Page Reviewed / Updated - May 2019
This webpage is intended to assist residents of Missouri in understanding the costs associated with aging and long-term care, such as assisted living, home care, and adult day care, throughout the state. Various financial assistance programs and payment options are explored that aid in caring for the elderly, whether it be in the home or in a residential care facility.
Cost of Care Calculator
In Missouri, as of 2019, the average cost of assisted living statewide is $2,844 / month, which is well below the national average of $4,000 / month. The least expensive assisted living in Missouri can be found in the areas of Joplin, St. Joseph, and Springfield, where the average cost of assisted living per month ranges from $2,215 - $2,650. Jefferson City and St. Louis, while over the statewide average for assisted living, is still less than the nationwide average at $3,500 to $3,545 / month. Those living in the areas of Cape Girardeau, Kansas City, and Columbia should be aware that these areas have the costliest assisted living. Here the monthly average is between $3,975 and $4,050.
Alzheimer’s care, also referred to as memory care, is also available in assisted living facilities for persons with dementia. Due to the higher level of security and supervision, an additional fee of approximately $700 / month should be expected.
The cost of non-medical home care in Missouri averages $20.00 / hour throughout the state in 2019. In Jefferson City, Joplin, and St. Joseph, the hourly cost of home care is the most affordable in the state at $18.00 - $18.63 / hour. Cape Girardeau also comes in just under the statewide average at $19.00 / hour. The most expensive home care is found in the areas of St. Louis, Kansas City, and Columbia, where the hourly average cost is between $21.00 and $22.50.
Home health care, which is provided by trained medical professionals, is also available in the state of Missouri. On average, the hourly cost is $1.00 more an hour than for home care.
Statewide, in 2019, the average cost of adult day care in Missouri is $84 / day. The area of St. Joseph offers the least expensive day care at $65 / day. In the cities of Cape Girardeau, Kansas City, and Springfield, the average daily rate ranges from $78 - $80. St. Louis has an average cost just over the average statewide cost at $86 / day. The costliest day care is found in the counties of Boone and Cole (the areas of Jefferson City and Columbia), where it runs, on average, $92 - 96 / day. It’s important to note that adult day care is often billed in half-day increments.
Medicaid State Plan
Medicaid is a program that offers health insurance to low-income residents throughout the U.S. While the federal government sets particular guidelines for the program, each state is able to manage the program as they see fit within the parameters set by the government. In Missouri, the Medicaid program is called MO HealthNet. As with the other states, the Missouri state Medicaid plan will cover the cost of nursing home care, as well as some home and community based services.
The Missouri Care Options (MCO) program, part of the state Medicaid plan, provides in-home and community care services to reduce the frequency of nursing home placement. This program is an entitlement, which means that anyone who is eligible is able to receive services. Benefits include personal care assistance, homemaker services, nursing services, adult day care, and respite care.
The Missouri state Medicaid plan allows for self-direction of non-medical personal care assistance via the MO HealthNet Consumer Directed Services program. Friends and select family members can be hired to provide care as long as they are registered with MO HealthNet.
The state of Missouri also offers Home and Community Based Services (HCBS) Medicaid Waivers. These waivers provide long-term care for those who are elderly and / or disabled, allowing them to live at home or in the community, rather than a nursing home facility. This is a win-win situation, as home and community based care is less expensive than nursing home care, allowing the state to save money, and the individual in question can remain living independently.
The Aged and Disabled Waiver (ADW) program provides in-home services to seniors who require a nursing home level of care. Benefits include chore services, adult day care, respite care, home delivered meals, and homemaker services. Unlike the MCO program, which is mentioned above, this program is not an entitlement and has limited slots available for eligible applicants.
The Supplemental Nursing Care (SNC) program offers financial assistance to help with the cost of care associated with living in a residential care facility, such as assisted living.
The Independent Living Waiver (ILW) program is intended for adults who are physically disabled, though those who enroll in this program prior to the age of 64 are able to continue to receive services via this waiver. Personal care assistance, home modifications, and specialized medical supplies and equipment are available benefits via the ILW. This waiver allows for self-direction of personal care assistance, meaning seniors can hire the caregiver of their choosing. This includes some family members.
In order to be eligible for long-term care Medicaid, level of functioning, assets, and income of the individual are all taken into account. As of 2019, senior applicants are allowed up to $3,000 in liquid assets, which refers to cash assets or assets that can easily be converted to cash. (This asset limit was increased from $2,000 in July of 2018). However, several assets are considered exempt, or non-countable, towards Medicaid’s asset limit. This includes an individual’s home, given they, or their spouse, live in the home and it is valued under $585,000. The monthly income limit is set at 85% of the Federal Poverty Level (FPL). Currently, this amount is equivalent to $885 / month ($10,620 / year). Married applicants, with both spouses applying for Medicaid services, are permitted a higher level of income and assets. In 2019, a couple can have income as high as $1,198 / month ($14,376 / year) and assets up to $6,000.
If a single applicant or couple is over the allowable income and / or asset amount(s), Medicaid qualification is still possible. However, in this instance, one might want to consult a Medicaid Planning Professional for assistance. Medicaid eligibility can be complicated and this gives one the best chance of qualifying for Medicaid services. Learn more.
Eligibility requirements may vary slightly if applying for a Medicaid waiver.
Missouri’s Pharmacy Assistance program, often referred to as MORx or Missouri Rx Plan, provides financial assistance of up to 50% of co-payments and deductibles on prescription medications. Program participants must be eligible for both Medicaid and Medicare. See additional eligibility requirements here.
One might also find additional non-medical assistance under the Older Americans Act, available through their local Area Agency on Aging (AAA). Services often vary based on the area in which one resides and the AAA office that services them. Find your local AAA here.
Along with these state-sponsored options, there are several more ways in which one can receive assistance in paying for care. Other options to consider are programs at the federal level, as well as local and non-profit routes. Our Resource Locator Tool is a great source to use to find such reduced-cost programs and should be utilized to find the program that best meets ones needs.
As one can see from the numbers above, the cost of senior care varies a great deal across the state of Missouri. To best manage the cost of care, one needs to find the most affordable care. Our organization has partnered with several organizations to aid in this search by providing a free service that matches specific care needs with care providers in the area in which one resides. Click here to find affordable care.