How to Start a Home Health Care Business in Texas

Aug 9, 2023 · 8 minutes to read

Professional helpful caregiver at nursing home.

Texas’ population is getting older. Though the Lone Star State has one of the youngest overall populations, the number of people aged 65 or older grew by 43.5% between 2010 and 20191. As Texas’ generations continue to age, the demand for in-home caregiver services is likely to increase.

Starting a non-medical home health care business in Texas now could help you ride the wave of Texas’ aging population. You can also fill the need for in-home caregiver services for people living with chronic illnesses and disabilities.

But before you can start assisting patients, you’ll need to get a home health care license in Texas. This guide covers how to start a home health care business, from writing a business plan and marketing to getting licensed and finding home health care insurance.

Why become a home care provider in Texas?

The population of Texas may be young, but that doesn’t mean that in-home caregiver services are not needed. Home health care businesses often work with patients of all ages, helping those recovering from a serious injury or living with a disability or chronic illness.

As of May 2022, Bureau of Labor Statistics data shows that Texas has the third-highest employment level for Home Health Aides (HHA) and Personal Care Aides2. The Dallas-Fort Worth and greater Houston metro areas have the highest employment levels in the state.

There are also three areas in Texas with some of the highest concentrations of HHA and personal care aide jobs in the nation. These are McAllen, Brownsville, and Laredo.

Getting started

Small business experts recommend writing a business plan. This important document serves as a guide during the early days of your business and beyond. It helps you set goals, understand if you are meeting them, and make decisions.

Business plans typically include information such as:

  • Your business details – Business structure, high-level employees or partners, location(s) and other information about your business.
  • Mission statement – Why you are starting a business and what you hope the business achieves.
  • Market research – Details on the need for in-home caregiver services in your area, as well as your competition, the services they provide, and how they advertise.
  • Business goals – Specific benchmarks you hope to achieve and when you estimate that you’ll reach your goals.
  • Financial information – Earnings projections, operating budgets, and if you’ll need startup funding.
  • Marketing plan – Where and how you intend to advertise and promote your business to potential patients.

A business plan may be required to apply for a small business loan or grant. However, having a plan can be helpful regardless of whether you are seeking outside funding or not.

Making it legal

You must apply for a license to become a home care provider in Texas. Texas Health and Human Services oversee personal care businesses to ensure they meet state and federal requirements for patient care and safety.

To receive a home health care license, you will be asked to:

  • Complete the online pre-survey training
  • Submit requested documentation about your business and the services you plan to provide
  • Register and be in good standing with the State Comptroller of Public Accounts and the Secretary of State of Texas
  • Apply for a Medicare certification if you want to provide services to Medicare recipients
  • Pay the licensing fee

A general business license is not required in Texas, but there may be other licenses and permits necessary to run your business. The Business Permit Office can help you determine if additional documentation is needed in your area.

Protecting your business

Many non-medical home health care businesses in Texas choose different types of insurance to protect their finances and employees. Because you work closely with patients, the potential for claims made against you, your business, or your employees may be high. Business insurance can help you manage the common risks of being an in-home caregiver.

Popular forms of coverage include:

General Liability – Also referred to as Commercial General Liability (CGL) or “slip and fall coverage”, this insurance can protect your business against bodily injury or property damage lawsuits from outside parties.

Professional Liability – Also known as Errors and Omissions (E&O) insurance, this type of policy protects your business against claims of negligence, misrepresentations, or mistakes. Professional Liability claims are typically made by clients who allege some form of financial damage as a result of your services, products or employees.

Workers’ CompensationWorkers’ Compensation insurance provides protection for employers if an employee suffers a work-related illness or injury.

Business Owner’s Policy – A Business Owner’s Policy (BOP) is a combination of policies, combining covers such as General Liability insurance and business personal property coverage, to help protect small businesses from costly interruptions to service.

Home health care insurance policies help safeguard your bank accounts from the costs associated with expensive claims and lawsuits. Without coverage, you and your business could be responsible for compensation payments, medical bills, or legal fees that could devastate your operations.

Staffing your business

Hiring qualified home health aides and in-home caregivers is essential to any non-medical home health care business. They work with your clients every day and can have a significant impact on a patient’s wellbeing and health outcomes.

Texas HHAs are required to complete a 75-hour training course to become licensed. This course must be conducted or supervised by a registered nurse and includes:

  • Classroom instruction on patient care, safety, and record keeping
  • A minimum of 16 hours of clinical experience. This portion of the training may take place in a hospital, nursing home, laboratory, or patient’s home.
  • An assessment that tests the HHA’s ability to follow instructions, as well as read and write in English

You may also want to hire office staff to help you run the administration side of your business. This may include hiring part-time or full-time employees to help you:

  • Create work schedules
  • Handle your bookkeeping, accounting, and payroll
  • Manage patient requests and complaints
  • Advertise and market your business to new clients
  • Hire and onboard new employees
  • Provide ongoing training to your HHAs


Advertising and promoting your personal care business is essential to creating lasting success. After all, without patients to care for, you probably won’t be in business for long!

There are many ways to market a non-medical home health care business in Texas. The techniques you use will depend on factors like where people look for in-home caregiver services in your area and your budget. It’s common for businesses to use a mix of marketing methods and for these to change over time as your business grows and changes.

Some common ways to market a personal care business include:

  • Maintaining a business website
  • Setting up social media profiles on appropriate apps
  • Getting your business listed on Google and other search engines
  • Placing ads on social media, radio, or in newspapers
  • Running a booth at local health expos, street fairs, or community events
  • Networking with health professionals and non-competing businesses who can refer patients to you

BizInsure understands home health care agencies.

Becoming a home care provider in Texas takes hard work, but BizInsure is here to make the insurance part easier.

In as little as 10 minutes, you can compare quotes from top-rated insurers, choose the policies that are right for your personal care business, and buy instant coverage. BizInsure even offers home health care insurance packages designed for home health agencies and individual HHAs.

Start protecting your home care business today—no paperwork, no hassles. Compare online quotes now!

1. Texas Comptroller’s Office, Population Age 65 and Older, Share of Total Population, 2019.
2. Bureau of Labor Statistics, Occupational Employment and Wages, May 2022, accessed July 2023.
This information is a general guide only and does not take into account your objectives, financial situation or needs. Always check with your local licensing board when getting or renewing your home health agency license to ensure you are meeting their current licensing requirements.
As with any insurance, coverage will be subject to the terms, conditions and exclusions contained in the policy wording. The information contained on this guide is general only and should not be relied upon as advice. The number of quotes provided varies between products, occupations and other underwriting factors determined by the insurers.
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