Missouri is an appealing location for older adults who are considering in-home care. The state has a pleasant Midwestern climate, and the cost of living is about 15% lower than the national average. Residents can choose from nine metropolitan areas and many charming cities and towns that are home to more than 1 million seniors. According to estimates, more than 20% of the state’s population will be aged 65 or older by 2030. This surge is increasing the demand for in-home care and supportive services.

With a median cost of $4,767 per month, home care in Missouri costs less than the national average. Agencies may offer in-home medical care, skilled nursing and physical therapy or help with errands, chores and nonmedical tasks.

This guide provides information about long-term care costs in Missouri and the state’s Medicaid financial assistance programs. We’ve also included some free resources to help you learn more about aging in place.

The Cost of In-Home Care in Missouri

In Missouri, home health care and non-medical in-home care cost $4,767 per month, which is $200 lower than the national average. According to data from Genworth Financial’s 2021 Cost of Care Survey, these rates are typical for the region. Seniors in Illinois pay $5,339 per month for in-home chore assistance and personal care. Prices in Iowa are even higher at $5,529, an increase of $762. Home care prices drop below the national average to $4,576 in Kansas, and seniors in Arkansas pay just $4,185, which saves them $580 compared to Missouri.

$4767

Missouri

$4957

The United States

$5529

Iowa

$4576

Kansas

$4185

Arkansas

$5339

Illinois

In Missouri’s largest cities, the cost of in-home care ranges from a low of $3,813 in Jefferson City to a high of $5,482 in St. Louis. Prices are on par with the state median in St. Joseph and Springfield at $4,767. Seniors in Kansas City pay $4,957, which is slightly more than average, and median rates rise to $5,053 in Columbia. Joplin also offers a competitive value at $4,481, which could save you $286 on the state average.

$4957

Kansas City

$5482

St. Louis

$4767

Springfield

$5053

Columbia

$4767

St. Joseph

$4481

Joplin

$3813

Jefferson City

Missouri’s long-term care prices vary significantly depending on how much assistance you require and where you receive these services. Prices start at $1,907 for community-based daytime health care programs. Assisted living is significantly more affordable than the national average of $3,000. Medical and nonmedical care costs $1,767 more at $4,767. Nursing homes are more expensive yet with an average of $5,262.

$4767

In-Home Care

$4767

Home Health Care

$5262

Nursing Home Care

$3000

Assisted Living

$1907

Adult Day Health Care

Does Medicaid Cover Home Care in Missouri?

Missouri covers in-home care through its Medicaid State Plan and several home- and community-based services waivers. Basic Personal Care Services are available to Medicaid-eligible adults aged 18 and older who require a nursing home level of care. The program covers medically oriented services to help recipients with activities of daily living, including bathing, grooming, toileting, mobility and medications. There are limitations on how much care may be provided relative to the cost of nursing home care. Advanced Personal Care is available to individuals who have greater functional limitations. Medicaid members may also be eligible for nursing visits and home health care through the Medicaid State Plan. You must apply for regular Medicaid and qualify based on your income and assets to be considered for these programs.

Home Care Waiver Programs in Missouri

Missouri offers several home-based and community-based services waivers depending on your age and health. Eligibility is based on medical and financial needs. The following programs cover in-home care and chore assistance and some more advanced services.

Contact
Area Served
Services Provided

(573-) 751-4054

Statewide

The Independent Living Waiver provides self-directed care similar to the services offered by the Medicaid State Plan. It also covers additional services, including case management, home modifications, medical equipment and bill payment assistance. It covers applicants who are too young to qualify for the Aged and Disabled Waiver.

(573) 751-4054

Statewide

The Aged and Disabled Waiver is available to seniors who have unmet personal or medical needs due to functional limitations that require a nursing home level of care. The waiver helps with the cost of homemaker services, chore assistance, delivered meals, daytime health programs and respite care. It's open to seniors aged 65 or older and disabled adults starting at age 63.

(573) 751-4054

Statewide

Missouri’s Structured Family Caregiving Waiver provides in-home care and other supports to adults aged 21 or older who have been diagnosed with Alzheimer’s or dementia and would otherwise require a nursing home level of care. This waiver is administered by the Division of Senior and Disability Services.

(573) 751-6246

Statewide

Individuals who are eligible for Medicaid and require private-duty nursing or more advanced medical services may qualify for the state's Medically Fragile Adult Waiver. Eligibility is based on a level of care determination.

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

Medicaid is a group of programs available to various individuals based on their medical and financial needs, so it may be difficult to determine which programs you qualify for without applying. To receive regular Medicaid for the aged, blind or disabled in Missouri, your monthly income can’t exceed $963 ($11,556 yearly) if you’re applying individually or $1,297 ($15,564 yearly) if you’re applying as a couple. Assets are limited to $5,035 per person. Income limits are slightly higher for applicants who are blind and for certain programs that require a nursing home level of care.

2022 Medicaid Income Limits for Seniors in Missouri

Income Limits*
Asset Limits

Single Person

$11,556

$5,035

Two-Person Household

$15,564

$10,070

*Per year

As part of the Medicaid application process, you may be asked to prove your:

  • Age and disability
  • Citizenship and state residency
  • The clinical need for long-term care for some programs
  • Financial need for assistance

How to Apply for Medicaid in Missouri 

If you need long-term care and think that you may qualify for financial assistance, you can apply for Medicaid online using the state’s secure application portal. For assistance over the phone, call the Medicaid call center at (855) 373-9994. You may also complete a paper application or have someone help you complete this step. Signed applications should be submitted to the Family Support Division by mail, email or fax.

Family Support Division
615 E. 13th St.
Kansas City, MO 64106
Email: FSD.Documents@dss.mo.gov
Fax: 573-526-9400

If you’re aged 65 or older, disabled, live in a long-term care facility or receive other government benefits, such as Social Security, Medicare or VA health care, make sure to submit the Supplemental Form when you apply.

What Information You Will Need 

Missouri’s Medicaid application asks for a variety of personal and financial information. To simplify the process, make sure to have the following items on hand.

  • Name and address
  • Household members
  • Birth dates
  • Social Security numbers
  • Citizenship and residency information
  • Federal tax status
  • Income and employment
  • Monthly expenses
  • Vehicles
  • Property
  • Assets and resources
  • Insurance policies
  • Medical needs

How to Get Help Applying for Medicaid 

Applying for Medicaid is designed to be a simple process. If you have questions or need extra help, contact these government agencies for assistance.

Contact
Area Served
Services Provided

(855) 373-4636

Statewide

To check on the status of a new or existing Medicaid application or to request in-person assistance at a local office, contact the Family Support Division Information Center.

(855) 373-9994

Statewide

If you need help completing an online application or if you already submitted an application using the state's benefits portal, call the Family Support Division Contact Center for assistance. This call center can process your Medicaid application over the phone.

Central (573) 751-0335, East (314) 877-2072, West (816) 325-5918

Regional

If your application for Medicaid has been denied or if you disagree with another benefits-related decision, you may contact the division of Legal Services to request an appeal.

Does Medicare Cover In-Home Care in Missouri?

In general, Medicare does not cover the cost of non-medical home care. That being said, there are situations in which Medicare provides some coverage for medical home care, referred to as “Home Healthcare.” There are several eligibility restrictions for coverage, including that individuals must be homebound and have a referral from their doctor specifically for home healthcare services.

Below is an overview of some of the skilled medical professionals whose in-home services are typically covered by Medicare – for more in-depth information, refer to our Guide to Home Healthcare.

  • Physical Therapists: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), treat ongoing conditions such as arthritis, and assist in recovery from surgeries and procedures such as a knee or hip replacement.
  • Visiting Nurses: Licensed nurses can provide a number of medical services for those who don’t need to stay in the hospital, but do need regular medical services such as wound care, changing feeding tubes, etc.
  • Occupational Therapists: Occupational therapists help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, and other daily activities.
  • Speech Therapists: Speech therapists help seniors who are struggling to adequately communicate due to a stroke, dementia, or any other cause regain the ability to functionally communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets, teaching special techniques to swallow safely, and retraining associated muscles.

As mentioned above, in-home care is distinctly different from home healthcare. But, there can be some overlap in services between the two types of care. So, while Medicare doesn’t cover non-medical in-home care, there are in-home care services that may be covered in special circumstances when they’re provided in conjunction with home healthcare (such as an occupational therapist helping with eating or dressing)

Other Financial Assistance Options for In-Home Care in Missouri

While the above programs help many people finance in-home care, they will not cover all costs for everyone. There are other ways to pay for in-home care, including out-of-pocket arrangements with siblings, annuities, reverse mortgages, private insurance and more. Read Caring.com’s Guide to In-Home Care Costs to learn more about these alternative payment options.

Free and Low-Cost Resources for Seniors in Missouri

If you live in Missouri and want to maintain your independence, check out the following resources to find services in your area. Many programs are free to residents aged 60 or older.

Contact
Area Served
Services Provided

(573) 526-4542

Regional

Missouri has 10 Area Agencies on Aging that serve seniors and family caregivers across the state. These agencies provide information and referrals and administer federally funded programs, including senior activities, accessible transportation, nutrition services and other supports. They can also help you apply for in-home care and financial assistance.

(800) 235-5503

Statewide

Seniors may face a variety of legal challenges when it comes to aging in place. Missouri’s Senior Legal Helpline can assist callers with wills, trusts, advance directives, long-term care access and government benefits. Staff can also provide information about housing and consumer rights.

(888) 875-6287

Statewide

OATS is a statewide transportation service serving seniors, disabled adults and rural or isolated residents in all 87 counties. This nonprofit corporation operates deviated fixed-route bus routes and provides a variety of other transportation services, including shared rides, demand-response van service and door-to-door escorts.

(800) 361-4827

Statewide

The Missouri Department of Natural Resources works with 18 regional agencies to administer the state’s Low-Income Weatherization Assistance Program. Eligible households may qualify for free weatherization services and energy efficiency updates. Eligibility is based on income and household size. If you’re applying with your spouse, you can have up to $34,840 in annual income.

(855) 373-4636

Statewide

Low-income families who need help paying their gas, electric or water bill may qualify for crisis intervention services to prevent disconnection. LIHEAP pays up to $1,200 during the summer or $1,600 during the winter. It also offers one-time bill payment assistance during the heating or cooling season. LIHWAP pays up to $750 on balances and fees to prevent disconnection or restore your water service.

(573) 751-3505

Statewide

Senior homeowners and renters who earn less than $34,000 or $29,200 per year may qualify for a state income tax credit based on the real estate tax they pay. Renters may be eligible for a tax credit of up to $750, and homeowners may be able to claim a credit of up to $1,100.

COVID-19 Rules for In-Home Care Providers in Missouri

Starting in 2022, the Centers for Medicare and Medicaid Services is requiring home health aides and other direct care workers to be fully vaccinated to prevent the spread of COVID-19. These rules apply to home health agencies in Missouri and all 50 states. However, workers may request an exemption for certain reasons. If you’re concerned about being exposed to COVID-19 through a health care worker, contact your provider to learn more about the company’s policies for vaccinations, masking and routine testing. These regulations are current as of April 2022. However, they are subject to change. Contact your Area Agency on Aging for more information about this issue.

In-Home Care Laws and Regulations in Missouri

Missouri Department of Health and Senior Services oversees Home Care and Rehabilitative Standards to safeguard services provided through home health agencies. The MDHSS conducts on-site inspections for Medicare certification and/or state licensure compliance and issues state licenses for the operation of these agencies. It also investigates allegations of inappropriate patient care, verifies the training and credentials of agency staff, visits patients and reviews quality assurance programs. The table below provides an overview of the rules and regulations in the State of Missouri.

In-Home Care Laws and Regulations in Missouri
Scope of Care
Home care agencies may provide assistance with activities of daily living, personal care, homemaking, companionship, respite, self-administered medications that don't require a licensed nurse and other non-skilled services a patient might need.


Care Plan Requirements
Patients must receive an individualized written plan of care that specifies the care, services and equipment necessary to meet their specific needs as identified in a comprehensive assessment, plus the frequency and duration of visits, nutritional requirements and patient and caregiver education and training. All services must be furnished in accordance with accepted standards of practice.
Medication Management Requirements
Home care providers may assist patients with self-administered medications that don't require the skills of a licensed nurse.
Staff Screening Requirements
In-home services providers, home health agencies and consumer directed services providers must conduct background screenings prior to hiring an employee, including a criminal background check and an Employee Disqualification List check. Individuals cannot have been found guilty of abuse, neglect, mistreating residents or misappropriation of residents' property. Eldercare workers hired on or after January 1, 2001, must register with the Family Care Safety Registry.
Staff Training Requirements
Home health aides must complete a state-approved training and competency evaluation program that includes classroom and supervised practical training. Home health aides also must receive at least 12 hours of in-service training during each 12-month period, which may occur while caring for a patient.
Medicaid Coverage
The Missouri Care Options, Aged and Disabled Waiver and Independent Living Waiver programs will cover some or all the cost of in-home care for those who qualify.
Reporting Abuse
Abuse, neglect, bullying and financial exploitation of individuals age 60 and older should be reported to the Adult Abuse and Neglect Hotline 1-800-392-0210 or make an online report.

Frequently Asked Questions

How much does in-home care cost in Missouri?

According to Genworth Financial’s 2019 Cost of Care Survey, Missouri residents pay an average of $4,195 for in-home care services whether the service is non-medical care provided by a homemaker or skilled nursing care provided by a home health aide.

Does Missouri Medicaid pay for in-home care?

Missouri’s Medicaid program is called MO HealthNet and covers some home-based and community-based services for individuals who meet eligibility requirements through its Missouri Care Options, which provides personal care assistance, homemaker services, nursing services, adult day care and respite care. Missouri also has two Medicaid waiver programs in place. The Aged and Disabled Waiver provides in-home services for seniors age 63 or older who need assistance with homemaker services, chore services, adult day care, respite care and home delivered meals and the Independent Living Waiver helps with personal care services, home modifications, specialized medical supplies and equipment, financial management services and case management.

Are there programs to cover home modifications in Missouri?

Missouri’s Independent Living Waiver helps cover environmental accessibility adaptations; home modifications like ramps, grab bars and specialized electric systems; and specialized medical equipment, such as lift chairs and shower benches.

What is the difference between in-home care and home health care?

In-home care providers are non-medical caregivers that provide assistance with activities of daily living, meal preparation, housecleaning, transportation, shopping and other non-clinical services, while also offering companionship. Home health care must be provided by licensed medical professionals who supply skilled nursing services, which may include rehabilitation therapy, medication administration, wound care, pain management and other medical care assistance.

What are Activities of Daily Living

Activities of daily living (ADLs) are fundamental tasks individuals do everyday to care for themselves and maintain their independence. ADLs include all types of routine personal care tasks, including bathing, grooming, dressing, eating, going to the bathroom, walking and getting in and out of a chair or bed.

How to Find an In-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. When you hire an in-home care aide you’re placing a lot of trust in the hands of the person by inviting them into your home, so you’ll want to be diligent in your search. At Caring.com, we’re here to help – 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 provide the best care possible.

Finding a Home Care Provider Checklist

Find Home Care Agencies Near You

To find quality home care providers near you, simply input the zip code or city where you would like to start your search. We have an extensive directory of home care agencies all across the nation that includes in-depth information about each provider and hundreds of thousands of reviews from seniors and their loved ones.

2018, 2020, 2021, 2022

Right at Home St. Louis Central

121 Hunter Ave, Ste 202, Saint Louis, MO, 63124

I asked if they could do a meet and greet. They don’t do that but I think that’s helpful. We were impressed with the case manager. They were extremely compassionate.
I asked if they could do a meet and greet. They don’t do that but I think that’s helpful. We were impressed with the case manager. They were extremely compassionate.

BrightStar Care South St. Louis County, MO

1065 Executive Parkway Dr, Suite 215, St. Louis, MO, 63141

BrightStar Care of West St. Louis County and St. Charles is available to you 24 hours a day, 7 days a week to make more possible for you and your loved ones. Our Joint Commission Accredited agency pro … (read more)
BrightStar Care of West St. Louis County and St. Charles is available to you 24 hours a day, 7 days a week to make more possible for you and your loved ones. Our Joint Commission Accredited agency pro … (read more)

2020, 2022

Assistance Home Care

9893 Manchester Road, Saint Louis, MO, 63119

When Moving Isn’t An Option… Assistance Home Care is committed to honoring one’s wishes to stay at home and enrich the journey of aging with compassion, dignity, and respect. Established in 2011, … (read more)
When Moving Isn’t An Option… Assistance Home Care is committed to honoring one’s wishes to stay at home and enrich the journey of aging with compassion, dignity, and respect. Established in 2011, … (read more)

Interim HealthCare of Fenton, MO

1736 Westpark Center Dr., Fenton, MO, 63026

Interim HealthCare is very good. They have a nurse come in for my dad to do stuff for him. They also clean, they help with bathing, cooking the meals, and laundry. The caregiver is very polite and pro … (read more)
Interim HealthCare is very good. They have a nurse come in for my dad to do stuff for him. They also clean, they help with bathing, cooking the meals, and laundry. The caregiver is very polite and pro … (read more)

2022

Home Instead – St. Louis, MO

8147 Delmar Blvd, Suite 215, Saint Louis, MO, 63130

The staff was professional and caring. They spent the time that was needed to learn about my Mom to give her the best services possible. They recognized how hard this process was for me as an individu … (read more)
The staff was professional and caring. They spent the time that was needed to learn about my Mom to give her the best services possible. They recognized how hard this process was for me as an individu … (read more)

Family Values Home Health Care LLC

4144 Lindell Blvd, Suite 203 ,, St Louis, MO, 63108


LRB In-Home Hospice Care LLC

320 Brookes Dr , Saint Louis, MO, 63042

Here at LRB Hospice Care, we are committed to making our clients comfortable and giving them the best care and making sure we satisfy all of the needs of our clients and their family. We offer music t … (read more)
Here at LRB Hospice Care, we are committed to making our clients comfortable and giving them the best care and making sure we satisfy all of the needs of our clients and their family. We offer music t … (read more)

2019, 2020, 2021

Seniors Home Care

504 Marshall Ave, Saint Louis, MO, 63119

It is nice to have your house straightened and clean. I like the caregiver that I have, she is friendly and very thorough.
It is nice to have your house straightened and clean. I like the caregiver that I have, she is friendly and very thorough.

Compassionate Nursing Services

11710 Administration Dr, Saint Louis, MO, 63146

They’ve had no impact. I would recommend them. I don’t have any frustrations with them; I just don’t need them.
They’ve had no impact. I would recommend them. I don’t have any frustrations with them; I just don’t need them.

2017, 2018

Senior Services Unlimited

6255 Knox Industrial Drive , St. Louis, MO, 63139

They are wonderful my mother needed them the nursing director came to the nursing home she was at on day she was discharged to meet us she was very warm and caring explained everything to us and the … (read more)
They are wonderful my mother needed them the nursing director came to the nursing home she was at on day she was discharged to meet us she was very warm and caring explained everything to us and the … (read more)

FirstLight HomeCare of North St. Louis, MO

320 Brookes Drive Suite 217, Hazelwood, MO, 63042

My husband currently receives care from FirstLight. I cannot say enough good things about this company. They have met every need that he has even though he is a "difficult" client. The caregivers h … (read more)
My husband currently receives care from FirstLight. I cannot say enough good things about this company. They have met every need that he has even though he is a "difficult" client. The caregivers h … (read more)

Griswold Home Care

428 McDonough Street, St. Charles, MO, 63301

This is an awesome resource. I used Griswold for temporary care after surgery and found the people to be wonderful and the scheduling process very accommodating. Highly recommended.
This is an awesome resource. I used Griswold for temporary care after surgery and found the people to be wonderful and the scheduling process very accommodating. Highly recommended.

Private Home Care St. Louis – St. Louis, MO

6900 Delmar Blvd., University City, MO, 63130

After interviewing several agencies, we selected Private Home Care because they seemed most in touch with what we wanted for my father and because they listened to and shared our goals. After several … (read more)
After interviewing several agencies, we selected Private Home Care because they seemed most in touch with what we wanted for my father and because they listened to and shared our goals. After several … (read more)

SYNERGY HomeCare of St. Louis

2705 Dougherty Ferry Road, Suite 200, Saint Louis, MO, 63122

I called this company last week and spoke to a senior specialist. He was very knowledgeable in the veterans services that are offered.
I called this company last week and spoke to a senior specialist. He was very knowledgeable in the veterans services that are offered.

On The Go Home Healthcare LLC

1515 N Warson Rd, St. Louis, MO, 63132

Im happy that I choose On The Go Homehealth as my provider. They are Professional and Helpful in many ways. My staff goes above and beyond expectations. I love my Aide more like family…Im very pleas … (read more)
Im happy that I choose On The Go Homehealth as my provider. They are Professional and Helpful in many ways. My staff goes above and beyond expectations. I love my Aide more like family…Im very pleas … (read more)

Home Care Solutions of St. Louis

113 Hilltop Village Center Dr, Eureka, MO, 63025

Excellent service, caring, professional, dependable. Would be happy to be a reference.
Excellent service, caring, professional, dependable. Would be happy to be a reference.

Faith Hope & Love Homecare

9191 W. Florissant , St. Louis, MO, 63136

I have been a client of Faith Hope & Love for a few years and they help me with my daily needs. The ladies in the office are very professional and they ALWAYS communicate effectively with me. My c … (read more)
I have been a client of Faith Hope & Love for a few years and they help me with my daily needs. The ladies in the office are very professional and they ALWAYS communicate effectively with me. My c … (read more)

Heavenly Helpers Senior Home Care

23 N Gore, Suite 309, Saint Louis, MO, 63119

I am a current client of 2 years. I love them! They are so adorable. I don’t know what I’d do without them. They really helped me with everything. When I first started as a quilter, ‘Melanie’ bought m … (read more)
I am a current client of 2 years. I love them! They are so adorable. I don’t know what I’d do without them. They really helped me with everything. When I first started as a quilter, ‘Melanie’ bought m … (read more)

Algonquin Nurses Home Health Care I, St. Louis, MO

10135 Manchester Road, Saint Louis, MO, 63122

Absolutely delightful. The caregiver was wonderful, clean, prompt, polite and really seemed to take pride in her role.
Absolutely delightful. The caregiver was wonderful, clean, prompt, polite and really seemed to take pride in her role.

CaringLegends, LLC

4244 Ellenwood Ave, St. Louis, MO, 63116

This agency has a lot of credible workers, my mother has relied on the services of this agency for the past 3yrs and everyone of their caregivers are respectful, professional and very compassionate.
This agency has a lot of credible workers, my mother has relied on the services of this agency for the past 3yrs and everyone of their caregivers are respectful, professional and very compassionate.

Home Care Services in Missouri (301)