (for I/DD, documenting onset before age 22); medical records documenting the qualifying diagnosis; school or IEP records; Texas Medicaid enrollment confirmation; and identity documents (birth certificate, state ID or Social Security card). For STAR+PLUS and MDCP, the document set differs — confirm requirements with your MCO or HHSC before your assessment. Document requirements may vary; confirm with your LIDDA or the relevant agency.

What is the HCS interest list and how is my place tracked?

The HHSC HCS interest list is maintained statewide. Your place on the list is determined by your original interest list registration date with your LIDDA — earlier dates have priority. HHSC contacts families when a waiver slot becomes available; missing that contact can result in losing your place. Keep your contact information — address, phone, and email — current with your LIDDA at all times. Request written confirmation of your interest list registration date and store it as a permanent record. Confirm current HHSC interest list policies, notification procedures, and your registration status directly with your local LIDDA.

Does WaiverPath apply for the waiver on my behalf in Texas?

No. Texas HCS and TxHmL applications go through your local LIDDA; CLASS applications go through HHSC or a CLASS provider agency; STAR+PLUS LTSS enrollment goes through your Medicaid MCO; MDCP enrollment goes through your STAR Kids MCO. WaiverPath is your organizer — it helps you identify the right track, record your HHSC interest list registration date, track required documents, and log every agency contact so an eligibility window or slot invitation does not slip past you.

Related Texas and national guides

Last reviewed: August 2026.