Page Reviewed / Updated – February 29, 2020

Program Description

Missouri’s Supplemental Nursing Care (SNC) is a financial assistance program from MO HealthNet (Medicaid). It is a cash benefit to help the elderly who are frail, blind, and/or disabled to pay for costs associated with residential care, most relevantly to help with the cost of assisted living. Eligibility requirements include monthly income and asset limits.

Payments to a recipient vary per the type of facility in which an individual resides. Individuals in Assisted Living Facilities (ALFs) receive almost twice as much support as do individuals who live in Residential Care Facilities (RCFs).

Supplemental Nursing Care is one of several programs operated by MO HealthNet (formerly known as the Division of Medical Services). Eligibility is determined by the Family Support Division (FSD). Both are divisions are within Missouri’s Department of Social Services (DSS).

Eligibility Guidelines

Age – candidates must be at least 21 years of age.

Residency – candidates must be legal Missouri residents. 

Place of Residence – candidates must reside in an assisted living residence or residential care facility to receive the benefit. It is not a requirement that the residence accept Medicaid. 

Care Needs – applicants must require the level of care typically provided in a nursing facility

Monthly Income – For seniors that are 65 years of age and older, as of April 2019 through March 2020, the monthly income limit is $885 for a single applicant and $1,198 for a couple with both spouses as applicants. (These figures are equivalent to 85% of the Federal Poverty Level). For those who have income over these amounts, there is another pathway to Medicaid eligibility known as a “Spend-down” program. Sometimes referred to as a medically needy program, individuals who have more than $885 per month in income, or couples who have more than $1,198 per month, can demonstrate their income is significantly reduced by medical expenses each month. In simple terms, if an individual or couple is able to spend down their monthly excess income on medical bills / care, they are able to qualify for this program. Furthermore, income may be transferred from an applicant spouse to a non-applicant spouse to prevent the non-applicant spouse from living in poverty. As of 2020, this spousal income allowance may be as much as $3,216 per month.

Assets – applicants must have less than $4,000 in countable assets, which exclude the value of a home, if occupied by a spouse. A couple with both spouses as applicants cannot have assets in excess of $8,000. There is a five-year Medicaid Look-Back Period for assets to determine whether anything of value has been sold or transferred for less than market value. If one is found to be in violation of this look-back period, one may be ineligible for Medicaid for a period of time. Married applicants who have a spouse who is not also applying for Medicaid services, can set aside some joint assets for their healthier spouse following the Medicaid rules to prevent the impoverishment of spouses. As of 2020, this amount could be as great as $128,640. Learn more about how Medicaid views assets of married couples here.  

These criteria are approximate and for planning purposes. As mentioned above, final eligibility is conducted by the Family Support Division (FSD). If one has income and / or assets above the income limit(s), it is highly recommended that advice be sought from a professional Medicaid Planner.

Benefits and Services

As of February 2020, Supplemental Nursing Care pays up to $292 per month for care in assisted living and up to $156 per month for residential care facilities. This program also offers other benefits for full-time, permanent, nursing home care. However, these details have been omitted as they are less relevant to our audience. One can read more about this program here.

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How to Apply / Learn More

Contact your local Family Support Division county office for more information. A list can be found here.

The state hotline number for the Family Services Division is 1-855-373-4636.  There is also a 24-hour number with an automated response 7 days a week at 1-800-392-1261.

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