The state of Missouri ranks 25th overall in the 2022 Senior Living Report. It ranks 14th in Senior Living & Housing and 15th in Affordability, making it attractive to seniors looking for affordable long-term care options, including assisted living communities. As of the 2020 Census, 17.3% of people living in Missouri are aged 65 and older, and this population is expected to grow by 450,000 over the next 15 years.

As the number of seniors in Missouri grows, so will the demand for quality long-term care and health care. The average cost of assisted living in the state is $3,000 per month, well below the national average of $4,500. Most of the large metropolitan areas in Missouri are below the national average as well. The state also has many great hospitals, including Barnes-Jewish Hospital in Saint Louis, which is nationally ranked in 11 specialties.

In this guide, you will find further information about assisted living facilities in Missouri as well as links to helpful resources for families looking for long-term care.

The Cost of Assisted Living in Missouri

The average cost for assisted living in Missouri is $1,500 less per month than the national average of $4,500, making it one of the more affordable states in the country for this type of long-term care. It’s also the least expensive state in the region, according to Genworth Financial’s Cost of Care Survey for 2021. With a median rate of $3,448 per month, Kentucky is the next least expensive state. The most expensive nearby state for assisted living is Kansas, with a monthly average of $4,580. Iowa and Illinois are not far behind, at $4,367 and $4,488 per month, respectively. To the south, in Arkansas, the median price is $3,760 per month. 

$3000

Missouri

$4500

The United States

$4580

Kansas

$4367

Iowa

$4488

Illinois

$3448

Kentucky

$4105

Tennessee

$3760

Arkansas

Kansas City, at $4,585, is the only city in Missouri where the median price for assisted living is higher than the national average. The least expensive place is Jefferson City, where the monthly average is just $2,075. Joplin and Cape Girardeau both have more affordable rates at $2,805 and $2,538 per month, respectively. In Missouri’s largest city, Saint Louis, the average price for assisted living is $4,100 per month. The state capital, Jefferson City, has a median price of $3,250 per month.

$4100

St. Louis

$4585

Kansas City

$2075

Jefferson City

$2805

Joplin

$2538

Cape Girardeau

$3250

Springfield

Assisted living is the least expensive type of long-term care in Missouri that offers room and board. Seniors who only need supervision during the day will pay an average of $1,907 for adult day health care. Both in-home care and home health care cost an average of $4,767 per month for families who need 40 hours of service per week. Nursing homes are the most expensive type of senior care in Missouri, costing an average of $5,262 per month for a semiprivate room.

$4767

In-Home Care

$4767

Home Health Care

$1907

Adult Day Health Care

$3000

Assisted Living

$5262

Nursing Home (semiprivate room)

Does Medicaid Cover Assisted Living in Missouri?

Yes, Missouri’s Medicaid system MO HealthNet covers the cost of assisted living for eligible seniors. There are also several waiver programs that may cover certain types of specialized care that assisted living may not normally provide in order to prevent placement in a nursing home. These waivers are automatically checked when you apply for Missouri’s Medicaid. 

What Assisted Living Services Are Covered by Medicaid in Missouri?

MO HealthNet covers nonmedical personal care within assisted living facilities. Home and Community-Based Services (HCBS) waiver programs provide funding for services that can prevent you or a loved one from being placed in a nursing home, including skilled nursing, specialized medical equipment and respite. Unlike Missouri’s primary Medicaid system, these waivers have limited availability. 

Assisted Living Waiver Programs in Missouri

Independent Living Waiver

The Independent Living Waiver may be able to cover additional services not included with MO HealthNet’s standard plan. These include specialized medical equipment, environmental accessibility adaptations, financial management and case management. To qualify, you’ll need to demonstrate that you’re in need of these services to a health department representative. If you’re already signed up for MO HealthNet, call (573) 751-4054 to see if you’re eligible for this waiver.

Aged and Disabled Waiver

The Aged and Disabled Waiver can help seniors who are living at home but need assistance and are at risk of being admitted to a nursing home. Its services include homemaker services, adult day care and respite. Before you can receive this waiver, you must first be approved for MO HealthNet. As with the Independent Living Waiver, call (573) 751-4054 to sign up for this program.

How To Know If You’re Eligible for Medicaid in Missouri

To be eligible for MO HealthNet services, a single applicant must earn no more than $10,956 per year, and a couple applying together must earn no more than $23,169 per year. The asset limits are $5,000 for a single applicant and $10,000 for a couple, but assets do not include your home or vehicle. You can have $137,400  in assets if only one person in a two-person household is applying for Medicaid. These limits are subject to change as the federal poverty level shifts. 

2022 Medicaid Income Limits for Seniors in Missouri

Annual Income Limits

Asset Limits

Single Applicant

$10,956

$5,000

Two-Person Household

(Only One Person Applying)

$17,244

$137,400

Two-Person Household
(Both People Applying)

$23,169

$10,000

In addition to asset and income limits, Missouri Medicaid requires that you:

  • Be aged 65 years or older or disabled
  • Have or apply for a Social Security number
  • Be a U.S. citizen or have eligible residency
  • Be a resident of Missouri

If you already receive Social Security disability benefits, you are automatically eligible for Medicaid.

How to Apply for Medicaid in Missouri

MO HealthNet offers several ways to apply for Medicaid:

  • Call (855) 373-9994 to speak with an application assistant
  • Use the online portal
  • Print and fill out the application, then fax it to (573) 526-9400, email it to FSD.Documents@dss.mo.gov or mail it to the family Support Division at 615 East 13th Street, Kansas City, MO 64106

Information You Will Need

To complete your MO HealthNet application, you will need to provide your:

  • Social security number
  • Personal information, such as an address, phone number and other contact details
  • Proof of income and assets, including pay stubs and bank account numbers
  • Existing health insurance information
  • Any health care coverage options available to your family

The law requires that all the information you provide on your Medicaid application will be kept private and secure.

How to Get Help Applying for Medicaid

The following public and private organizations can help you or your family member apply for Medicaid. 

Resource

Contact

Service

(800) 390-3330

CLAIM is the official State Health Insurance Assistance Program (SHIP) for Missouri. With help from 180 community partners throughout the state, it offers free and unbiased information about your financial options for long-term care, including Medicaid. CLAIM keeps your information confidential. 

(314) 776-0155

Hope is a nonprofit organization that assists older adults and their families find long-term care that meets their needs and budget. Its expert counselors can provide affordable case management for clients in the Saint Louis area. General assistance over the phone is available nationwide. 

(800) 466-3213

The Missouri Foundation for Health (MFH) operates Cover Missouri to help you find health care coverage, including financial aid for assisted living through Medicaid. It can connect you directly with a knowledgeable person who can help you learn about your options and apply for benefits. 

Does Medicare Cover Assisted Living in Missouri?

The short answer is that no, Medicare does not cover the cost of assisted living in Missouri. Assisted living facilities are considered to be a “residential setting” and not a “clinical setting,” (think nursing homes). While Medicare doesn’t cover the cost of care received in an assisted living community, it does still cover things like approved medications, doctor visits, medical equipment, etc., just like it would if you lived at home.

For more information about when Medicare can be used to pay for senior living in a nursing home, and for Medicare-related resources, see our guide to Nursing Homes in Missouri.

Other Financial Assistance Options for Assisted Living in Missouri

Seniors who are not eligible (due to location, financial situation, or other factors) for other types of financial assistance, do still have some options. See the table below for an overview of some of the most common ways to make Assisted Living affordable.

.

How to Apply

How It Works

Aid and Attendance

Learn more and apply online at va.gov.

Veterans who receive a VA pension may also be eligible for the Aid and Attendance benefit, a monthly cash allowance that veterans receive in addition to their standard pension amount. The benefit is intended for veterans in need of long-term care services and may be used towards paying for Assisted Living.

Reverse Mortgages

Learn more about your options and how to apply at ftc.gov

If you own a home, you may be able to use a reverse mortgage to help pay for Assisted Living. Reverse mortgages are loans that one can take out against the value of their home, essentially converting some of the home's equity into cash. Reverse mortgage loans do need to be repaid with interest, typically within 12 months of receiving the loan.

Long-Term Care (LTC) Insurance

Learn more about Long-Term Care Insurance and how to apply for a policy at acl.gov.

Seniors who already have long-term care insurance may be able to use it to pay for Assisted Living. Most policies cover at least a portion of the cost, but it depends on the specific policy terms. Note that older adults who are already in need of Assisted Living will not typically be eligible to sign up for a LTC insurance policy.

Free and Low-Cost Resources for Seniors in Missouri

The following free and low-cost resources in Missouri can help you apply for government benefits, locate medical services, obtain nutrition and transportation assistance and find affordable long-term care in your area. Several resources also provide more valuable information about assisted living in your area.

Resource

Contact

Description

(888) 262-5644

This nonprofit organization advocates for the safety and interests of seniors in long-term care settings throughout Missouri. It strives to hold assisted living facilities accountable for the quality of their care and helps ensure seniors get the assistance they need to live a healthy, comfortable life. MCQC also accepts reports of abuse online and over the phone. 

(573) 526-4542

There are 10 AAAs in Missouri responsible for delivering services beneficial to seniors, including legal aid, nutrition assistance, in-home services, disease prevention and transportation access. These agencies also oversee the general welfare of seniors through the ombudsman program, which strives to empower older adults through advocacy and education. The NAPIS (National Aging Program Information System) tracks how well seniors in Missouri can access these services.

(866) 389-5627

AARP's low-cost membership gives seniors a variety of discounts and rewards available throughout Missouri. Both members and nonmembers can get valuable information about long-term care and other senior services through AARP's live and online events. AARP has local sites in Saint Louis, Kansas City and Springfield that offer additional services. 

(855) 380-4400

Veterans Care Coordination is a nonprofit organization based in Saint Louis that strives to connect veterans in the community with affordable long-term care options, including assisted living facilities. It works with veterans and their families to ensure they get the pensions and Aid & Attendance benefits they deserve. It also coordinates the delivery of care at home or in assisted living, making lives easier for eligible families.

(800) 989-8137

The Missouri Care Planning Council (MCPC) is an organization that connects seniors in the state with a wide range of local service providers, long-term care advisors and informational resources. MCPC is focused on long-term planning but is also available for emergency situations. It accepts specific requests for help both over the phone and through its online form.

COVID-19 Rules for Assisted Living in Missouri

The following information is based on research done on several government websites, including ltc.health.mo.gov and The CDC. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 3/16/2022, but since COVID-19 is a rapidly evolving pandemic, contact your local senior living facility or Area Agency on Aging for more specific and up-to-date information.

Visitation Policies

Rules for Missouri Communities

Are loved ones allowed to visit to provide emotional support?

Yes (Conditions Apply)

Are relatives allowed to visit for end-of-life care?

Yes

Are residents required to quarantine after visiting with a loved one?

No

Are visitors required to wear PPE (including masks) in order to visit residents?

Yes

Are non-medical contractors (such as hairdressers and entertainers) allowed in senior living facilities?

Yes

Are visitors checked for elevated temperatures?

Yes

Are visitors required to answer questions about health, travel, and potential virus contact?

Yes

Outings & Social Activities

Rules for Missouri Communities

Are residents allowed to leave (errands, visiting family, etc.) for non-medical reasons?

Yes

Are residents who leave required to quarantine when they return?

No (Conditions Apply)

Are senior living communities required to cancel all group outings?

No

Are residents allowed to eat meals together in a common area?

Yes (Conditions Apply)

Are residents allowed to gather in common areas for group activites?

Yes (Conditions Apply)

*Note: This information was not available for this state, contact your local area agency on aging or senior living facility for more information.

COVID-19 Safety Measures for Staff and Residents

Rules for Missouri Communities

Are staff members regularly required to do a temperature check?

Yes

Are staff members regularly tested for COVID-19?

Yes (Conditions Apply)

Are staff members members regularly required to do a health and safety screening, including questions about travel, contact with positive cases, etc?

Yes

Are residents regularly screened for COVID-19 symptoms?

Yes

Are residents regularly checked for elevated temperatures?

Yes

Are residents regularly tested for COVID-19?

Yes (Conditions Apply)

Assisted Living Laws and Regulations in Missouri

Assisted living facilities in Missouri are licensed and regulated by the Department of Health and Senior Services. Rules are described in Division 30, Chapter 86.

MISSOURI LAWS AND REGULATIONS

Assisted Living Service Plan Requirements

To create a service plan that meets all the needs of a resident, a thorough interview with the applicant and interested family members is required before admission. This plan must be amended any time the behavior or care needs of a resident change. An individualized evacuation plan should be included if the resident has unique mobility challenges. 

Assisted Living Admission Requirements

After approval and moving in, a physical assessment of the resident must be completed within 5 days to confirm that the assisted living facility can provide appropriate care. Any resident that requires long-term skilled nursing, restraints or other high levels of medical care does not qualify for assisted living. 

Assisted Living Scope of Care

Assisted living facilities in Missouri are required to provide the following care services:

  • 24-hour housing
  • Personalized assistance
  • Basic housekeeping and laundry
  • Access to social and recreational activities
  • Transportation for emergencies

Facilities must also ensure that residents have access to health care.

Assisted Living Medicaid Policy

MO HealthNet covers personal care services received in assisted living facilities. There are also waiver programs that can cover extra services, such as temporary skilled nursing and therapy for disabled residents. 

Assisted Living Facility Requirements

Assisted living facilities must include private units and social spaces. There must be at least 70 square feet of space for each resident, whether a person is housed in a single or multi-occupant unit. Each unit must include a window that looks to the outside. A bathroom or tub is required for every 20 residents in a facility. 

Medication Management Regulations

During the initial assessment, a registered nurse or physician determines if a resident can self-administer their own medication. Only approved medication will be available to these residents, and they must be stored properly. A medication regimen must be reviewed every two months. 

Staffing Requirements

In Missouri, assisted living facilities must have one staff member for every 15 residents during the day, one staff member for every 20 residents in the evening and one staff member for every 25 residents during the night. A registered nurse is required for at least 8 hours per week for facilities with 30 or fewer residents and 40 hours per week for facilities with over 90 residents. An administrator is also required to ensure the facility is adhering to regulations. 

Staff Training Requirements

Each staff member must be trained in one hour of fire safety, two hours of transfer assistance, person-centered care and resident privacy and 24 hours of training related to the needs of seniors with cognitive impairments. Direct caregivers must also go through an orientation that covers their specific duties and responsibilities.

Background Checks for Assisted Living

Background checks are required for all full-time, part-time and temporary employees and contracted workers at assisted living facilities in Missouri. Documentation of background checks is also required. Persons with class A or B felonies may not have direct contact with residents unless they receive a good cause waiver.

Requirements for Reporting Abuse

Any staff member who witnesses abuse, neglect, exploitation or other types of mistreatment must report the incident to the facility administrator. The administrator must then report the incident to the Missouri Department of Health and Senior Services at (800) 392-0210.

Assisted Living Facilities in Missouri (104)