What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through “Medicaid Waivers,” which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services.
Waiver Description
The Missouri Medicaid Aged and Disabled Waiver (ADW) provides in-home services to Missouri residents aged 63 or over who have been assessed to require nursing home care, but have chosen to receive care in their homes instead.
This Waiver pays for a range of services, such as adult day care, chore services, and home delivered meals. Services are intended to make it easier for family members or a spouse to care for a loved one at home.
The Aged and Disabled Waiver is managed by the Division of Senior and Disability Services within the Missouri Department of Health and Senior Services, in coordination with MO HealthNet.
Did You Know? By 2030, 70 million Americans will be 65 or older, up 100% from the year 2000.
Eligibility Guidelines
Financial Requirements
The applicant’s income and assets are both considered.
Income Limits
As of 2024, a single applicant’s monthly income is limited to $1,649. A couple’s income is limited to twice that amount.
For couples with only one spouse applying, income from the applicant can be shifted to the non-applicant spouse (also referred to as a community spouse). As of 2024, this figure can be as much as $3,853.50 a month. If the spouse’s income is already at this amount, the monthly transfer is not permitted.
Asset Limits
The asset limit for individual applicants is $5,909. When both spouses of a couple are applying, each is allowed $5,909. However, not all assets are included. An applicant’s home, provided either the owner or the spouse lives in it, and the equity is valued under $713,000, is exempt. A primary vehicle, certain personal effects, household goods, and a prepaid funeral / burial plan are also exempt.
In addition, 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.
Over the Financial Limits?
If an applicant exceeds the financial limits but still cannot afford their cost of care, it is possible he or she can still gain entrance to MO HealthNet by working with a Medicaid planning expert.
Please note, in Missouri, there is no medically needy pathway to reach Medicaid’s income limit. However, persons can deposit extra income into a Qualified Income Trust to become income eligible. There are both public and private financial experts who can help families qualify. Read more.
Benefits and Services
The ADW provides a variety of services to help participants remain living in the community, including:
- Adult day care, which provides assistance with daily living activities and meals.
- Respite care, both in-home and in facilities.
- Chore services.
- Homemaker services, such as assistance with housekeeping, laundry, and shopping.
- Home delivered meals.
How to Apply / Learn More
To apply, one should contact their local Area Agency on Aging. Contact information is available here. Some additional information about the waiver is available on the Missouri Department of Social Services’ website.
