Written by a parent, not a doctor. Nothing here is medical advice.

Childhood Cancer Lantern
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Texas program

Home nursing and personal care once Medicaid is in place

Nursing, personal care, equipment and supplies at home for children under 21 with Medicaid.

What it is

Nursing, personal care, equipment and supplies at home for children under 21 with Medicaid.

Medicaid enrollment opens the door to a home-care assessment. The doctor describes the care, the plan reviews the request, and a nursing agency finds staff. Approved hours alone do not mean a nurse is available.

Eligibility rules
  • There are three kinds of help at home: nursing shifts, occasional nurse visits, and an attendant for daily tasks beyond what a child that age normally needs. Each has its own assessment, and all need Medicaid first.
  • STAR Kids enrollment can follow MBIC or qualifying SSI-associated Medicaid. From October 1, 2026, HHSC separately checks immigration eligibility for SSI-associated Medicaid and considers Children’s Medicaid when appropriate. Ordinary STAR families can ask DSHS Texas PCS at 888-276-0702.
What you get
  • Medicaid-paid nursing hours, personal care, equipment and supplies when approved.
  • Help planning care after discharge.
What the help covers
  • A parent cannot be paid as their own child's nurse or attendant while the child is under 18. For an 18-to-20-year-old the answer depends on the parent's legal role; ask the service coordinator.
  • Training a parent does not by itself remove a child’s need for professional nursing. The assessment must describe skilled needs, approved hours and the care an agency can actually staff.
If you decide to apply
  1. Ask your plan’s service coordinator and hospital discharge planner to review a full day and night of care.
  2. Keep a note of each task and how long it takes. Ask the clinic to prepare the nursing packet.
  3. Ask the nursing agency which approved hours it can actually staff.

Plan member line or service coordinator; DSHS Texas PCS: 888-276-0702

After you apply
  • Superior and UnitedHealthcare publish three-business-day rules for complete requests in specified categories. UnitedHealthcare separately explains missing-information procedures. Your coordinator can confirm the rule for your plan and service.
  • Community First aims to schedule the first SK-SAI within 15 business days for Level 1 or 30 business days for Levels 2–3. Scheduling is different from completing the assessment.
  • The service coordinator can put in writing when the request became complete, the decision deadline, the date the first assessment will be finished, and who can arrange urgent help before then. An appointment-scheduling target is not the same as an authorization decision or a completed assessment. If approved care will be reduced or stopped, a separate appeal and continued-services deadline may apply.
Good to know

A minor child’s parent cannot be the paid private-duty nurse. Paid attendant work has separate family-role limits, which the coordinator checks.

Other details
  • The HHSC service-area roster was revised May 2025. Your service area determines available STAR Kids plans.
  • Plan changes requested by the 15th start the first of the next month; later requests start the following month. The exact hospital campus, doctors and treatment still need checking.
  • Your service area decides which STAR Kids plans you can choose; the counselor can show you the two or three for your county.
Official sources
Ask your social worker

“Which home-care tasks could Medicaid cover, who will write the request, and who can staff the hours? Could you help us plan this before discharge?”

Why I’m asking: I need to understand what help can actually reach our home and what care remains with us.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Describe the full day and night of care, sign the parent sections, and choose an agency.

Your social worker

Coordinates the discharge planner, agency and payer, and tracks staffing separately from the authorization.

The care team

The physician and nurse write the plan of care, the nursing addendum and the task-by-task medical-necessity request.

Who decides
The STAR Kids plan (or TMHP) authorizes. The nursing agency decides whether it can staff the hours
Ask your social worker
“Who is writing the home-nursing packet, which agency can cover the hours, and has the plan named our service coordinator?”

How to apply

First step: Once Medicaid starts, call the plan for a home-care assessment before discharge. With STAR Kids, ask for a service coordinator. For personal care under ordinary STAR, call the state assessment team at 888-276-0702.

  1. Ask the plan for a named service coordinator.
  2. Ask the discharge planner for a home-nursing assessment before discharge.

Where it starts: Plan member line; service coordinator; DSHS PCS 888-276-0702 for ordinary STAR

What to gather

  • Medicaid card and plan name
  • Physician plan of care and registered nurse's assessment
  • Nursing addendum and the daily task schedule
  • Equipment orders

How long: Ask before discharge. Plans post their own clocks: Superior answers a complete authorization request within three business days; Community First tries to schedule the first STAR Kids assessment within 15 business days of enrollment for the highest-need level, 30 otherwise. Start-of-care signatures use a 30-day deadline. Authorizations run up to 180 days with reassessment.

What a yes looks like

A written authorization listing hours, tasks and dates, and an agency that can staff them.

What a no looks like, and the next move

Ask which skilled need was rejected. The oncologist answers it. Appeal by the member deadline in the letter (plan decides in 30 days, 72 hours if urgent).

Watch out

  • Order matters: Medicaid first (MBIC in treatment, SSI, or Children's Medicaid), then the STAR Kids coordinator, then the nursing packet.
  • A parent cannot be paid as the child's private-duty nurse. Under Consumer Directed Services the paid attendant for a child under 18 cannot be a parent or other legal representative either.
  • Approved hours are not a nurse: ask the agency for a staffing plan before discharge.
  • Pick a STAR Kids plan the oncology center lists. You can change plans any month: call by the 15th and the change starts the 1st of the next month; after the 15th it starts the month after.
  • Use HHSC’s STAR Kids service-area list to identify plans, then ask each plan about the exact hospital campus and oncology team before choosing. A directory listing is not a guarantee for every service, clinician or campus.
  • UnitedHealthcare publishes a three-business-day decision target for complete requests sent electronically or by fax. This is UHC practice, not a verified statewide PDN/PCS deadline. Ask your own plan to confirm the applicable clock and whether the packet is complete.
  • The April 2026 CDS form excludes the child’s parent or legal representative as the paid CDS provider. Ask the coordinator about another permitted provider; the research did not establish a permanent pandemic exception.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 10, 2026.

What it is worth

Private-duty nursing hours, personal care help, home health, supplies and equipment for a child under 21 on Medicaid, authorized by the STAR Kids plan.

Covers: Private-duty nursing at home · Personal care services · Home health nursing and aides · Feeding-tube, line and other supplies. Equipment · PPECC day nursing

What it costs the family: No cost. Approved hours and tasks, not cash.

The eligibility facts, as published

Medicaid required
yes
Age max exclusive
21
Medical necessity
physician plan of care and nursing addendum; plan or TMHP authorization
Parent as paid attendant
Form 1726, April 2026 edition: the child’s parent/legal authorized representative cannot be the CDS service provider. A permanent post-pandemic exception was not established.
Authorization clocks
statewide UMCM clock not found; Superior posts an approval or denial notice within three business days after a complete request; Community First attempts to schedule the first SK-SAI within 15 business days of enrollment (Level 1) or 30 business days (Levels 2–3)
Star kids service areas
service area: Bexar; plans: code: KA; name: Community First Health Plans; phone: 855-607-7827; code: KE; name: Superior HealthPlan; phone: 844-590-4883; source refs: RES_TX4_01; service area: Dallas; plans: code: K2; name: Wellpoint; phone: 844-756-4600; code: KW; name: Aetna; phone: 844-787-5437; source refs: RES_TX4_02; service area: El Paso; plans: code: K3; name: Wellpoint; phone: 844-756-4600; code: KF; name: Superior HealthPlan; phone: 844-590-4883; source refs: RES_TX4_03; service area: Harris; plans: code: K4; name: Wellpoint; phone: 844-756-4600; code: KM; name: Texas Children's Health Plan; phone: 800-659-5764; code: KQ; name: UnitedHealthcare Community Plan; phone: 877-597-7799; source refs: RES_TX4_04; service area: Hidalgo; plans: code: KC; name: Driscoll Children's Health Plan; phone: 877-324-7543; code: KG; name: Superior HealthPlan; phone: 844-590-4883; code: KR; name: UnitedHealthcare Community Plan; phone: 877-597-7799; source refs: RES_TX4_05; service area: Jefferson; plans: code: KN; name: Texas Children's Health Plan; phone: 800-659-5764; code: KS; name: UnitedHealthcare Community Plan; phone: 877-597-7799; source refs: RES_TX4_06; service area: Lubbock; plans: code: K5; name: Wellpoint; phone: 844-756-4600; code: KH; name: Superior HealthPlan; phone: 844-590-4883; source refs: RES_TX4_07; service area: Nueces; plans: code: KD; name: Driscoll Children's Health Plan; phone: 877-324-7543; code: KV; name: Superior HealthPlan; phone: 844-590-4883; source refs: RES_TX4_08; service area: Tarrant; plans: code: K1; name: Aetna; phone: 844-787-5437; code: KB; name: Cook Children's Health Plan; phone: 844-843-0004; source refs: RES_TX4_09; service area: Travis; plans: code: K8; name: Blue Cross Blue Shield of Texas; phone: 877-688-1811; code: KL; name: Superior HealthPlan; phone: 844-590-4883; source refs: RES_TX4_10; service area: Medicaid RSA - West Texas; plans: code: K6; name: Wellpoint; phone: 844-756-4600; code: KJ; name: Superior HealthPlan; phone: 844-590-4883; source refs: RES_TX4_11; service area: Medicaid RSA - Northeast Texas; plans: code: KP; name: Texas Children's Health Plan; phone: 800-659-5764; code: KU; name: UnitedHealthcare Community Plan; phone: 877-597-7799; source refs: RES_TX4_12; service area: Medicaid RSA - Central Texas; plans: code: K7; name: Blue Cross Blue Shield of Texas; phone: 877-688-1811; code: KT; name: UnitedHealthcare Community Plan; phone: 877-597-7799; source refs: RES_TX4_13
Star kids roster version
HHSC Appendix XI, revised May 2025; checked September 10, 2026. Confirm current service area and enrollment with HHSC. The revision date is not a new coverage-start date.
First sk sai completion
Unknown: a scheduling target and the PSU-notification pathway do not establish a general completion deadline from enrollment.

The trap: Order matters: Medicaid first, then the STAR Kids service coordinator, then the nursing packet.

Where I read this

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