Page Reviewed / Updated – March 7, 2023

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. It can be in the home or in a residential care facility.

Missouri Eldercare Costs for 2023

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Assisted Living / Memory Care

In Missouri, as of 2020, according to Genworth’s Cost of Care Survey 2019, the average cost of assisted living statewide is $2,881 / month, which is well below the national average of $4,051 / month. The least expensive assisted living in Missouri can be found in the area of Joplin, where the average cost of assisted living per month is $2,750. St. Joseph and Kansas City have monthly costs in line with the statewide average with a range between $2,880 and $2,898. Cape Girardeau and Springfield have costs over the statewide average for assisted living, but still less than the nationwide average at $3,224 to $3,309 / month. Those living in the areas of Columbia, Jefferson City, and St. Louis should be aware that these areas have the costliest assisted living, but again, it is still under the nationwide average. Here the monthly average is between $3,750 and $3,848.

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, the cost is approximately 20% – 30% greater than is traditional assisted living. An additional fee of approximately $687 – $962 / month should be expected.

Home Care

Per Genworth’s 2019 Cost of Care Survey, the cost of non-medical home care in Missouri averages $22.00 / hour throughout the state in 2020. In Jefferson City, Springfield, and Cape Girardeau, the hourly cost of home care is the most affordable in the state at $17.38 – $21.16 / hour. St. Joseph also comes in just under the statewide average at $21.75 / hour. Kansas City, Columbia, and St. Louis have an average hourly cost of $22.00, which is consistent with the statewide average. The most expensive home care is found in Joplin, where the hourly average cost is $23.63.

Home health care, which is provided by trained medical professionals, is also available in the state of Missouri. On average, the hourly cost is consistent with the cost for home care. However, in the areas of St. Louis, Jefferson City, and Kansas City, the price is on average $1.00 – $2.00 more per hour.

Adult Day Care

Statewide, in 2020, the average cost of adult day care in Missouri is $82 / day, as indicated by Genworth’s Cost of Care Survey 2019. The area of St. Joseph offers the least expensive day care at $65 / day. In the cities of Cape Girardeau, Kansas City, St. Louis, and Springfield, the average daily rate is near the statewide average and ranges from $80 – $85. 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.

Missouri Medicaid Financial Assistance Programs

Medicaid Programs & Waivers for the Elderly

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.

Medicaid Waivers

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. It allows 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. It allows 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. Although those who enroll in this program before 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.

Medicaid Eligibility

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 July 2023, senior applicants are allowed up to $5,726 in liquid assets, which refers to cash assets or assets that can easily be converted to cash. 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 $688,000. The monthly income limit is set at 85% of the Federal Poverty Level (FPL). As of April 2023, this amount is equivalent to $1,032 a month. Married applicants, with both spouses applying for Medicaid services, are permitted a higher level of income and assets. A couple can have income as high as $1,397 a month and assets up to $11,452. Please note that the Aged and Disabled Waiver allows applicants a higher level of income.

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 Non-Medicaid Assistance Programs

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.

PACE Programs in Missouri

The Program of All-Inclusive Care for the Elderly (PACE) is a joint initiative between Medicare and Medicaid to help seniors get the care and services they need in the community rather than transitioning to a nursing home for care. Because Medicaid differs in each state, PACE eligibility varies between states.

The PACE program in Missouri provides care services to seniors in the state who require nursing home levels of care but do not currently live in a nursing home. Seniors receive care from providers covered by state Medicare and Medicaid as long as they are:

  • Over 55 years old
  • Living in the provider’s designated service area (St. Louis)
  • Certified by the State of Missouri as meeting care level requirements
  • Capable of living safely in the community

How To Get Started With PACE in Missouri

To apply for PACE in Missouri, you need to contact the provider directly who will coordinate with Missouri’s Medicaid organization, MO HealthNet Division (MHD). However, you don’t need to be eligible for Medicaid or Medicare to receive PACE services; they do accept private payment.

PACE Provider


Areas Served

New Horizons PACE

(833) 654-7223)

St. Louis

Other Financial Options for Care

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. 

Finding Affordable Care in Missouri

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.

Eldercare Financial Assistance Locator

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Top Cities for Senior Care in Missouri

For more information about the costs and resources available in Missouri cities, click on the links below. 

Top Cities for Memory Care

Top Cities for Assisted Living