Missouri seniors who want to age in place benefit from numerous statewide resources for older adults through the Missouri Department of Health & Senior Services. The average cost of in-home care in Missouri is $4,195, which is nearly $100 lower than the national average. The MDHSS also provides peace of mind by closely regulating in-home care providers. With 16.9% of Missouri’s population aged 65 or over, the Show Me state shows how much it wants to help older adults remain independent.

Continue reading to learn more about the cost of in-home care in Missouri, financial assistance options, additional free and low-cost resources for seniors and laws and regulations governing home health care.

The Cost of In-Home Care in Missouri

In-Home Care Costs in Nearby States

Whether in-home care is provided by a homemaker or a home health aide, expect to pay an average of $4,195 per month in Missouri, according to Genworth Financial’s 2019 Cost of Care Survey. This is less than the national average of $4,290 per month for homemaker services and lower still than the national average of $4,385 for home health aide care. Compared to nearby states, home care in Missouri is much lower than Illinois’ average of $4,481 for homemaker care and $4,576 for home health aide care, and significantly lower than Iowa’s average of $4,767 for either type of in-home service. The state is also equal to Kansas’ average cost for home health aide care and only slightly higher than its average of $4,004 for homemaker care, but Missouri is much higher than Arkansas’ average of $3,623 for both homemaker and home health aide care.




U.S. National Average









Cost of Other Types of Care in Missouri

Unlike some states, in-home care in Missouri costs the same whether service is provided by a homemaker or a home health aide. At an average monthly cost of $4,195 for either service, it’s more affordable than nursing home care in a semi-private room, which runs an average of $5,061 per month. The average monthly cost of an assisted living facility is $2,881 and adult day health care runs about $1,777 per month, making them more affordable options over home care. However, neither of these options may appeal to those who wish to age in place in their own home.


Homemaker In-Home Care


Home Health Aide Care


Adult Day Health Care


Assisted Living Facility


Nursing Home Care (semi-private room)

The Cost of In-Home Care in Missouri’s Top Cities

Comparing Costs Across Missouri

In a comparison of homemaker care costs among the most populous cities across the state, many of the larger cities are comparable. Kansas City, the largest city in the state, matches the state average of $4,195 for homemaker care as does the next largest city, St. Louis, and Columbia. Springfield and St. Joseph have a lower average cost of homemaker care at $4,004 and $4,147, respectively.


Kansas City


St. Louis






St. Joseph

Financial Assistance for In-Home Care in Missouri

Missouri Care Options

The Missouri Care Options program is part of the state Medicaid plan and helps reduce the need for seniors to go to nursing homes by providing in-home and community care services that instead allow them to age in place. Benefits include homemaker services and assistance with personal care, such as activities of daily living like eating, bathing, grooming and dressing. Other benefits include nursing services, adult day care and respite care. Anyone eligible for this program receives services.

Who is Eligible?
Program participants must be age 18 or older, eligible for Medicaid and in need of assistance. Because the MDHSS is committed to helping people live independently, individuals residing in long-term care facilities who qualify for care in a more independent setting are also eligible for home and community long-term care services through this program.

How to Apply
Missouri residents may call the Division of Senior and Disability Services at 866-835-3505 or contact their local Area Agency on Aging after being referred for home care services.

Aged and Disabled Waiver

The Aged and Disabled Waiver provides in-home services for seniors age 63 or older who would require nursing home care without these services. Benefits include homemaker services, chore services, adult day care, respite care and home delivered meals. Eligible applicants are encouraged to request service, but the program has limited space.

Who is Eligible?
Missouri residents age 63 or over who require nursing home care, but choose to receive in-home care instead. Applicants must have a functional disability and are subject to specific income and asset limitations.

How to Apply
Call the Missouri Department of Social Services, MO HealthNet Division at 573-751-9290 or contact the local Area Agency on Aging to apply for this Medicaid waiver program.

Independent Living Waiver

Although the Independent Living Waiver isn’t specifically for seniors, it can be used by seniors with a physical disability who want to continue living independently at home instead of moving to a nursing home. Administered by the MDHSS, Division of Senior and Disability Services, along with the state Medicaid agency, benefits of this waiver include home modifications, specialized medical supplies and equipment, financial management services and case management. Program participants also receive personal care services, including assistance with activities of daily living. Personal care services are consumer-directed, which means participants may hire any person they choose who is qualified to provide care, except a spouse or legal guardian.

Who is Eligible?
Physically disabled individuals age 18 to 64 who would require nursing home care without community-based alternatives may apply. Applicants must require a nursing home level of care, but can still self-direct their personal care. Program participants must be eligible for and activity enrolled in the state Medicaid plan.

How to Apply
Call the Missouri Department of Health and Senior Services at 573-751-6400 or apply through the local Missouri Department of Social Services office.

More Ways to Pay for In-Home Care

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 In-Home Care Resources in Missouri

ContactServices Provided
Aging Adult Nutrition

1-573-489-1317 or contact the local Area Agency on Aging

Aging Adult Nutrition helps seniors sign up for home delivered meals and provides information about other programs that provide meals to seniors, including the Farmer’s Market Nutrition Program, food stamp program and commodity supplemental food program.
Area Agencies on Aging & Services

1-573-526-4542 or info@health.mo.gov or contact the local Area Agency on Aging

Missouri’s Area Agencies on Aging & Services assists seniors with case management and care coordination, family caregiver assistance, legal services, nutrition, transportation, elder rights, tax counseling and in-home services, including homemaker, chore, personal or respite care.
OATS Transit

1-888-875-6287OATS Transit provides rides to medical appointments or to do essential shopping with ADA accessible buses and reduced fares to help seniors get around. Fares may also be covered by the Area Agency on Aging.
Missourians Stopping Financial Exploitation (MOSAFE)1-573-526-4542 or info@health.mo.gov

MOSAFE helps prevent financial exploitation of elderly or disabled customers of financial institutions by providing education to the staff on recognizing and reporting suspected exploitation. It also provides information about preventing financial exploitation to seniors and their families.
Missouri Rx Plan

1-800-769-3880 or 1-800-375-1406Missouri Rx provides additional assistance with prescription drug costs to Missouri residents who receive MO HealthNet (Medicaid) benefits.
Long-Term Care Ombudsman

1-800-309-3282 or LTCOmbudsman@health.mo.gov

Missouri’s long-term care ombudsman program provides advocacy, support and assistance with any problems or complaints to residents of nursing homes and residential care facilities.

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.

Scope of CareHome 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 RequirementsPatients 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 RequirementsHome care providers may assist patients with self-administered medications that don’t require the skills of a licensed nurse.
Staff Screening RequirementsIn-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 RequirementsHome 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 CoverageThe 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 AbuseAbuse, 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.

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