How to Pay for Home Modifications in Texas

The honest answer: Original Medicare generally does not pay for grab bars, wheelchair ramps, walk-in tubs, or stair lifts — it treats them as home improvements, not durable medical equipment. The programs that do help are the VA HISA grant (Home Improvements and Structural Alterations) for eligible veterans, the Texas Medicaid STAR+PLUS waiver's Minor Home Modifications benefit for qualifying Medicaid enrollees, and a handful of local and nonprofit options. Many Central Texas families combine more than one source. Below, we walk through each program in plain language — including what Medicare does cover and exactly who qualifies for a HISA grant.

If you are reading this, you are probably weighing the cost of making a home safer against the very real cost of a fall or a move to assisted living. That is a stressful place to be, and the funding rules are genuinely confusing. Our goal here is not to sell you anything — it is to give you the straight facts so you can plan with confidence. We help families across the Austin metro, the Hill Country, and Central Texas every week, and the questions below are the ones we hear most.

One thing to keep in mind as you read: we help with paperwork, but we are not medical, legal, or financial advisors. Always verify current program details directly with each program before you make decisions, because eligibility rules and dollar amounts change from year to year.

By Michael Chandler, Certified Aging-in-Place Specialist (CAPS) · Updated 2026-06-21

Does Medicare cover grab bars, stair lifts, or walk-in tubs?

This is the first question almost everyone asks, and the answer surprises a lot of people. The short version: Original Medicare (Parts A and B) generally does not pay for home modifications. Medicare draws a hard line between two kinds of things:

• Durable medical equipment (DME) — items like wheelchairs, walkers, and hospital beds that your doctor prescribes as medically necessary for use in your home. Medicare Part B usually does cover these, with you paying a share of the cost.
• Home modifications — changes to the structure of the house itself, like grab bars anchored into the wall, a wheelchair ramp, a walk-in tub, a tub-to-shower conversion, or a stair lift. Medicare generally treats these as home improvements and does not pay for them.

That distinction is why Medicare may buy your father a wheelchair but will not pay for the ramp he needs to get it through the front door. The table below sums up the most common questions we get.

Does Medicare cover stair lifts?

No. Original Medicare does not cover stair lifts. The Social Security Act defines stair lifts as home modifications — not durable medical equipment — so Medicare will not pay for the unit or the installation. Some Medicare Advantage plans list home-safety benefits, but stair lift coverage is rare; call your plan directly to find out what yours allows. If you are a veteran or qualify for Medicaid, the programs below may help cover a stair lift as part of a broader modification project.

Does Medicare cover walk-in tubs?

No. Original Medicare views a walk-in tub as a home improvement rather than durable medical equipment, so it is not covered under Parts A or B. A small number of Medicare Advantage plans offer a supplemental home-safety allowance that could apply toward bathroom safety products — but coverage is plan-specific and not guaranteed. Call your plan and ask specifically about "supplemental home-modification benefits" before you buy. If you want to explore accessible bathing options that may qualify for VA or Medicaid funding, a free in-home assessment is the best starting point.

What about Medicare Advantage (Part C)?

Here is the one bright spot. Medicare Advantage plans are run by private insurers, and in recent years some have started offering limited supplemental benefits aimed at home safety — which can include things like grab bars or small bathroom-safety items. This is not guaranteed, and it varies enormously from plan to plan and year to year.

Does Medicare cover wheelchairs?

Yes — and this is worth repeating because it confuses so many families. Original Medicare Part B generally covers manual wheelchairs, power wheelchairs, and scooters as durable medical equipment when a doctor documents they are medically necessary for use in your home. You typically pay 20% of the Medicare-approved amount after your Part B deductible, and you usually need to use a Medicare-enrolled supplier. The catch, again, is that Medicare pays for the chair but not for the wheelchair ramp or doorway widening that makes your home actually work with it. That gap is exactly where the programs below come in.

VA benefits: the HISA grant (and SAH/SHA)

If you or your parent is a veteran, this is often the most generous and most overlooked option. The VA offers several programs to help pay for medically necessary home modifications. The one most aging-in-place families use is HISA — Home Improvements and Structural Alterations.

What the HISA grant covers

A HISA grant helps pay for medically necessary improvements to a veteran's home. Commonly funded work includes:

• Roll-in and curbless showers, and tub-to-shower conversions
• Grab bars and bathroom safety upgrades
• Wheelchair ramps and accessible entries
• Widening doorways for a wheelchair or walker
• Improving access to essential bathroom and kitchen fixtures

Who qualifies for a HISA grant?

HISA is available to veterans and, in some cases, service members. In general terms:

• Veterans with a service-connected disability can qualify, and
• Veterans with a non-service-connected condition can often qualify too, though the lifetime benefit amount is different for the two groups.

In every case, a VA physician or provider must document that the modification is medically necessary. The lifetime dollar amounts for HISA are set by the VA and are different for service-connected versus non-service-connected veterans — verify current VA HISA figures with the VA, because these amounts are updated over time and we never want you planning around an outdated number.

HISA contractors: how the work actually gets done

People often search for "HISA grant contractors" expecting the VA to send someone. It does not work that way. The VA does not employ the contractor — you hire a licensed, insured contractor to perform the approved work, and the grant helps cover the cost. That is where we come in. We are HISA-experienced contractors serving the Austin metro and Central Texas who:

• Build to the medical specifications your VA provider documents
• Provide the itemized estimates and invoices the VA requires
• Coordinate with your VA provider and case manager so reimbursement goes smoothly

Request a free in-home assessment and let us know you are working with the VA — we will make sure the estimate is in the exact format the HISA application requires.

The HISA process and timeline

The general path looks like this:

1. 1

   Medical documentation

   Your VA provider documents that the modification is medically necessary. Starting this early is the single biggest thing that speeds up the whole process.

2. 2

   Application & estimate

   You submit the HISA application along with our written, itemized estimate in the format the VA expects.

3. 3

   VA approval

   The VA reviews and approves the request. Timelines vary by region and by how complete the paperwork is.

4. 4

   Work & reimbursement

   We complete the work, protect your floors, clean up daily, and submit the invoices and photos needed for the grant.

We cannot promise a set number of weeks, because every region and case is different — verify current VA timelines and requirements with the VA. What we can promise is that we will keep the paperwork on our end moving so nothing stalls because of us.

SAH and SHA: larger grants for severe disabilities

Beyond HISA, the VA offers two larger housing grants for veterans with specific severe service-connected disabilities:

• Specially Adapted Housing (SAH) — helps buy, build, or substantially adapt a home for veterans with certain severe service-connected disabilities (for example, particular mobility impairments).
• Special Home Adaptation (SHA) — a related grant for veterans with other qualifying severe conditions, such as certain vision impairments or loss of hands.

SAH and SHA amounts are much larger than HISA, but eligibility is stricter and tied to specific disabilities. Many families use HISA for bathroom and entry work, and SAH or SHA may apply when major adaptations are needed. Verify current VA figures and eligibility with the VA before counting on any program.

Texas Medicaid: STAR+PLUS and Minor Home Modifications

For Texans who qualify for Medicaid, there is a real path to funded home modifications through the STAR+PLUS Home and Community-Based Services (HCBS) waiver. STAR+PLUS is the Texas Medicaid managed-care program that serves many older adults and adults with disabilities, and its HCBS waiver is built around a simple, humane idea: it is better — for the person and often for the budget — to help someone stay safely at home than to pay for a nursing facility.

The Minor Home Modifications benefit

Within STAR+PLUS HCBS is a benefit usually called Minor Home Modifications. It can cover physical changes to the home that help a person remain safe and independent, such as:

• Wheelchair ramps and accessible entries
• Grab bars and bathroom safety modifications
• Accessible bathroom changes, including roll-in showers
• Other modifications tied to a documented need

How to qualify and apply

To use this benefit you generally must:

• Be enrolled in STAR+PLUS HCBS (which has both financial and functional eligibility requirements), and
• Have the modifications approved and coordinated through your managed-care service plan and service coordinator.

The work is planned with your service coordinator, who ties each modification to your assessed needs. One important, practical note: capacity for waiver programs can be limited and there may be interest lists, so apply as early as you can. If you are not sure whether you or your parent qualifies, your service coordinator or your local Medicaid office is the place to start. To apply for Medicaid or check your eligibility, use YourTexasBenefits.com or dial 2-1-1; full program details are on the Texas HHS STAR+PLUS page.

Local help: Area Agencies on Aging, nonprofits, and tax deductions

Not everyone is a veteran or qualifies for Medicaid, and that is okay — there are still meaningful resources, especially here in Central Texas.

Area Agencies on Aging (CAPCOG and AACOG)

Area Agencies on Aging are a tremendous, free first call. They do not usually fund large remodels themselves, but they connect you to home-modification, benefits-counseling, and safety programs in your area. For our region:

• CAPCOG Area Agency on Aging — the Capital Area Council of Governments serves the Austin metro and surrounding Hill Country counties (Travis, Williamson, Hays, Bastrop, Burnet, Blanco, Caldwell, and more). Benefits counseling and referrals are free.
• AACOG Area Agency on Aging — the Alamo Area Council of Governments serves counties to the south (Comal, Guadalupe, Kendall, and more).

A quick call to the Area Agency on Aging that covers your county can surface programs you would never find on your own.

Nonprofits and volunteer groups

Several nonprofits help income-qualified seniors with smaller safety projects — think a single ramp or a set of grab bars. Habitat for Humanity affiliates, faith-based volunteer groups, and disability-focused charities sometimes offer materials or labor for accessibility work. Availability shifts with funding and location, so ask your Area Agency on Aging or your local senior center what is active right now.

Tax deductions for medical home modifications

This one is easy to miss: certain home modifications made for a documented medical reason may qualify as deductible medical expenses on your federal income taxes, particularly the portion of the cost that does not increase the home's value. The rules are specific, so talk to a qualified tax professional — we can provide the itemized invoices and documentation you would need to make that conversation easy.

Paying out of pocket and planning the cost

Many families end up paying for at least part of the work themselves, often combining a benefit with personal funds. If that is you, it helps to know the typical Central Texas ranges before you plan. Our Central Texas cost guide walks through what common projects — from walk-in tubs to ramps and full bathroom remodels — tend to run. These are typical Central Texas ranges; a free in-home assessment gives you an exact quote for your home.

Can you combine funding sources?

Often, yes — and this is where having an experienced partner pays off. A veteran might use a HISA grant for a roll-in shower and pay out of pocket for additional comfort upgrades. A family might pair a STAR+PLUS Minor Home Modifications benefit with a small nonprofit grant. Each program has its own rules about what it will and will not cover, and the order in which you use them can matter. Use one benefit the wrong way and you can accidentally complicate another.

We help you sequence the paperwork so your benefits work together instead of against each other. This is general guidance, not financial advice — always verify current program details with each program.

Official resources & how to apply

Bookmark these. When a program's rules or dollar amounts change, these official government and nonprofit sources are where to confirm the current details — and where to actually start an application.

If you are a veteran

• VA HISA grant (Home Improvements & Structural Alterations) — program details and the application form (VA Form 10-0103): prosthetics.va.gov — HISA. First step: ask your VA primary-care provider to document medical necessity.
• VA SAH & SHA housing grants — eligibility and how to apply (VA Form 26-4555): va.gov — disability housing grants.
• VA benefits help line — 1-800-827-1000.

If you have Texas Medicaid

• STAR+PLUS HCBS waiver & Minor Home Modifications — Texas HHS — STAR+PLUS. First step: ask your STAR+PLUS plan's service coordinator to add home modifications to your service plan.
• Apply for Medicaid / manage benefits — YourTexasBenefits.com or dial 2-1-1.

For everyone

• Medicare coverage (durable medical equipment) — medicare.gov — DME coverage · 1-800-MEDICARE.
• Area Agency on Aging (Austin region) — CAPCOG; (counties to the south) — AACOG. Both offer free benefits counseling and referrals.
• Eldercare Locator — eldercare.acl.gov · 1-800-677-1116.
• 2-1-1 Texas — dial 2-1-1 · 211texas.org.
• Medical-expense tax deduction — IRS Publication 502: irs.gov/publications/p502 (confirm with a tax professional).

These links go to official government and nonprofit sources. Live Oak Home Access is not affiliated with these agencies — we help you assemble the documentation they ask for. We do not provide medical, legal, or financial advice; verify current eligibility and amounts with each program.

A quick, honest summary

If you remember nothing else, remember this: Medicare almost never pays for grab bars, ramps, walk-in tubs, or stair lifts, so do not wait on it. If you are a veteran, look hard at VA HISA (and possibly SAH/SHA). If you have Medicaid, ask your service coordinator about STAR+PLUS Minor Home Modifications. Everyone should call their Area Agency on Aging and ask a tax professional about deductions. And whenever a program is involved, verify the current details — the rules really do change.

Prefer to talk it through? You can request a free in-home safety assessment any time, or call or text us at (512) 797-6518. We will help you figure out which doors are open to you — no pressure, no jargon.