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Assisted Living in Missouri
The state of Missouri ranks 25th overall in the 2024 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.
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The Cost of Assisted Living in Missouri
When trying to decide how to pay for assisted living, one of the first questions that comes up is "How much does it cost?" With the impact of inflation, it's more important than ever to have up-to-date information when making a financial plan for senior living. To help shed light on real senior living prices, Caring.com has compiled proprietary cost data from its network of over 75,000 senior living providers to offer insight into the average cost of assisted living in Missouri and its 48 cities.
The Cost of Assisted Living in Missouri's Top Cities
Assisted living costs in Missouri vary significantly across the state. Kansas City and Branson are on the pricier side, with monthly costs averaging $4,329 and $4,412 respectively. In contrast, St. Louis offers a more affordable option, with costs approximately $700 less than the state average, coming in at $3,510 per month. However, Columbia tops the list with some of the highest costs in the state, averaging a substantial $5,632 monthly.
Missouri
$4,217
Kansas City
$4,329
St. Louis
$3,510
Branson
$4,412
Columbia
$5,632
Inflation's Impact on the Cost of Assisted Living in Missouri
Despite the inflation-driven surge in the national average cost of assisted living, Missouri recently experienced a decrease in rates. Statewide prices saw a 6% reduction from 2022 to 2023, though a 2.3% increase is projected for 2024. Concerning the nationwide trend, rates escalated by 9.5% in 2023.
Missouri is an outlier compared to neighboring states for current prices. Tennessee experienced some of the region's highest inflation, with rates climbing by 24.2%. Oklahoma also saw a steep increase of 19.4%, while rates in Kansas jumped by 18.9%. Iowa experienced a more modest price change, but statewide rates still rose by 2.3%.
| Location | 2022 Cost (Historical) | 2023 Cost (Current) | 2024 Cost (Estimated) |
|---|---|---|---|
| Missouri | $4,488 | $4,217 | $4,318 |
| U.S. Average | $4,070 | $4,459 | $4,802 |
| Kansas | $4,066 | $4,834 | $5,149 |
| Iowa | $4,770 | $4,879 | $5,006 |
| Tennessee | $3,383 | $4,201 | $4,543 |
| Oklahoma | $3,173 | $3,789 | $4,035 |
The Costs of Other Types of Senior Living
Seniors can choose from several senior living options depending on their daily needs. In Missouri, independent living is the most affordable at $2,822 per month. Seniors who require daily personal care assistance may be a better fit for assisted living, which costs $4,217 on average. Memory care is the costliest option, as it provides comprehensive dementia support for $5,502 per month.
Assisted Living
$4,217
Memory Care
$5,502
Independent Living
$2,822
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 $19,176 per year, and a couple applying together must earn no more than $38,352 per year. The asset limits are $5,301.85 for a single applicant and $10,603.70 for a couple, but assets do not include your home or vehicle. You can have $148,620 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.
| Household Size | Number of Applicants | Income Limits Per Year* | Asset Limits: Applicant(s) | Asset Limits: Non-Applicants |
|---|---|---|---|---|
| One Person | 1 | $19,176 | $5,302 | |
| Two People | 1 | $19,176 | $5,302 | 148,620 |
| Two People | 2 | $38,352** | $10,604 |
*Depending on the facility setting, a recipient may not be able to keep income up to this level.
**Income limit is $1,598 per month per spouse.
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.
| Program | Contact | Services provided |
|---|---|---|
| Missouri CLAIM Program | (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. |
| Housing Options Provided for the Elderly (HOPE) | (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. |
| Cover Missouri | (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.
Paying for Assisted Living Facilities in Missouri
This Supplemental Nursing Care program offers financial assistance to help cover the cost of care associated with living in an RCF and ALF. Residents receive a cash stipend each month.
To be eligible, applicants must:
- Have no more than $2,000 in countable liquid assets
- Have income that puts them at no greater than 85 percent of the poverty line.
To learn more about eligibility requirements, seniors can apply for MO Healthnet and the Nursing Care Program by submitting an application to the Missouri Department of Social Services.
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.
| Name | 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
There are many resources in Missouri that assist seniors in their retirement. caring.com has compiled information on local organizations, programs and agencies and categorized them into care types for easy reference.
Area Agency on Aging
Retirees can find support and advice on various senior-related issues from their local Area Agency on Aging. The agency provides advice on topics such as financial assistance programs, in-home care and long-term care planning. It also connects seniors and caregivers with community-based resources.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Area Agencies on Aging | Missouri's Area Agencies on Aging provide information and assistance that older adults and their families can use to enhance their daily quality of life. They help support seniors' health and wellness through food assistance programs, exercise classes and transportation to medical appointments. The agencies also connect seniors to groups providing in-home services, home modifications and legal assistance. Older Missourians can use local AAA's resources, including case management, respite and caregiver services, to help them maintain their independence and autonomy. |
Cash Assistance Programs
Cash assistance programs in Missouri provide financial support to help low-income retirees remain in their own homes for as long as possible. Seniors and caregivers can apply for tax rebates and reductions, discounts on vital services and help covering the cost of heating and cooling their home.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Lifeline Program | 800-234-9473 | The Missouri Lifeline program grants seniors a price reduction on phone and internet prices, helping them stay connected to loved ones, medical professionals and the rest of the outside world. Interested eligible Missourians within a particular income range must register with a participating internet or phone company if their current provider isn't part of the program. Seniors must submit an application and the appropriate documentation to apply for the program. |
| Missouri Temporary Assistance (TA) | 855-373-4636 | Missouri residents, including seniors, may qualify for Missouri Temporary Assistance if they are the parent or guardian of a child under 18. This cash assistance program provides a monthly payment to those who are eligible. The value of any assets, other than a home and one automobile, must not exceed $1,000. Seniors applying for this program must also meet income requirements. Residents can call (855) 373-4636 to learn more about this financial assistance program. |
Food Assistance Programs
Local organizations help ensure elderly citizens have a balanced diet and receive essential vitamins and minerals to remain healthy. Through nutrition programs, congregate meals, home-delivered meals and food pantries, these programs help Missouri seniors afford the nutritious food they need.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Meals on Wheels | Missouri Meals on Wheels provides nutritious meals and socialization for statewide seniors ages 60 and over. Those who are mobile enough can attend congregate meals with their peers, while those who are immobile can receive daily meal deliveries to their homes. Each meal delivery includes a safety check, and emergency authorities will be alerted if a fall, accident or emergency situation does arise. Meals are provided on a sliding-fee scale, so they range from free to full cost. | |
| Missouri Supplemental Nutrition Assistance Program (SNAP) | 855-823-4908 | The Missouri Supplemental Nutrition Assistance Program provides qualified seniors with financial help to buy healthy foods. Missouri residents who meet the income requirements for participants ages 60 and older qualify for an electronic benefit once a month that's accepted at food retailers across the state. Other eligibility factors include having resources under $2,750 per person, excluding home, vehicle, life insurance and prepaid burials. Seniors can use the funds to supplement their current food budget, so they can prepare nutritious meals. |
Financial Assistance for Senior Living
Low-income elderly individuals in senior living communities can access financial assistance through local-run programs. These Missouri resources offer advice, guidance and support to help older adults pay for the services offered by long-term care providers.
| Program Name | Phone Number | Description |
|---|---|---|
| Supplemental Nursing Care Waiver | MO HealthNet does not directly pay for nonmedical expenses, such as an assisted living community's board and service fees. If you have MO HealthNet coverage and need help paying for assisted living, you may be eligible for a Supplemental Nursing Care waiver. This waiver helps nursing home-eligible seniors stay out of more intensive levels of senior care by paying for assisted living expenses, including the monthly fee and caregiver help. The program provides a monthly cash allowance that can be paid directly to the assisted living provider to cover common costs of assisted living. |
Free Used Medical Equipment
Due to the high cost of purchasing new medical equipment, several organizations in Missouri collect lightly used medical devices such as wheelchairs, ramps and walkers and distribute them to local seniors and residents in need.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Accessibility Medical Equipment | 866-201-3829 | AME provides free in-home assessments to establish participants' equipment needs. Durable medical equipment is available new or used, at a discount for income-eligible participants. |
| Missouri Swap 'n Shop Equipment Exchange Program | 816-655-6700 | Swap 'n Shop operates as a free online exchange program for people in Missouri to trade durable medical equipment and to share information about where to find needed mobility and health aids. |
Legal Resources
Many organizations offer free or low-cost legal services to Missouri seniors. Older adults can access advice on issues such as estate planning, living wills and power of attorney. Some firms also act as long-term care ombudsmen, advocating for the rights of seniors in senior living communities.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Coalition for Quality Care | 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. |
| Missouri Long-Term Care Ombudsman Program | 800-309-3282 | The Ombudsman program cultivates a network of individuals around the state to assist residents in long-term care facilities in the preservation of their rights. The program coordinates regular visits with residents to help them resolve any challenges they might encounter, and advocates and educates those unable to do so for themselves. |
| Missouri Senior Legal Helpline | 800-235-5503 | As an Older American Act funded program, the Missouri Senior Legal Helpline gets seniors aged 60 and above in contact with a regional lawyer. Older adults can get assistance and limited representation on civil matters such as living wills, advance directives, power of attorney and guardianship. The helpline doesn't provide assistance on criminal matters or traffic-related incidents. |
Senior Centers
Senior centers in Missouri bring together residents through recreational activities and events. Many also offer advice and support on senior issues, run wellness and nutrition programs, and connect older adults with other resources in the local area.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Care Planning Council (MCPC) | 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. |
Senior Engagement
Senior engagement resources and programs in Missouri help older adults remain active and ensure they contribute to the community. Resources include wellness programs, volunteer opportunities, support groups and organizations that help residents connect with the community to live fulfilling lives.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Community Options and Resources (MOCOR) | 855-834-8555 | Missouri Community Options and Resources is partnered with the state departments of Health and Senior Services and Social Services to connect residents to appropriate programs in all 114 counties. Through MOCAR, older adults can access help with the activities of daily living, transportation, meals, housework, cooking and caregiver respite. Seniors must be on Medicaid to be eligible for MOCOR services. The minimum age is 63 for some resources, while most are available at age 65. |
| Missouri DHSS Division of Senior and Disability Services | 573-751-6400 | The Missouri DHSS Division of Senior and Disability Services preserves the health and independence of the state's seniors through an extensive roster of programs. These include adult day care, a meal program to help seniors meet their nutritional needs and a 24/7 Alzheimer's response service that provides emergency medical treatment. The agency also maintains an elder abuse hotline families can contact around the clock to report health and safety concerns in long-term care. |
Social Security Offices
Social Security offices in Missouri help seniors and disabled people access the benefits they're entitled to. Older adults can contact their local office for information about receiving retirement benefits, disability allowance and Supplemental Security Income.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Social Security | Social Security is a source of income available to retirees and people who can no longer work because of a disability. The money for Social Security comes from a payroll tax levied on employers, employees and self-employed individuals. When you retire, you'll receive monthly payments based on how much you earned when you were working. |
Utility & Energy Bill Assistance
Low-income seniors who are struggling to meet the costs of maintaining their homes can find support from organizations that offer assistance with utility and energy bills. Missouri retirees could also qualify for emergency funding programs if they're in danger of losing utility services due to unpaid invoices.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri Low Income Home Energy Assistance Program (LIHEAP) | 855-373-4636 | LIHEAP programs are administered on the local level in Missouri, and which program you apply to depends on where you live. These programs can pay a portion (up to 50%) of your gas and electricity bills, while a related program helps with the cost of water and sewer fees. Emergency bill payment assistance may also be available if you're in danger of disconnection. |
| Missouri Low Income Household Water Assistance Program (LIHWAP) | 855-373-4636 | The Low Income Household Water Assistance Program (LIHWAP) may be able to help you with a one-time payment for your water and/or wastewater (sewer) bill from November - September. The maximum amount you could get is $750.00. LIHWAP can help with: • Disconnection or reconnection fees • Threat of disconnection • Past due and current bills |
| Missouri Water/Wastewater Utility Bill Credit Program | 816-439-4460 | Qualified seniors are eligible for a 15% reduction in their water and wastewater rates through Liberty's Utility Bill Credit Program. Older adults must provide paperwork proving they meet certain requirements to receive the bill credit. |
Veteran's Services
Missouri retirees who have served in the U.S. military can find support from local veteran services. These offices and organizations help vets access the benefits they're eligible for and provide advice and information on a variety of issues.
| Program Name | Phone Number | Description |
|---|---|---|
| Missouri VA Benefits and Health Care | Missouri VA Benefits and Health Care provides medical services to senior veterans. These centers are located throughout the state and provide claims assistance, counseling and other services that may help veterans and their families. Missouri also hosts multiple senior centers for veterans where recreational, social and education opportunities are available. All veterans can reach the Crisis Line by dialing 988 and pressing 1 for immediate telephone assistance. | |
| Missouri Veterans Care Coordination | 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. |
| Veterans Services Program | 314-253-4455 | The Veterans Services Program in Jefferson City, MO, provides counseling and support for veterans and their dependents. Accredited Veterans Services Officers can assist eligible seniors with completing applications for VA benefits. VSOs can also provide advice about survivor's benefits, burial payments, disability payments and health care. A VSO is available Monday to Friday from 7:30 a.m. to 3:30 p.m. |
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.
| Topic | Rule |
|---|---|
| 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. A doctor must conduct a physical assessment and document the resident's physical health and medical status, and record specific orders regarding care. This plan must be amended any time the resident’s behavior or care needs change. An individualized evacuation plan should be included if the resident has unique mobility challenges. |
| Assisted Living Admission Requirements | Any resident that requires long-term skilled nursing, restraints, or other high levels of medical care does not qualify for assisted living. If residents experience an illness or injury that results in needing skilled nursing care, they may remain in the community or be admitted to the hospital for up to 45 days with a physician's written approval. Facilities must be able to accommodate residents who require assistance to evacuate the building in the event of an emergency. |
| Assisted Living Scope of Care | Assisted living facilities in Missouri are required to provide 24-hour housing, personalized assistance, basic housekeeping and laundry, and access to social and recreational activities. ALFs in Missouri must also provide transportation for emergencies, and 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 | While assisted living facilities in Missouri are not required to offer apartment-style units, the units must be home-like. This means they are to have a common area, a kitchen and family-style dining area, laundry, a bathroom with a sink, toilet and bathing area, and an outdoor area. Units may be single-occupancy or house up to four residents. There must be at least one tub or shower for every 20 residents and a toilet for every four residents. |
| 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.Staff members who administer medications must be certified as a level I medication aide or certified medication technician, unless they are a licensed pharmacist, a nurse or a physician. |
| 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. There are 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 – including maintenance staff. 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. |
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