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

According to Genworth’s 2020 Cost of Care Survey, seniors in St. Louis pay an average of $4,481 per month for in-home care. This rate matches the U.S. average but is slightly higher than Missouri’s statewide average of $4,372 per month. Other cities across Missouri generally have less expensive home care costs with the exception of Kansas City and Columbia, which are tied at $4,576 per month. Home care in Jefferson City, located 130 miles west of St. Louis, costs $4,052 per month. Cape Girardeau, less than 120 miles south of St. Louis, has the most affordable home care services in the Show-Me State with a monthly average of just $3,318.   

Although home health care includes skilled clinical services, it costs the same as basic home care in St. Louis, averaging $4,481 per month. Adult day health, which provides weekday care for seniors, costs just $1,842 per month. Assisted living facilities in St. Louis average $3,750 per month, while nursing homes generally require a monthly fee of $5,355.

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.