What is the income limit for Medicaid in Missouri in 2024? Navigating the complexities of Medicaid eligibility can be challenging, especially when it comes to income limits. At income-partners.net, we provide clarity on the income limits for Medicaid in Missouri in 2024, empowering you to explore partnership opportunities that can help you or your loved ones access essential healthcare. Discover how strategic collaboration and innovative income solutions can pave the way to improved healthcare access, leveraging our income strategies and financial partnerships for a secure future.
1. Understanding Missouri Medicaid (MO HealthNet) and Long-Term Care
Medicaid, known as MO HealthNet in Missouri, is a healthcare program designed for individuals with limited income and resources, regardless of age. While it caters to a wide array of Missouri residents, our primary focus is on long-term care Medicaid eligibility for seniors aged 65 and over. MO HealthNet provides coverage for nursing home care, assisted living services, and various non-medical support services, enabling seniors to maintain their independence at home.
There are three main categories of Medicaid long-term care programs available in Missouri:
- Institutional / Nursing Home Medicaid: This is an entitlement program, ensuring that all eligible individuals receive assistance exclusively within nursing home facilities.
- Medicaid Waivers / Home and Community Based Services (HCBS): Unlike entitlement programs, HCBS waivers have limited participant slots, potentially leading to waiting lists. These waivers aim to prevent or delay nursing home admissions by offering services and support at home, in adult day care settings, or within assisted living facilities.
- Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled (MHABD): As an entitlement program, MHABD guarantees benefits to those who meet the eligibility criteria. It offers a range of long-term care services, including personal care assistance and adult day care.
MO HealthNet is a collaborative effort between the state and federal governments, administered by the Missouri Department of Social Services in accordance with federal guidelines.
2. What Are the Income and Asset Limits for Missouri Medicaid Eligibility in 2024?
Navigating the financial requirements for Medicaid eligibility can be intricate. The income and asset limits vary depending on the specific Medicaid program, marital status, and are subject to annual adjustments. Furthermore, Missouri provides several routes to qualify for Medicaid.
Simplified Eligibility Criteria: Single Nursing Home Applicant In 2024, a single Nursing Home Medicaid applicant in Missouri must meet the following criteria: 1) All available income, with just a few exceptions, must go to the nursing home 2) Assets under $5,909.25 3) Require a Nursing Home Level of Care.
The following table provides a simplified overview to help seniors assess their potential eligibility for long-term care benefits through MO HealthNet. However, it’s important to remember that not meeting all criteria doesn’t automatically disqualify you from Medicaid eligibility in Missouri.
| 2024 Missouri Medicaid (MO HealthNet) Long-Term Care Eligibility for Seniors | |
|---|---|
| Type of Medicaid | Single |
| Income Limit | |
| Institutional / Nursing Home Medicaid | All available income must be paid towards care* |
| Medicaid Waivers / Home and Community Based Services | Structured Family Caregiving Waiver ($1,109 / month – eff. 4/1/25 – 3/31/26) Aged & Disabled Waiver ($1,690 / month – eff. 1/1/25-12/31/25)† |
| Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled | $1,109 / month (eff. 4/1/25 -3/31/26)‡ |
*With the exception of a Personal Needs Allowance of $50 / month, Medicare premiums, and potentially a Needs Allowance for a non-applicant spouse, all of a beneficiary’s monthly income must go towards nursing home costs. This is called a Patient Liability. †Based on one’s living setting, a program beneficiary may not be able to keep monthly income up to this level. ‡These limits are only relevant for persons who are aged and disabled. For persons who are blind, the income limit is $1,305 / month for a single applicant and $1,763 / month for a married couple.
3. What Types of Income Are Considered for Missouri Medicaid?
When determining Medicaid eligibility, it’s essential to understand which sources of income are considered countable and non-countable. Generally, Medicaid counts nearly all income an applicant receives, including:
- Employment wages
- Alimony payments
- Pension payments
- Social Security Disability Income (SSDI)
- Social Security Income (SSI)
- IRA withdrawals
- Stock dividends
However, certain types of income are exempt from being counted towards Medicaid’s income limit. In Missouri, these exemptions include:
- Aid & Attendance and Housebound Allowances: These allowances, which are above and beyond the Basic VA Pension, are not counted as income.
- Nationally, Holocaust restitution payments are also excluded from countable income.
Understanding these distinctions is crucial for accurately assessing Medicaid eligibility and exploring potential strategies to qualify for benefits.
4. How Is Income Treated for Married Couples Applying for Missouri Medicaid?
The treatment of income for married couples applying for Medicaid in Missouri depends on the specific Medicaid program.
4.1. Nursing Home Medicaid or HCBS Medicaid Waiver
When only one spouse applies for Nursing Home Medicaid or a HCBS Medicaid Waiver, only the applicant’s income is considered. The non-applicant spouse’s income is disregarded and does not affect the applicant’s income eligibility.
However, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from the applicant spouse. The MMMNA is a Spousal Impoverishment Provision designed to ensure the non-applicant spouse has sufficient income to avoid impoverishment.
In 2024, the MMMNA is $2,555 (eff. 7/1/24 – 6/30/25). If the non-applicant spouse’s monthly income is below this amount, income can be transferred from the applicant spouse to bring their income up to $2,555.
Furthermore, if the non-applicant spouse’s housing and utility costs exceed a “shelter standard” of $767 per month (eff. 7/1/24 – 6/30/25), they may be able to further increase their Spousal Income Allowance. However, in 2024, a Spousal Income Allowance cannot push a non-applicant’s total monthly income over $3,948, which is the Maximum Monthly Maintenance Needs Allowance.
4.2. Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled
When only one spouse applies for Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled, the income of both spouses is considered when determining the applicant’s income eligibility. Unlike Nursing Home Medicaid and HCBS Medicaid Waivers, there is no Monthly Maintenance Needs Allowance for the non-applicant spouse.
5. What Assets Are Countable and Non-Countable for Missouri Medicaid?
When evaluating Medicaid eligibility, it’s crucial to understand the distinction between countable and non-countable assets. Countable assets are those whose value is considered when determining whether an applicant meets Medicaid’s asset limit. These include:
- Cash
- Stocks
- Bonds
- Investments
- Bank accounts (checking, savings, and credit union)
- Real estate (excluding the applicant’s primary residence)
- IRAs / 401(k)s
Conversely, non-countable assets are exempt and do not count towards the asset limit. Common examples of exempt assets include:
- Personal belongings
- Household furnishings
- One automobile
- The applicant’s primary home
- Irrevocable pre-need burial contracts established with a funeral home
- Personal funeral trust accounts (up to $9,999)
Knowing the difference between countable and non-countable assets is essential for effective Medicaid planning.
6. How Are Assets Treated for Married Couples When Applying for Missouri Medicaid?
Regardless of the specific long-term care Medicaid program for which a married couple is applying, all assets are considered jointly owned. However, Spousal Impoverishment Rules offer protection for the non-applicant spouse of a Medicaid nursing home or Waiver applicant through a Community Spouse Resource Allowance (CSRA).
In 2024, the community spouse (the non-applicant spouse) can retain 50% of the couple’s assets, up to a maximum of $157,920. If the non-applicant spouse’s half of the assets is under $31,584, they can retain 100% of the assets, up to $31,584.
It’s important to note that the CSRA does not apply to Regular Medicaid.
7. What Is the Medicaid Look-Back Period in Missouri?
Missouri has a 5-year Medicaid Look-Back Period for Nursing Home Medicaid and Medicaid Waivers. This period immediately precedes the date of application and involves Medicaid reviewing the applicant’s financial history to ensure no assets were gifted or sold below fair market value. The purpose is to prevent individuals from deliberately reducing their assets to meet Medicaid’s eligibility requirements.
If assets were transferred in this manner, Medicaid presumes it was done to become eligible for benefits. This can result in a Penalty Period of Medicaid ineligibility, during which the applicant will not receive benefits.
It’s worth noting that Regular Medicaid does not have a Look-Back Period.
The U.S. Federal Gift Tax Rule allows individuals to gift up to $19,000 per recipient in 2024 without filing a Gift Tax Return. However, it’s crucial to understand that gifting under this rule still violates Medicaid’s 5-year Look-Back Period.
8. What Are the Home Exemption Rules for Missouri Medicaid?
For a home to be exempt from Medicaid’s asset limit in Missouri, the Medicaid applicant or their spouse must reside in the home. If there is no spouse living in the home, there is a home equity interest limit of $730,000 (in 2024). Home equity refers to the value of the home minus any outstanding debt against it, while equity interest represents the portion of the home’s equity owned by the applicant.
If neither the applicant nor their spouse lives in the home, the applicant must demonstrate Intent to Return. However, for Regular Medicaid, there is no home equity interest limit.
While a home is generally exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s Estate Recovery Program. After a long-term care Medicaid beneficiary passes away, Missouri’s Medicaid agency may seek reimbursement for the cost of care provided through the deceased’s estate, which often includes the home. Without proper planning, the home may be used to reimburse Medicaid instead of being passed on to family members as inheritance.
9. What Medical or Functional Needs Must Be Met to Qualify for Missouri Medicaid?
In addition to financial criteria, applicants must also demonstrate a medical need for long-term care services to qualify for Missouri Medicaid.
For Nursing Home Medicaid and HCBS Medicaid Waivers, a Nursing Facility Level of Care (NFLOC) is required. Certain program benefits, such as home modifications, may have additional eligibility criteria, such as the need to modify the home to ensure the applicant’s safety and independence.
For long-term care services through the regular Medicaid program, a functional need involving assistance with Activities of Daily Living (ADLs) is necessary, but a NFLOC is not always required.
10. How Can You Qualify for Missouri Medicaid If You Exceed the Income or Asset Limits?
Even if you don’t meet the standard financial eligibility requirements for Missouri Medicaid, there are still pathways to qualify for long-term care benefits:
10.1. Medically Needy Pathway
Missouri has a Spend Down Program for seniors applying for Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled who have income above the Medicaid limit. This allows them to become income-eligible by “spending down” their income on medical expenses, such as:
- Prescription drugs
- Dental and eye care services
- Durable medical equipment
- Home nursing services
- Hospital bills
If the applicant is married, medical bills incurred by their spouse can also be used.
Effective 4/1/24 – 3/31/25, the medically needy income limit (MNIL) for individuals who are aged and disabled is $1,109 per month for an individual and $1,499 per month for a couple. For individuals who are blind, the MNIL is $1,305 per month for an individual and $1,763 for a couple.
The “spend down” amount is the difference between the applicant’s monthly income and the MNIL. Once the “spend down” is met, the individual becomes Medicaid eligible for the remainder of the month. The medically needy asset limit is $5,909.25 for an individual and $11,818.45 for a couple.
10.2. Qualified Income Trusts (QITs)
Also known as Miller Trusts, QITs provide a way for seniors with income exceeding the Medicaid limit to become income-eligible for a Medicaid Waiver. Money deposited into an irrevocable QIT does not count towards Medicaid’s income limit.
An irrevocable trust cannot be changed or canceled once established. The applicant’s excess income is directly deposited into the trust, and a trustee is appointed to manage the funds. The money can only be used for specific purposes, such as:
- Contributing to the cost of long-term home and community-based services
- Paying for medical expenses and items not covered by MO HealthNet, such as wheelchairs
Upon the Medicaid participant’s death or disenrollment, any remaining funds must be paid to the state of Missouri.
10.3. Asset Spend Down
Individuals with countable assets above MO HealthNet’s asset limit can “spend down” excess assets on non-countable ones to become asset-eligible. Examples include:
- Making home modifications (wheelchair ramps, stair lifts, widening doorways)
- Modifying vehicles (hand controls, pedal extenders)
- Prepaying funeral and burial expenses
- Paying off debt
Remember, gifting assets or selling them below fair market value within 60 months of applying for Nursing Home Medicaid or a Medicaid Waiver violates the Look-Back Rule and can result in a Penalty Period of Medicaid ineligibility. It’s recommended to keep documentation of how assets were spent to prove compliance with this rule.
10.4. Medicaid Planning
Many individuals considering Medicaid have income and/or assets exceeding the eligibility limits, yet they still cannot afford the cost of care. In these situations, Medicaid Planning can be invaluable. By working with a Medicaid Planning Professional, families can implement a variety of strategies to help them become Medicaid-eligible and protect their home from Medicaid Estate Recovery.
11. What Specific Missouri Medicaid Programs Are Available for Seniors?
In addition to covering nursing home care, MO HealthNet offers several programs to help seniors remain living at home or in the community:
- Aged and Disabled Waiver (ADW): Provides adult day health care and respite care to support families caring for loved ones at home, enabling them to maintain full-time employment. It also offers homemaker services and home-delivered meals to help seniors live independently.
- Supplemental Nursing Care (SNC) Assistance: This cash benefit helps individuals afford the cost of assisted living residences and residential care facilities. While it doesn’t cover the full cost, it can be combined with other income sources.
- Consumer Directed State Plan Personal Care: Under MO’s Regular Medicaid program, this allows family members (excluding spouses) to be hired as personal care providers and paid by the state.
- Structured Family Caregiving Waiver (SFCW): For individuals with dementia or Alzheimer’s, this program provides for an adult foster care living situation, allowing relatives, including spouses, to be paid for providing care.
- Program of All-Inclusive Care for the Elderly (PACE): Combines the benefits of Medicaid, including long-term care services, and Medicare into one program. Additional benefits, such as dental and eye care, may be available.
- Money Follows the Person (MFP): Also called Show-Me Home in Missouri, this federal program helps institutionalized individuals eligible for Medicaid transition back home or into the community.
12. How Do You Apply for Missouri Medicaid?
Missouri seniors can apply for MO HealthNet through the following methods:
- Online: Through the myDSS portal
- Phone: By calling 855-373-9994
- Mail: By downloading and submitting a completed application
Applicants must also submit the Supplemental Form.
For application assistance, contact the MO Department of Social Services Family Support Division at 1-855-373-4636. You can also visit your local Family Support Division Resource Center for program information and application assistance. The application process may vary based on the specific program you’re applying for.
It’s crucial to ensure you meet all eligibility criteria before submitting a completed application. If you’re uncertain about meeting income and/or asset limits, or if you exceed them, Medicaid planning can significantly increase your chances of approval.
Navigating the Medicaid application process can be complex, so it’s essential to approach it seriously. Familiarizing yourself with general information about the long-term care Medicaid application process can be highly beneficial.
FAQ: Missouri Medicaid Income Limits
1. What is the income limit for Medicaid in Missouri for a single person in 2024?
The income limit for Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled is $1,109 / month (eff. 4/1/25 -3/31/26). For Nursing Home Medicaid, all available income must be paid towards care, with a Personal Needs Allowance of $50 / month.
2. What is the asset limit for Medicaid in Missouri for a single person in 2024?
The asset limit for Medicaid in Missouri for a single person in 2024 is $5,909.25.
3. How does Missouri Medicaid treat income for married couples?
For Nursing Home Medicaid or HCBS Waivers, only the applicant’s income is counted. For Regular Medicaid, both spouses’ income is considered.
4. What if my income is over the Medicaid limit in Missouri?
You may still qualify through the Medically Needy Pathway by spending down excess income on medical expenses or by using a Qualified Income Trust (QIT).
5. Are there any assets that Missouri Medicaid does not count?
Yes, non-countable assets include personal belongings, household furnishings, one car, and your primary home.
6. What is the Medicaid Look-Back Period in Missouri?
Missouri has a 5-year Look-Back Period for Nursing Home Medicaid and Medicaid Waivers, where asset transfers are reviewed.
7. Can I give away assets to qualify for Medicaid in Missouri?
Gifting assets within the 5-year Look-Back Period can result in a Penalty Period of Medicaid ineligibility.
8. Does owning a home affect my Medicaid eligibility in Missouri?
Your home is generally exempt if you or your spouse live there, with a home equity interest limit of $730,000 in 2024 if no spouse lives in the home.
9. What is a Qualified Income Trust (QIT)?
A QIT, or Miller Trust, allows individuals with income over the Medicaid limit to become income-eligible for a Medicaid Waiver.
10. Where can I get help applying for Missouri Medicaid?
Contact the MO Department of Social Services Family Support Division at 1-855-373-4636 or visit your local Family Support Division Resource Center.
Navigating the intricacies of Medicaid eligibility can be daunting, but with the right knowledge and resources, you can access the healthcare support you need. At income-partners.net, we’re committed to providing valuable insights and partnership opportunities to help you navigate the financial landscape and secure a brighter future.
Ready to explore partnership opportunities and innovative income solutions? Visit income-partners.net today and discover how strategic collaborations can pave the way to improved healthcare access and financial security in Missouri. Let us help you connect with partners and strategies that can make a real difference in your life. Contact us at 1 University Station, Austin, TX 78712, United States or call +1 (512) 471-3434.
