Overview of MO HealthNet Long-Term Care Options
Missouri’s Medicaid program, known as MO HealthNet, offers several care pathways for older adults needing long-term services:
- Institutional / Nursing Home Medicaid – An entitlement program covering nursing home care for those who meet income, asset, and level-of-care requirements.
- Home and Community-Based Services (HCBS) Waivers – Includes Aged & Disabled Waiver (ADW) and Structured Family Caregiving Waiver (SFCW); these offer in-home or assisted living support, though slots and funding may be limited.
- Aged, Blind, and Disabled (ABD) Regular Medicaid – Another entitlement program that provides support for personal care and community-based services. Medicaid Planning Assistance Missouri Foundation for Health
Key Changes Effective July 1, 2025
Asset Limits (Resource Allowance)
- Single Applicant (all LTC programs): Asset limit increased from $5,909.25 to $6,068.80 ltc.health.mo.gov Medicaid Long Term Care.
- Married Couples (both applying): Combined asset cap is $12,137.55 Medicaid Planning Assistance Medicaid Long Term Care.
- Married Applicant (one spouse applying): Applicant may hold up to $6,068.80; the non-applicant (community spouse) may retain up to $157,920 (Community Spouse Resource Allowance, CSRA) Medicaid Planning Assistance Medicaid Long Term Care.
Income Limits
Income thresholds differ by program:
- ABD Medicaid
- Single: $1,109/month
- Married couple (both applying): $1,499/month combined
- Married (one spouse applying): $1,499/month (combined) Medicaid Long Term Care
- HCBS Waivers
- ADW: Single: $1,690/month; married (both): each $1,690/month
- SFCW: Single: $1,109/month; married (both): each $1,109/month Medicaid Long Term Care
- Nursing Home Medicaid: There’s no fixed income cap—applicants must contribute nearly all income toward their care. A $50/month Personal Needs Allowance is permitted, plus coverage of Medicare premiums if dual-eligible Medicaid Long Term Care Medicaid Planning Assistance.
Why These Adjustments Matter
These July 1, 2025 updates reflect modest inflation adjustments, allowing slightly higher asset retention before eligibility thresholds are breached. Maintaining these precise financial thresholds is critical—missing them by even small margins can render someone ineligible.
Eligibility Summary Table
| Program Type | Asset Limits | Income Limits |
| Nursing Home Medicaid | Single: ≤ $6,068.80 Married (both): ≤ $12,137.55 Married (one): ≤ $6,068.80 (app) + ≤ $157,920 (spouse) |
No cap; most income toward care; $50/month personal needs allowance |
| Aged, Blind & Disabled (ABD) | Same as above | Single: $1,109/mo Married: $1,499/mo combined |
| HCBS Waivers (ADW / SFCW) | Same as above | ADW: $1,690/mo (single) SFCW: $1,109/mo (single) |
Key Reminders
- Functional requirement: Applicants must meet a Nursing Facility Level of Care (NFLOC), showing need in Activities of Daily Living (ADLs) or similar assessments Medicaid Long Term Care.
- Home equity may be exempt up to a point (commonly around $730,000), though asset exemption rules can evolve.
- Planning matters: Since gift transfers or strategic spending can trigger penalties, it can be wise to consult with an elder law attorney.
Final Takeaway
As of July 1, 2025, Missouri modestly increased both asset and income thresholds for long-term care Medicaid eligibility under MO HealthNet. While these adjustments offer a bit more flexibility, the eligibility rules, especially around asset limits, income contributions, and look-back penalties, remain complex. Staying informed and seeking professional guidance remains essential for safeguarding access to care while preserving family resources.
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