Missouri is home to more than 6 million residents and has a relatively large senior community that makes up nearly 17% of its population. The number of adults aged 60 and over is projected to increase to 26% of the state’s population by 2030, and the population of those aged 85 and over is estimated to grow by 51,000 between 2015 and 2030. To accommodate these seniors, the state has over 1,100 long-term care facilities, including about 370 residential care facilities and 270 assisted living facilities. Together, these facilities house more than 80,000 seniors, providing numerous options for those seeking long-term care.

Compared to the national average, Missouri has a modest cost of living, which may make it an economical option for seniors seeking affordable senior living. For instance, most seniors in Missouri pay about $2,881 per month for assisted living, compared to the national monthly average of $4,051—a savings of over $1,000 per month.

This guide provides an overview of the costs of senior care in Missouri, as well as the local programs and resources that are in place to support seniors who need financial assistance.

The Cost of Senior Living in Missouri

Note: There currently isn’t authoritative data on the average cost of Independent Living Facilities nationwide, so instead, we use the cost of Assisted Living to estimate it. Since the cost of Independent Living is typically 30-40% lower than the cost of Assisted Living, the numbers below were calculated by subtracting 35% from the cost of Assisted Living.

Note: Memory care is typically provided in communities licensed as assisted living facilities, and in general, costs 20-30% more than standard assisted living services. No authoritative cost data is available for this type of care, so we estimated memory care rates by adding 25% to assisted living fees in the Genworth 2021 Cost of Care Survey.

Missouri is a very affordable location for long-term care. According to Genworth Financial’s 2021 Cost of Care Survey, prices for all senior living options are lower than the national average. Independent living is a budget-friendly choice with a median cost of $1,950 per month. Facilities that provide personal care typically charge $3,000 for assisted living. Memory care costs an additional 25% at $3,750. This is still more affordable than skilled nursing, which costs $5,262 per month on average.

The Cost of Assisted Living in Missouri

Assisting living provides a good value for many seniors since rates include housing, meals, activities and personal care. In Missouri, seniors can expect to pay about $3,000 per month for all of these services. Average prices are 33% lower than the national average, and Missouri is $760 to $1,567 more affordable than neighboring states. Prices range from $3,760 in Arkansas to $4,580 in Kansas. Rates in Illinois and Iowa are slightly lower than the national average at $4,488 and $4,367, respectively.

The Cost of Nursing Home Care in Missouri

Nursing home care in the Midwest tends to be more affordable than the national average, but prices in Missouri are exceptionally low. The going rate in Arkansas is $821 higher at $6,083. Seniors in Kansas and Illinois pay roughly $1,000 more per month. In Iowa, the average increases to $6,874. However, this is still lower than the U.S. median of $7,908. Missouri residents save $2,646 per month on nursing home care compared to the national average.

Can You Use Medicaid to Pay for Senior Living in Missouri?

MO HealthNet is a state and federal program available to low-income families who need help paying for health care. In addition to covering primary and emergency medical care and diagnostic services, such as labs and imaging, it provides a variety of benefits to seniors who require long-term care. Coverage is available for skilled nursing, and the state’s Supplemental Nursing Care program provides monthly cash grants to individuals who require assisted living or memory care. This program is an alternative to Medicaid waivers that are only available to individuals receiving assistance in a private home. Medicaid does not provide coverage for independent living since these services are intended for seniors who are healthy, active and don’t have a medical need for assistance.

	Medicaid Coverage Level	Type of Medicaid Coverage	Entitlement?*
Assisted Living	Cash Grant	Medicaid	Yes
Independent Living	None	N/A	N/A
Memory Care	Cash Grant	Medicaid	Yes
Nursing Home Care	Full	Medicaid	Yes

*Note: Entitlement programs mean that everyone who qualifies will receive coverage and be accepted into the programs. If the program is not “entitlement,” then participant caps could be in place, and there may be a waiting list.

Medicaid’s Coverage of Assisted Living & Memory Care in Missouri

Medicaid usually covers assisted living and memory care through waivers that are designed to support community living and noninstitutional care. However, Missouri’s Aged and Disabled Waiver and dementia-related Structured Family Caregiving Waiver are only available to individuals who live at home. Individuals who require assisted living or memory care and use most of their income for these services may be eligible for the state’s Supplemental Nursing Care program. SNC is an entitlement program that provides a monthly cash grant of up to $292 for assisted living residents or up to $156 for those who live in residential care facilities. Individuals who are interested in receiving this benefit should complete the Aged, Blind and Disabled supplement when applying for Medicaid.

Medicaid’s Coverage of Nursing Home Care in Missouri

MO HealthNet provides comprehensive coverage to medically needy seniors who require a nursing home level of care and have limited income and assets. Seniors can request a financial needs assessment once they’re admitted to a nursing home for an expected stay of at least 30 days. Although there’s no fixed income limit, the cost of care must exceed the senior’s monthly cash flow. There are exemptions for Medicare premiums and a $50 personal needs allowance. The state also provides generous exemptions if only one spouse requires this level of care.

Eligibility for Medicaid in Missouri

In Missouri, Medicaid long-term care eligibility is based on the applicant’s medical need and monthly expenses. There’s no fixed income limit, but the cost of care must exceed available funds. This rule applies to seniors who require assisted living or nursing home care or live in a residential care facility. Seniors are entitled to a $50 personal needs allowance, and they may keep enough money to pay for their Medicare premiums before expenses are considered. The state also provides exclusions for a home, a vehicle and up to $137,400 in other assets if only one spouse requires this type of assistance.

2022 Missouri Medicaid Income Limits

	Income Limits*	Asset Limits
Single Person	Less than the cost of care	$5,035
Two-Person Household (Only one applicant)	Less than the cost of care	$5,035 for applicant $137,400 for nonapplicant
Two-Person Household (Two applicants)	Less than the cost of care	$10,070

*per year 

Eligibility for MO HealthNet is based on the following criteria:

• Income and assets
• Age, health or disability status
• A level of care determination
• State residency
• Citizenship or immigration status

Applying for Medicaid in Missouri

Seniors who need help paying for long-term care should complete an application for Medicaid for the Aged, Blind and Disabled. The state encourages residents to apply online through the Department of Social Services’ online portal at My DSS. Individuals who require long-term care, including help paying for assisted living or skilled nursing, should complete the Aged, Blind and Disabled application supplement. Applications are accepted over the phone by calling (855) 373-9994. Seniors can find paper application forms online or contact the Family Support Division to request a copy by mail. Completed documents should be returned to the following address:

Family Support Division
615 E 13th St
Kansas City, MO 64106
Fax: (573) 526-9400
Email: [email protected]

Before You Apply

The Missouri Department of Social Services provides a comprehensive list of documents and personal information that’s required for MO HealthNet Nursing Home applications. Seniors should gather the following items before applying:

• Proof of income and government benefits
• Real estate deeds and tax statements
• Guardianship or conservatorship information
• Social Security cards and proof of citizenship
• Proof of housing and monthly expenses
• Health insurance cards and proof of premiums
• Life insurance policies
• A list of financial assets
• Marriage certificate 

How to Get Help

Seniors who need help applying for MO HealthNet should contact the Family Support Division for assistance. The state also offers resources for residents who need to report fraud or want to appeal an adverse decision or coverage denial.

Resource	Contact	What You Should Know
Family Support Division Information Line	(855) 373-4636	Seniors who have questions about Medicaid or want to check the status of their application should contact the FSD Information Line for assistance. Agents can help callers with other DSS benefits. This hotline is available Monday through Friday with modified weekend hours.
DSS Benefit Hearings	(573) 751-0335 (Central) (816) 325-5918 (Western) (314) 877-2072 (Eastern)	The DSS Division of Legal Services is responsible for handling appeals related to Medicaid, food stamps and other government benefits. Seniors who disagree with a notice or denial should contact this department to request a hearing.
Medicaid Fraud	(573) 751-3285	Seniors who have concerns about Medicaid fraud or billing issues can contact this department for assistance or to file a report. Common issues include duplicate bills, service bundling and charges for services that were unnecessary or were never provided.

Can You Use Medicare to Pay for Senior Living in Missouri?

Unfortunately, Medicare does not cover the cost of assisted living, independent living, or memory care. Unlike nursing homes, these care types are not considered to be “clinical settings” and so are not eligible for Medicare coverage. That being said, those who live in these communities can still use Medicare to cover the cost of approved medications, doctor visits, medical equipment, etc.

When it comes to nursing home care, it gets much more complicated. Medicare does provide limited coverage for a qualified stay in a nursing home,but there are strict rules and requirements of which you should be aware. This benefit is available to seniors who have been hospitalized for at least three days, excluding the date of discharge.

Once you’ve met the hospitalization requirement, Medicare will pay for up to 100 days in a skilled nursing facility (per benefit period). While the first 20 days are covered in full, there is a daily coinsurance rate that must be paid starting on day 21. After day 100, seniors are responsible for the entire cost.

	Medicare Coverage	Medicare Coverage Duration	Coinsurance Requirement?
Assisted Living	None	N/A	N/A
Independent Living	None	N/A	N/A
Memory Care	None	N/A	N/A
Nursing Home Care	Limited	100 Days Per Benefit Period	Yes – After 20 Days

What Nursing Home Care Services Does Medicare Cover?

Medicare covers a number of specific services, including:

• Meals
• A semiprivate room
• Medications
• Skilled nursing services
• Physical therapy
• Occupational therapy
• Speech therapy
• Audiologist care
• Medical supplies
• Medical social services
• Nutritional counseling
• Ambulance transportation

What Nursing Home Care Services Aren’t Covered by Medicare?

Medicare does not cover long-term custodial care that addresses seniors’ day-to-day needs. This includes help with daily activities, such as bathing, dressing and using medical equipment.

Medicare Support & Resources in Missouri

Medicare is a complex health insurance program that includes several components offered by the federal government and private insurers. Seniors who are enrolling in Medicare for the first time or have questions about coverage for skilled nursing and in-home care can contact the following agencies for assistance.

Resource	Contact	What You Should Know
Missouri CLAIM	(800) 390-3330	CLAIM is a free resource available to all Medicare recipients and their families. It provides informational materials and one-on-one advisory consultations to help seniors understand their coverage options, apply for financial assistance and select the best plan for their needs and budget. The program is supported by more than 300 volunteers and 180 community partners statewide.
Missouri Senior Medicare Patrol	(888) 515-6565	Seniors who have questions about their Medicare billing statement or have noticed duplicate charges or unfamiliar items on their summary of benefits can contact the state’s Senior Medicare Patrol program to make a report. This program provides one-on-one claims assistance, educates seniors about scams and works to prevent Medicare fraud and waste.
Medigap Medicare Supplements	(573) 751-4126	Medigap supplements are sold through private insurers and can help to reduce or eliminate seniors’ out-of-pocket costs, excluding their Part B deductible. The Missouri Department of Insurance provides a handy shopper tool and a variety of informational resources to help seniors learn more about this coverage.
Missouri Rx Plan	(800) 375-1406	MORx is a state-sponsored prescription drug assistance program available to Medicare beneficiaries who need help paying for their medications. The program pays for half of the beneficiary’s prescription copays and out-of-pocket drug costs, excluding Part D premiums. It also works with Medicare Advantage Plans.

Are There Other Financial Assistance Options for Senior Living in Missouri?

Depending on your unique situation, there may be other financial assistance options to partially or fully cover the cost of senior living in Missouri. Below, we cover some of the common ways that seniors can make senior living options such as assisted living or memory care more affordable.

	How to Get Started	What You Should Know
Aid and Attendance	Apply online at va.gov.	If you are a veteran and you receive a VA pension, you may also be eligible for the Aid and Attendance benefit. This benefit takes the form of a monthly cash allowance that you receive in addition to your standard pension. This benefit is used by veterans who need long-term care services, including care received at an assisted living facility.
Reverse Mortgages	Research and learn about the different types at ftc.gov.	If you own a home, you may be able to use a reverse mortgage to access some of the equity in your home. Like traditional loans, reverse mortgages do need to be repaid with interest, typically within 12 months, so seniors should carefully weigh this option alongside other financing methods.
Long-Term Care (LTC) Insurance	Learn about how to receive LTC insurance benefits at acl.gov.	While those who currently need assisted living will typically not be eligible, if you purchased an LTC insurance policy in the past, you may be able to use it to help pay for assisted living. While most policies cover at least a portion of the cost, you still need to check the specific terms of your policy.

Free Senior Living Resources for Seniors in Missouri

Seniors who want to learn more about independent living and when to transition to more advanced levels of care can contact their Area Agency on Aging for assistance. The following services are available to seniors and families statewide.

	Contact	What You Should Know
Area Agencies on Aging & Services	(573) 526-4542	Missouri has 10 Area Agencies on Aging dedicated to serving caregivers, disabled adults and seniors starting at age 60. Staff members connect residents to supportive services in their area, including home-delivered meals, recreational activities, fall prevention programs, transportation and case management services. These agencies are designed to be a single point of contact for services that can address all of seniors’ needs.
Missouri Division of Senior and Disability Services	(573) 751-4842	The Division of Senior and Disability Services is responsible for overseeing nearly all of the state’s age-related benefits and community supports. It offers information about healthy aging, prescription drug assistance, nursing home care and possible alternatives. The division is also responsible for preventing elder abuse and enforcing the state’s health and safety regulations.
Missouri Long-Term Care Ombudsman	(800) 309-3282	Missouri’s Long-Term Care Ombudsman provides confidential, impartial advice to current nursing home and assisted living residents and to individuals who are considering long-term care. Services are provided at the state level and through Missouri’s network of Area Agencies on Aging. The ombudsman also publishes educational materials covering everything from nursing home admissions and evictions to financial planning.
Missouri Senior Legal Helpline	(800) 235-5503	This free legal hotline is sponsored by the Department of Health and Senior Services thanks to funding from the Older Americans Act. It provides free legal advice to seniors aged 60 and older who have questions about wills, advance directives, estate planning and other civil legal issues. Attorneys can also help with questions about housing, long-term care, debt collection and government benefits.
United Way 2-1-1	211	This 211 program is sponsored by the Heart of Missouri United Way chapter and other community partners. It’s a comprehensive resource for all types of local programs and social services. Seniors can use this service to locate in-home care, utility bill assistance, volunteer opportunities, transportation and senior centers. It also provides information about museums, entertainment and cultural events.

COVID-19 Rules and Restrictions for Missouri Senior Living Facilities

The following information is based on research done on several government websites, including dph.illinois.gov/covid19. These rules apply to nursing homes and other types of senior living facilities. We’ve most recently updated this data on 2/7/2022, 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.

Visiting Loved Ones

Can I visit my relative in person if he/she wants emotional support from me?	Yes (Conditions Apply)
Can I visit my relative in person for end-of-life compassion care?	Yes
Will my loved one be required to self-quarantine after I visit him or her?	No
Do I need to wear PPE and/or a cloth mask if I do visit my relative in person?	Yes
Are Hairdressers and other non-medical contractors still allowed in senior living facilities?	Yes
Does the state recommend or require that senior living facilities assist families with setting up virtual visit alternatives?	Not Available*
Are visitors being screened for elevated temperatures?	Yes
Are visitors being asked questions about health, travel, and potential virus contact?	Yes

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

Outings and Group Activities

Are residents allowed to leave the facility for non-medical reasons?	Yes
Are residents of senior living facilities who leave and return required to self-quarantine?	No (Conditions Apply)
Are senior living facilities required to cancel all group outings?	No
Are residents still eating together in the dining hall?	Yes (Conditions Apply)
Are facilities still allowed to host group activities within the community?	Yes (Conditions Apply)

Safety Measures for Staff & Contractors

Are staff members and contractors being screened for elevated temperatures?	Yes
Are staff members and contractors being tested for Coronavirus?	Yes (Conditions Apply)
Are staff members and contractors being asked questions about health, travel, and potential virus contact?	Yes

Safety Measures for Residents

Are staff members required to regularly screen residents for coronavirus symptoms?	Yes
Are residents relied on to screen themselves and self-report potential coronavirus symptoms?	No
Are staff members required to take residents’ temperatures?	Yes
Are residents being tested for coronavirus?	Yes (Conditions Apply)

Senior Living Laws and Regulations in Missouri

Note: All these rules typically apply to non-clinical senior living facilities, such as independent living, assisted living, and memory care facilities. Nursing homes and other senior living facilities with a clinical setting may have additional or slightly different requirements and regulations.

To ensure that residents receive quality care and have access to necessary supports and services, Missouri enforces rules and regulations for senior living facilities.

Scope of Care

Senior living facilities in Missouri provide around-the-clock supervision and scheduled and unscheduled care with daily living activities such as bathing and toileting. They also offer recreational activities. Facilities must offer three meals daily. If they accommodate physician-prescribed specialty diets, then their meal plans must be reviewed by a physician, registered nurse, nutritionist or dietician every quarter. Facilities also must assist with storing, distributing and administering medications.

Service Plan Requirements

Before admitting a new resident, the senior living facility must complete screening to ensure that the prospective resident is eligible. Within five days of admission, an authorized staff member and a physician must conduct a physical exam to document the new resident’s medical status and write special orders regarding needed care. An individualized care plan must be developed that addresses the resident’s needs, goals and expectations.

Medication Management Requirements

Residents in senior living facilities may self-administer prescription and over-the-counter medications with the approval of a licensed health provider. Every other month, a physician, pharmacist or registered nurse must review the resident’s medication regimen. Staff who administer medications must be, at minimum, certified as Level I medication aide or certified medication technicians unless they are an RN, physician or pharmacist. Insulin can only be administered by a licensed nurse or physician or a certified medication technician or medication aide who has completed the state-approved course for insulin administration.

Staffing Requirements

Senior living facilities must employ a licensed administrator to oversee day-to-day operations and supervise staff. They must also employ a licensed nurse and a large enough direct care staff to cover scheduled and unscheduled needs. A Level I medication aide or certified medication technician must be available to provide medication administration. In addition to this, residential care facilities must be under the supervision of a physician who monitors treatments and medications prescribed by other health care professionals. Facilities must maintain a staff-to-resident ratio of 1:15 during the day and evening and 1:20 at night.

Caregiver Screening Requirements

Before allowing any full-time, part-time or temporary employees to have direct contact with residents, senior living facilities must conduct a criminal background check. If the employee’s background check indicates a criminal conviction, they aren’t permitted to have direct contact with facility residents.

Caregiver Training Requirements

All caregivers in residential care homes and senior living facilities must receive at least one hour of training on fire safety and job responsibilities, including information on preserving residents’ dignity, recognizing and reporting abuse or neglect, and working with residents with mental health issues. Caregivers in senior living facilities must also receive:

• At least two hours of training on transfer assistance
• Person-centered care and techniques for enhancing residents’ control over their environment
• 24 hours of training on assessing cognitive ability
• Service planning and interview skills

Medicaid Coverage

In Missouri, nursing home-level care in senior living facilities may be paid for by the state through MO HealthNet, the state’s Medicaid program.

Abuse and Neglect Reporting

Senior living facilities must report suspected or observed abuse, neglect or exploitation to the Missouri ombudsman program.

Memory Care Regulation

Senior living facilities that provide memory care services must give additional training to all staff regarding topics like behavior management, promoting independence and understanding and dealing with family issues.

Frequently Asked Questions

How much does assisted living cost in Missouri?

On average, Missouri seniors pay $2,881 per month for assisted living. Throughout the state’s major cities, the cost of this type of care ranges from $2,750 to $3,848 per month.

Does MO HealthNet pay for assisted living?

MO HealthNet, the state’s Medicaid program, pays for nursing home-level care in assisted living facilities. Currently, standard assisted living services aren’t covered by MO HealthNet or any waiver programs.

What are “Activities of Daily Living?”

Activities of daily living are routine activities that need to take place every day. There are six basic ADLs, including eating, bathing, dressing, continence, toileting and transferring. A person’s ability to perform ADLs is considered when determining long-term care decisions.

What types of amenities are common in Assisted Living Communities?

Amenities vary widely from one community to another and typically include community-organized on-site social activities, day trips, games, movie nights, exercise programs, live entertainment and arts and crafts classes.

Who should consider assisted living?

Assisted living is well-suited to seniors whose ability to care for themselves is declining or who have difficulty keeping up with the demands of maintaining a home. This level of care is also beneficial for seniors who have trouble managing their finances or who are experiencing depression or social isolation.

Learn More About Senior Living in Missouri

For more information about specific types of senior living in Missouri read our Guide to Assisted Living and Independent Living.

The Top Cities for Senior Living in Missouri

Learn more about the cost of senior living in the top Missouri cities. Additionally, find reviews and information about assisted living facilities and other senior living communities across the state.