Program Description
The Missouri Care Options (MCO) program provides home and community-based services (HCBS) to those in need. The objective is to reduce nursing home admissions by providing services to individuals in their home or in the community. These services are generally considered to be a win-win in that most individuals prefer to receive care at home, and providing services at home usually costs the state less money than would full-time nursing home care.
Missouri Medicaid has a similar program called the Aged and Disabled Waiver. Both programs provide financial aid to individuals at home for their ongoing care costs. The difference is that HCBS are entitlements, while the Aged and Disabled Waiver has a limited number of available slots. It is usually possible for individuals to receive HCBS while on the waiting list for the Waiver.
Eligibility Guidelines
Financial Requirements
Income Limits
As of 2024, single, senior applicants are eligible if their monthly income is less than $1,649. Married couples (both spouses applying) are eligible if their income is under $3,298 / month. (Please note that MO changes their annual income limits in April of each year).
Persons with income higher than these limits may still be eligible if they are married and their spouse, often called the community spouse, is not also applying for Medicaid. In this case, the applicant spouse can allocate some of his / her income to their non-applicant spouse. This is called a Monthly Maintenance Needs Allowance (MMNA). As of 2024, up to $3,854 / month can be transferred to the community spouse. If the non-applicant spouse already has monthly income equal to or above this figure, a transfer of income is not permitted from the applicant spouse.
Alternatively, applicants can “spend-down” their income each month on their care needs / medical bills until they reach the Medicaid income limit level. Persons in any of these situations should consider consulting with a Medicaid planner before application.
Asset Limits
The 2024 asset limit for a single applicant is $5,909.25 and $11,818.45 for a couple with both spouses applying for Medicaid services. It should be noted that there are many exceptions to what is counted as an asset. Most notably, the value of one’s home, should the equity value be less than $713,000, is not counted toward Medicaid eligibility.
When only one spouse of a married couple is applying, the non-applicant spouse can keep 50% of the couple’s assets, up to $154,140 (as of 2024). If the couple’s assets are under $30,828, the non-applicant spouse can keep all of the assets, up to this amount. The applicant spouse is still able to retain up to $5,909.25 in assets.
Please Note: Assets transferred out of the applicant’s name during the 5 years preceding their application will impact eligibility. This is known as Medicaid’s Look-Back Period.
Over the Asset Limits?
Medicaid planners are available to assist families in meeting the asset eligibility test. Learn more about how this may be an option for your family.
Benefits and Services
Each applicant is approved for different services depending on his or her needs. These can include:
- Aid with Activities of Daily Living, such as taking a bath, getting dressed, grooming, and mobility.
- Homemaker services, like assistance with cleaning, laundry, shopping, and cooking.
- Respite care, both at home and in adult day care.
- Nursing services are also covered, but not nursing home care.
How to Apply / Learn More
Individuals already approved for Missouri Medicaid can apply directly for Home and Community Based Services by calling 866-835-3505. Those who have not yet been approved for Medicaid should contact the Family Support Division (FSD) by calling 855-373-4636.
More information about this program is available on their website.
