Missouri Medicaid for Seniors & Long-Term Care
Updated August 2026
Missouri provides Medicaid coverage to eligible seniors through MO HealthNet for the Aged, Blind, and Disabled (MHABD), which covers individuals age 65 and older who meet income and asset requirements. Seniors needing long-term care may also qualify for Institutional/Nursing Home Medicaid or one of Missouri's HCBS waivers, which have their own eligibility rules. Together these pathways cover nursing facility care, home and community-based waiver services, personal care services, and all standard Medicaid medical benefits.
$6,220.50
Individual asset limit (2026)
MO HealthNet for the Aged, Blind, and Disabled
Missouri's Medicaid program for seniors 65+
Up to $162,660
Community spouse resource allowance (CSRA), 2026
H.R. 1 (2025): seniors 65+ are exempt from new Medicaid work requirements
Federal Medicaid legislation signed July 4, 2025 added community engagement requirements for certain adults. Individuals age 65 and older, and those receiving long-term services and supports, are exempt. Contact the MO HealthNet Division at 855-373-9994 with questions about your eligibility.
MO HealthNet for the Aged, Blind, and Disabled: Missouri's Medicaid program for older adults
The program is administered by the Missouri Department of Social Services (DSS) Family Support Division (FSD). Individuals who receive SSI automatically qualify for MHABD — the Social Security Administration notifies Missouri Medicaid directly, so no separate application is required. Missouri uses a Medically Needy Spend Down pathway for seniors whose income exceeds the Medicaid limit — they can qualify by spending down excess income on medical expenses until they reach the eligibility threshold.
Asset limits for long-term care in Missouri
Missouri's asset limit for long-term care Medicaid applicants — Institutional/Nursing Home Medicaid and HCBS waiver applicants — is $6,220.50 for a single individual as of 2026, higher than the $2,000 limit used by many states. The limit is indexed and adjusts periodically; it rose from $6,068.80 the year before. A married couple where both spouses are applying has a combined limit of $12,441.
| Category | Asset limit | Notes |
|---|---|---|
| Single individual | $6,220.50 | Institutional/Nursing Home Medicaid and HCBS waivers, 2026 |
| Married couple (both applying) | $12,441 | Countable resources |
| Community spouse CSRA | $32,532 – $162,660 (2026) | Federal spousal impoverishment protection |
| Home | Exempt | Primary residence while community spouse lives there; home equity limit $752,000 |
| Funeral trust accounts | Up to $9,999 exempt | Irrevocable pre-need burial contracts also exempt |
Single individual
- Asset limit
- $6,220.50
- Notes
- Institutional/Nursing Home Medicaid and HCBS waivers, 2026
Married couple (both applying)
- Asset limit
- $12,441
- Notes
- Countable resources
Community spouse CSRA
- Asset limit
- $32,532 – $162,660 (2026)
- Notes
- Federal spousal impoverishment protection
Home
- Asset limit
- Exempt
- Notes
- Primary residence while community spouse lives there; home equity limit $752,000
Funeral trust accounts
- Asset limit
- Up to $9,999 exempt
- Notes
- Irrevocable pre-need burial contracts also exempt
Home and community-based waiver services
Missouri operates multiple HCBS waivers under Section 1915(c) that allow eligible seniors to receive services in their homes and communities instead of nursing facilities. All HCBS waivers have enrollment caps — Missouri may have a waiting list for some programs. Contact the Area Agency on Aging (AAA) in your region for current availability and referrals; find your local AAA at health.mo.gov/seniors.
- Aged and Disabled Waiver (ADW): personal care assistance, homemaker services, home modification, respite care
- Structured Family Caregiving Waiver: for people with dementia or Alzheimer's in an adult foster care setting; allows a live-in caregiver — including a spouse — to be paid for providing supervision and help with daily activities
- Missouri Care Options (MCO): a free screening and care-coordination service through the Division of Senior and Disability Services that connects seniors at risk of nursing facility placement with available home and community services; call 866-835-3505
- PACE: program of all-inclusive care for the elderly, available in select metro areas
Nursing facility coverage
MO HealthNet covers skilled nursing facility care for seniors who meet clinical and financial criteria. Clinical eligibility requires a documented need for skilled nursing care — typically assessed through a standardized instrument. Financial eligibility means income and countable assets fall within the program's limits.
Once approved, Medicaid pays the nursing home directly. The resident contributes most of their monthly income toward the cost of care — typically all income minus a personal needs allowance, which is $50/month in Missouri. If income exceeds the institutional Medicaid limit, Missouri may use a "Miller Trust" (qualified income trust) arrangement to route excess income through a trust account, making the person financially eligible.
Medicaid estate recovery in Missouri
Missouri, like all states, operates a Medicaid Estate Recovery Program (MERP) under federal law (42 U.S.C. § 1396p). MERP allows the state to seek reimbursement from a Medicaid recipient's estate after death for long-term care costs paid by Medicaid. Recovery is typically limited to recipients age 55 or older. The home is generally not recovered while a surviving spouse, dependent child, or disabled/blind child lives there. Families with questions about estate recovery should consult an elder law attorney — Missouri has legal aid organizations that provide free or reduced-cost advice for income-eligible seniors.
What long-term care Medicaid typically covers
Long-term care MO HealthNet covers a range of institutional and home-based services for eligible seniors and adults with disabilities.
- Skilled nursing facility care — room, board, nursing services, and most medical care in the facility
- Physical, occupational, and speech therapy provided in a nursing home
- Personal care assistance with daily activities (bathing, dressing, eating) through HCBS waivers
- Home health aide visits for those receiving care at home
- Adult day health care programs
- Respite care to give family caregivers temporary relief
- Durable medical equipment prescribed by a physician
- Transportation to and from medical appointments
MO HealthNet (Missouri Medicaid)
- MO HealthNet Division: 855-373-9994
- Area Agency on Aging (AAA) locator: health.mo.gov/seniors
Related guides
Medicaid for Seniors
How Medicaid pays for nursing home and long-term care for older adults.
Read more →Estate Recovery
When states can seek reimbursement from an enrollee's estate after death.
Read more →Medicaid & Social Security
How Social Security benefits and Medicaid eligibility interact.
Read more →