The 10 Best Home Care Agencies for Seniors in Saint Louis, MO for 2025

Those looking for home health services in Saint Louis might be surprised to learn it is one of the most expensive regions in the state, according to the 2021 Genworth Cost of Care Survey. In fact, it is several hundred dollars more than both the national and Missouri averages for monthly care costs. Other cities in the area, including Kansas City, Columbia and Springfield, are quite a bit less expensive. Cape Girardeau has the lowest average costs of the entire state.

Monthly costs for in-home care in Saint Louis are the same whether you choose home care services or home health care services. However, the cost of opting for an adult day health care is considerably less. It is important to note the fees for an assisted living community are more than $1,000 less per month than in-home care, which is remarkable compared to the rest of the country. Those looking for a skilled nursing center with a semiprivate room can expect to pay moderately more.

Given the high cost of in-home care, many people use one or more forms of financial assistance to cover the expenses. Below, we explain some of the most common sources of financial help for paying for in-home care. If none of these options are available to you, you can reach out to your Area Agency on Aging or Aging and Disability Resource Center to learn about local resources.

• Long-Term Care Insurance: Long-term care insurance covers expenses related to senior care, including in-home care. Depending on the policy type, beneficiaries may receive a cash payment to use towards long-term care or reimbursement for qualifying long-term care expenses. Note that there are limitations- typically a maximum benefit of $150 per day- and exact coverage terms vary depending on the exact policy, so always check the details.
• Medicare: Medicare does not cover in-home care because it is classified as custodial, or non-medical, care. However, some Medicare Advantage and Medicare Supplement plans, which offer expanded benefits, may cover in-home custodial care.
• Medicaid: Medicaid coverage of in-home care varies between different states because it is not a federally mandated benefit. Currently, all states cover some in-home care either through their standard Medicaid or a waiver program. The specific coverage rules are set individually by each state.
• Veterans’ Benefits: The Aid and Attendance benefit is a monthly cash payment that beneficiaries can use to pay for senior care, including in-home care services. To qualify for A&A, Veterans must already receive the VA pension and meet several additional requirements, including needing assistance with the activities of daily living. Contact the Department of Veterans Affairs to learn more.
• Reverse Mortgages: Home Equity Conversion Mortgages (HECMs) are federally insured loans that are available to homeowners age 62 and over. Reverse mortgages allow you to access a portion of your home’s equity in cash, tax free. Many seniors use reverse mortgages to finance their care expenses, including in-home care. Note that although there are no monthly payments due on reverse mortgage loans, borrowers do have to repay the loan once the last surviving homeowner passes away, moves, or sells the home.