I. What You Should Expect to Pay for Home Care in Missouri

According to the Genworth Cost of Care Survey for 2021, seniors in Missouri pay an average of $4,767 a month for home care. This type of care typically includes personal care and companion services, and is not to be confused with home health care, which includes medical services that can only be provided by a licensed professional.

The Cost of Home Care and Home Health Care in Nearby States

When compared to nearby states, Missouri is near the high end for home care costs, but not by very much. The $4,767 monthly cost in Missouri is close to the $4,862 seniors pay for similar services in Oklahoma and the $4,576 that’s the average in Texas. Arkansas and Louisiana are less expensive than Missouri, at $4,185 and $3,623 a month, respectively. Nationally, home care costs an average of $4,957, which is $190 a month more than seniors pay in Missouri.

Home Care Home Health Care
Missouri $4,767 $4,767
National $4,957 $5,148
Oklahoma $4,862 $4,862
Texas $4,576 $4,576
Arkansas $4,185 $4,195
Louisiana $3,623 $3,718

The Cost of Home Care vs. Other Types of Care

Missouri seniors may find other types of senior care a better fit for their circumstances, either because of the cost or the level of care they can get. Adult day care, for example, costs an average of $1,907 a month, while assisted living averages $3,000. A semiprivate room in a Missouri nursing care home averages $5,262, which is closer to the average home care cost than the margin between these two in most other states.

II. Can Medicaid Help You Pay for Home Care in Missouri?

Medicaid can help out with a lot of the common medical costs associated with home care, but it has its limits. If you have Medicaid, you will probably be responsible for paying for the non-medical caregiver services and home modifications you need to remain safely in your own home. This is because Medicaid is generally unable to pay for services that aren’t directly related to your medical care.

Fortunately, seniors in Missouri who are enrolled in Medicaid can get help with caregiver expenses from the state’s Aged and Disabled waiver, which pays for various home care services. As with any other care program for people participating in Medicaid, you need a doctor’s authorization for this waiver before you can enroll in the program.

Home Care Waiver Programs in Missouri

Aged and Disabled Waiver

Missouri’s Aged and Disabled waiver pays for caregiver support to help you keep safe in your own home and avoid having to go into expensive residential care. To participate in the waiver program, you must be at least 62 years old or have a qualifying disability that creates a need for caregiver services.

These are not the only enrollment requirements. You must also be enrolled in or eligible for Medicaid in Missouri, submit an application with supporting documents showing your financial need for the waiver and participate in an interview and possibly a home visit from a program intake worker.

If you would like to apply for a home care waiver in Missouri but have not yet signed up for Medicaid, you can get started by submitting an application for the basic health coverage. You can ask your intake worker about getting a waiver at the same time, though the approval process is likely to take at least until your Medicaid benefits have been approved. Once this is done, a worker from the Missouri Department of Social Services will be in touch to schedule your visit and interview.

How to Know if You're Eligible for Medicaid in Missouri

Medicaid has financial restrictions for who can sign up. Before you can be accepted for Medicaid coverage, you have to demonstrate a financial need for insurance that your current finances can’t cover without help. Missouri’s Medicaid program does not have a maximum income limit, but all available income must go toward the cost of care. Single applicants may have up to $5,035 in countable assets and married couples can have twice that, or $10,070. Countable assets do not include equity in a single home you live in, a single car you keep for personal use or your own possessions, such as clothing and furniture.

2022 Medicaid Income Limits for Seniors in Missouri
Income Limits* Asset Limits
Single Person All available income must go toward care expenses. $5,035
Two-Person Household All available income must go toward care expenses. $10,070
Married Couple (Single Applicant) All available income must go toward care expenses. $5,035

* per year

In addition to the financial requirements, you must also meet the following criteria:

  • Reside in the state of Missouri
  • Be a U.S. citizen, green card holder or other permanent legal resident
  • Have a qualifying disability or chronic medical condition

How to Apply for Medicaid in Missouri

To apply for Medicaid coverage in Missouri, you can call (855) 373-9994 and request an application by phone. You can also apply online through the Missouri benefits online portal. To save time and speed up your approval, attach copies of documents supporting your claim at the time of upload or submission.

What Information You Will Need

Medicaid verifies all the information provided on your application. Delays in providing documentation can slow down your approval process, or it can even result in a denial of coverage. That’s why it is helpful to have your papers in order before submitting your application. Documents you’re likely to need include:

  • A state-issued ID card
  • Proof of citizenship
  • Bank statements and other financial records
  • Copies of any insurance policies or title deeds you have for property you own
  • Pay stubs and tax returns

How to Get Help Applying for Medicaid

The Medicaid application requires you to go into some depth with complex financial and health questions. It can be difficult for many seniors to successfully apply for Medicaid. Fortunately, Missouri has several free resources that can help seniors apply for Medicaid, Social Security and other programs.

Contact Area Served Services Provided
Missouri Senior Legal Helpline (800) 235-5503 Entire State The Missouri Senior Legal Helpline is available to answer your legal questions about Medicare and Medicaid, help you file an appeal and to manage many of the legal questions you might have about the process. Qualified legal experts at the helpline can advise you about various aspects of elder law, such as medical decision-making, estate and inheritance law and how to manage suspected cases of abuse.
CLAIM, State Health Insurance Assistance Program (SHIP) (800) 390-3330 Entire State CLAIM, the state health insurance agency, operates a senior health information program that can answer your questions about Medicare and Medicaid, issues with the VA and other kinds of senior health insurance. Staff at CLAIM can help you with expert, unbiased advice about your insurance options.
Missouri Department of Social Services (866) 269-5927 Entire State The Missouri Department of Social Services operates both a managed care and fee-for-service program that can help you sign up for comprehensive health insurance coverage. If you are eligible for Medicaid, the staff at this helpline can help you find and apply for the benefits you need.

III. Can You Use Medicare to Pay for Home Care in Missouri?

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

  • Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
  • Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
  • Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
  • Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

IV. Other Financial Assistance Options for Home Care in Missouri

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

V. Free Resources for Aging in Place in Missouri

Seniors in Missouri can often maintain a high level of independence and carry on living in their own homes with just a bit of help from caregivers or their loved ones. Sometimes, your needs might go beyond what a caregiver or home care aide can do for you. These organizations can help you with free and low-cost resources to support you at home.

Contact Area Served Services Provided
Aging and Disability Resource Center (573) 668-8824 Entire State The Missouri ADRC supports seniors with a wide range of services that are available throughout the state. ADRC services include respite care and other benefits for caregivers, as well as continuing education opportunities and abuse prevention services. There are 10 Area Agencies on Aging in Missouri, each of which serves a different region of the state. Reach out to the one in your area for services and advice.
Low Income Home Energy Assistance Program (LIHEAP)/Low Income Household Water Assistance Program (LIHWAP) (573) 751-6789 Entire State The Low Income Home Energy Assistance Program (LIHEAP) and Low Income Household Water Assistance Program (LIHWAP) can help eligible Missouri seniors pay their energy, water and sewer bills and avoid disconnections. Income limits apply, but seniors who qualify for Medicaid are generally within those limits.
Missouri Comptroller (573) 751-8533 Entire State The Missouri State Treasurer performs comptroller services for lost or abandoned property, as well as managing seniors’ tax rebates and other financial issues of concern for seniors living at home. The Treasurer’s office also monitors insurance and financial scams that target seniors, and updates about current risks are provided online.
Aging Ahead Online Entire State Aging Ahead is a volunteer nonprofit that supports seniors in their homes with regular hot meal deliveries and meals on wheels service. Seniors aged 60 and over can enroll in the program if they need regular food delivery or access to congregate meals at nearby senior centers.
Weatherization Assistance Program Online Entire State The Weatherization Assistance Program helps seniors save money and reduce risk inside their homes with energy audits, HVAC cleaning and inspection and insulation upgrades that can help prevent fires and make home heating more efficient. Contractors working with the program can inspect your carbon monoxide and smoke detectors, advise you about ways to reduce your home’s energy waste and make minor home improvements.

VI. Vaccination Requirements & COVID-19 Rules for Home Care Aides in Missouri

The federal government requires the employees and agents of all senior care entities, including home care agencies, that receive Medicare funds to be fully vaccinated. This rule was tested in the Supreme Court case of Biden v. Missouri, which was decided in favor of the federal rule in January 2022. As a result, while the state of Missouri does not impose a vaccine mandate, nearly all agencies receiving federal funds do require either proof of vaccination or a valid exemption from aides.

The current vaccination requirement situation is dynamic, and the rules are subject to change at any time. Speak with someone from your agency for the most up to date information about vaccination and the agency’s own policy.

VII. Rules and Regulations for Home Care Providers in Missouri

The Missouri Department of Health and Senior Services regulates home care under state law 19 CSR 30-26.010. The department sets health and safety standards, imposes training and background check requirements and monitors agencies for compliance.

What Types of Care Can Be Provided? Home care in Missouri law can include tasks such as helping seniors with personal care, companion services and household chores. Activities of daily living can include help with bathing, grooming, getting dressed, using the bathroom and performing other activities. Home care is distinct from home health care, which must be performed by a licensed medical professional.
Are Care Plans Required? Missouri law requires home care agencies to develop a comprehensive care plan for clients at the beginning of the caregiver relationship and to keep the plan updated with regular reassessments.
Can Home Care Providers Assist with Medication Management? Home care providers in Missouri are allowed to assist clients with taking self-administered medications, though they may not play a more active role, such as administering medication themselves or performing medical interventions other than first aid.
Are There Special Requirements for Screening Home Care Aides? Missouri requires caregivers and home care aides to undergo a background screening prior to having unsupervised contact with clients. The state makes caregiver backgrounds available for families to view as part of the hiring process.
Are Home Care Aides Required to Undergo Special Training? Licensed home care agencies must ensure their employees get initial training on memory care and on caring for people with Alzheimer’s disease. The state imposes an annual retraining requirement for employees and agents whose work puts them in contact with clients.
Does Medicaid Cover Home Care in Texas? Medicaid doesn’t cover home care directly, but the Aged and Disabled waiver covers personal care and other supports designed to help seniors age in place.
How Do I Report Abuse of Myself or a Loved One? Contact Adult Protective Services at (800) 392-0210.

VIII. How to Find a Home Care Provider in Missouri

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

Learn More About Home Care in Missouri’s Top Cities