What Is The Monthly Income Limit For Medicaid In Missouri?

What Is The Monthly Income Limit For Medicaid In Missouri? The monthly income limit for Medicaid in Missouri varies depending on the specific program and your marital status, and income-partners.net can help you navigate these complexities to find the best partnership opportunities for your financial situation. Missouri Medicaid, also known as MO HealthNet, provides healthcare coverage to low-income individuals and families, and understanding the income thresholds is crucial for eligibility, so explore partnership opportunities and discover ways to increase your income while maintaining access to essential healthcare services. Navigate financial strategies, explore partnership opportunities, and discover ways to boost your income while securing vital healthcare coverage.

1. Understanding Missouri Medicaid Long-Term Care

Medicaid offers healthcare for low-income people of all ages. While it covers various Missouri residents, our focus is on long-term care Medicaid for seniors aged 65 and over. Besides nursing home care and assisted living, MO Medicaid covers non-medical support services to help frail seniors stay in their homes. Missouri seniors can qualify for three types of Medicaid long-term care programs:

• Institutional / Nursing Home Medicaid: This is an entitlement, meaning anyone who qualifies receives assistance, but benefits are limited to nursing homes.
• Medicaid Waivers / Home and Community Based Services (HCBS): These are not an entitlement, as participant slots are limited, and waiting lists may exist. They aim to delay nursing home admission by providing services at home, adult day care, or in assisted living.
• Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled (MHABD): This is an entitlement; meeting the requirements ensures benefits. It may offer long-term care services like personal care or adult day care.

In Missouri, Medicaid is called MO HealthNet, funded by the state and federal government but managed by the state under federal guidelines. The Missouri Department of Social Services handles the administration.

2. Navigating Income and Asset Limits for Medicaid Eligibility

The financial and medical requirements for Medicaid long-term care programs differ across the three categories. To make matters even more complicated, the financial criteria change annually, vary based on marital status, and Missouri provides a variety of eligibility pathways.

Simplified Eligibility Criteria: Single Nursing Home Applicant

In 2025, a single Nursing Home Medicaid applicant in Missouri must meet these criteria:

1. All available income, with few exceptions, must go to the nursing home.
2. Assets must be under $5,909.25.
3. The applicant must require a Nursing Home Level of Care.

The table below offers a quick reference for seniors to determine if they might be immediately eligible for long-term care from a MO HealthNet program. Alternatively, one can take the Medicaid Eligibility Test.

2025 Missouri Medicaid (MO HealthNet) Long-Term Care Eligibility for Seniors
Type of Medicaid
Income Limit
Institutional / Nursing Home Medicaid
Medicaid Waivers / Home and Community Based Services
Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled

*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.

Meeting all of the criteria is not mandatory in order to be eligible or become eligible for Medicaid in Missouri. More.

2.1. What is Countable Income for Missouri Medicaid?

Nearly any income a Medicaid applicant receives counts towards Medicaid’s income limit. This includes employment wages, alimony, pension payments, Social Security Disability Income, Social Security Income, IRA withdrawals, and stock dividends. However, Holocaust restitution payments are not counted nationally. In Missouri, the Aid & Attendance and Housebound Allowances, which are above the Basic VA Pension, are also excluded.

2.2. How is Income Treated for a Couple When Only One Spouse Applies?

When only one spouse applies for Nursing Home Medicaid or a HCBS Medicaid Waiver, only the applicant’s income counts. The non-applicant spouse’s income is disregarded. However, the non-applicant spouse may be entitled to a Minimum Monthly Maintenance Needs Allowance (MMMNA) from their applicant spouse. The MMMNA is a Spousal Impoverishment Provision, ensuring the non-applicant spouse has enough income to avoid impoverishment.

The MMMNA is $2,555 (eff. 7/1/24 – 6/30/25). If a non-applicant’s monthly income is under $2,555, income can be transferred from the applicant spouse to reach this level. In Missouri, a non-applicant spouse can further increase their Spousal Income Allowance if their housing and utility costs exceed a “shelter standard” of $767 / month (eff. 7/1/24 – 6/30/25). However, in 2025, a Spousal Income Allowance cannot push a non-applicant’s total monthly income over $3,948, which is the Maximum Monthly Maintenance Needs Allowance. More on how this allowance is calculated.

Income is counted differently when only one spouse applies for Regular Medicaid / MO HealthNet for the Aged, Blind, and Disabled. The income of both spouses is calculated towards the applicant’s income eligibility, and there is no Monthly Maintenance Needs Allowance for a non-applicant spouse. More about how Medicaid counts income.

2.3. What are Countable vs. Non-Countable Assets for Missouri Medicaid?

The value of countable assets is calculated towards Medicaid’s asset limit. This includes cash, stocks, bonds, investments, bank accounts (credit union, savings, and checking), and real estate in which one does not reside. In Missouri, IRA’s / 401K’s are counted. Exempt (non-countable) assets include personal belongings, household furnishings, an automobile, one’s primary home, and irrevocable pre-need burial contracts with a funeral home. Personal funeral trust accounts are exempt up to $9,999.

2.4. How are Assets Treated for a Couple Under Missouri Medicaid?

All assets of a married couple are considered jointly owned, regardless of the Medicaid program for which they are applying. However, Spousal Impoverishment Rules allow the non-applicant spouse of a Medicaid nursing home or Waiver applicant a Community Spouse Resource Allowance (CSRA). In 2025, the community spouse (non-applicant) can retain 50% of the couple’s assets, up to a maximum of $157,920. If the non-applicant’s half of the assets is under $31,584, they can retain 100% of the assets, up to $31,584. Note: There is no CSRA for Regular Medicaid.

2.5. What is Missouri Medicaid’s Look-Back Rule?

Missouri has a 5-year Medicaid Look-Back Period for Nursing Home Medicaid and Medicaid Waivers that immediately precedes the application date. Medicaid checks for any assets gifted or sold under fair market value during this period. If so, Medicaid assumes it was to meet the asset limit. Violating the Look-Back Period results in a Penalty Period of Medicaid ineligibility. Note: There is no Look-Back Period for Regular Medicaid.

The U.S. Federal Gift Tax Rule does not extend to Medicaid eligibility. In 2025, this rule allows gifting up to $19,000 per recipient without filing a Gift Tax Return. Gifting under this rule still violates Medicaid’s 5-year Look-Back Period.

2.6. What are the Missouri Medicaid Home Exemption Rules?

For home exemption, the Medicaid applicant or their spouse must live in the home. If there is no spouse in the home, there is a home equity interest limit of $730,000 (in 2025). Home equity is the value of the home minus any outstanding debt. Equity interest is the amount of the home’s equity owned by the applicant. If neither the applicant nor their spouse lives in the home, the applicant must have Intent to Return. Note: For Regular Medicaid, there is no home equity interest limit. Other exemptions exist.

While one’s 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’s death, Missouri’s Medicaid agency seeks reimbursement of care costs from the deceased’s estate, often the home. Without proper planning, the home will be used to reimburse Medicaid for care rather than going to family as inheritance.

2.7. What Medical or Functional Needs are Required for Missouri Medicaid?

An applicant must have a medical need for Medicaid long-term care. Nursing Home Medicaid and HCBS Medicaid Waivers require a Nursing Facility Level of Care (NFLOC). Some program benefits, like home modifications, may have additional criteria. For instance, a waiver to cover home modifications might require an inability to live independently without modifying the home. For long-term care services via regular Medicaid, a functional need with Activities of Daily Living (ADLs) is required, but a NFLOC is not necessarily required.

3. Strategies for Qualifying for Missouri Medicaid When Over the Limits

For Missouri residents aged 65 and over who don’t meet the financial eligibility requirements, there are ways to qualify for long-term care Medicaid.

3.1. 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 over the Medicaid limit. They can become income-eligible by “spending down” their income on medical expenses like prescription drugs, dental and eye care, durable medical equipment, home nursing services, and hospital bills. If married, medical bills accrued by the spouse can also be used. Effective 4/1/25 – 3/31/26, the medically needy income limit (MNIL) for aged and disabled persons is $1,109 / month for an individual and $1,499 / month for a couple. For blind individuals, the MNIL is $1,305 / month for an individual and $1,763 for a couple.

The “spend down” amount, like a deductible, is the difference between one’s monthly income and the MNIL. Once met, one is Medicaid eligible for the rest of the month. The medically needy asset limit is $5,909.25 for an individual and $11,818.45 for a couple.

3.2. Qualified Income Trusts (QITs)

Also called Miller Trusts, QITs allow seniors over the Medicaid income limit to become income-eligible for a Medicaid Waiver. Money deposited into an irrevocable QIT does not count towards Medicaid’s income limit. “Irrevocable” means the trust cannot be changed or canceled once established. Excess income (over the Medicaid limit) is deposited into a trust, where a trustee manages the funds. The money can only be used for specific purposes, including long-term home and community-based services and medical expenses not covered by MOHealthNet, like wheelchairs. Upon the Medicaid participant’s death or disenrollment, the remaining funds go to the state of Missouri.

3.3. Asset Spend Down

Individuals with countable assets over MO HealthNet’s asset limit can “spend down” excess assets on non-countable ones to become asset-eligible. Examples include home modifications (wheelchair ramps, stair lifts, widening doorways), vehicle modifications (hand controls, pedal extenders), prepaying funeral and burial expenses, and paying off debt. Remember, assets cannot be gifted or sold under fair market value within 60 months of applying for Nursing Home Medicaid or a Medicaid Waiver. This violates the Look-Back Rule and can result in a Penalty Period of Medicaid ineligibility. Document all asset spending as proof of compliance.

Our Spend Down Calculator can assist persons in determining if they might have a spend down, and if so, provide an estimate of the amount.

3.4. Medicaid Planning

Most individuals considering Medicaid are “over-income” or “over-asset” but cannot afford their care costs. Medicaid Planning can help. Working with a Medicaid Planning Professional allows families to use various strategies to become Medicaid-eligible and protect their home from Medicaid Estate Recovery. Connect with a Medicaid Planner.

4. Specific Missouri Medicaid Programs for Seniors

Besides nursing home care, MO HealthNet offers programs to help seniors stay at home or in the community.

1. Aged and Disabled Waiver (ADW): Provides adult day health care and respite care to help families caring for loved ones at home. These supports enable caregivers to maintain full-time employment. Homemaker services and home-delivered meals are also available to help seniors live independently.
2. Supplemental Nursing Care (SNC) Assistance: A cash benefit to help afford assisted living residences and residential care facilities, which can be combined with other income sources.
3. Consumer Directed State Plan Personal Care: Under MO’s Regular Medicaid, this program allows family members (except spouses) to be hired and paid by the state as personal care providers.
4. Structured Family Caregiving Waiver (SFCW): For individuals with dementia/Alzheimer’s, this program provides adult foster care living situations, allowing relatives, including spouses, to be paid for providing care.
5. Program of All-Inclusive Care for the Elderly (PACE): Combines Medicaid and Medicare benefits, including long-term care services, into one program, with additional benefits like dental and eye care.
6. 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.

5. How to Apply for Missouri Medicaid

Missouri seniors can apply for MO HealthNet online at myDSS, by phone at 855-373-9994, or by submitting a completed application. They must also submit the Supplemental Form. The MO Department of Social Services Family Support Division can be reached at 1-855-373-4636 for application assistance. Local Family Support Division Resource Centers can also provide program information and help with applying. The application process may vary depending on the program.

MO HealthNet applicants should ensure they meet all eligibility criteria before applying. If uncertain about meeting income or asset limits, or if over the limits, Medicaid planning can be crucial. The Medicaid application process can be confusing and should be taken seriously, so familiarize yourself with general information about the long-term care Medicaid application process.

5.1. The Role of Strategic Partnerships in Navigating Medicaid Eligibility

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• Customized Solutions: We recognize that everyone’s situation is unique. Therefore, we offer personalized strategies tailored to your specific circumstances, helping you make informed decisions that balance income growth and healthcare coverage.

5.2. Discovering Partnership Opportunities on Income-Partners.net

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5.3. Real Stories: How Partnerships Have Helped Others Navigate Medicaid

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6. Frequently Asked Questions (FAQs) About Missouri Medicaid Income Limits

1. What is the income limit for Missouri Medicaid in 2025 for a single person?
The income limit varies depending on the specific Medicaid program. For Regular Medicaid, it’s typically around $1,109 per month, but for Nursing Home Medicaid, most income must go towards care costs, with a small personal needs allowance.

2. How are assets considered for Medicaid eligibility in Missouri?
Countable assets include cash, stocks, bonds, and bank accounts. Exempt assets typically include a primary home, personal belongings, and a car. The asset limit for a single person is generally around $5,909.25.

3. What happens if my income is over the Medicaid limit in Missouri?
Missouri has a Spend Down Program where you can deduct medical expenses from your income to meet the Medicaid income limit. Additionally, you might consider a Qualified Income Trust (QIT) or Miller Trust.

4. Does the income of my spouse affect my Medicaid eligibility?
For Nursing Home Medicaid or HCBS Waivers, only the applicant’s income is counted. However, for Regular Medicaid, both spouses’ incomes are considered.

5. What is the Minimum Monthly Maintenance Needs Allowance (MMMNA) in Missouri?
The MMMNA is $2,555 (eff. 7/1/24 – 6/30/25). If the non-applicant spouse’s income is below this, income can be transferred from the applicant spouse.

6. What is the Community Spouse Resource Allowance (CSRA) in Missouri?
In 2025, the community spouse can retain 50% of the couple’s assets, up to a maximum of $157,920. If half the assets are under $31,584, the community spouse can retain up to $31,584.

7. 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 Medicaid reviews asset transfers to ensure no gifting or selling below fair market value occurred.

8. What is a Qualified Income Trust (QIT) and how does it help with Medicaid eligibility?
A QIT, or Miller Trust, is an irrevocable trust where excess income is deposited, allowing individuals over the income limit to become eligible for Medicaid Waivers. The funds can only be used for specific purposes like long-term care and medical expenses.

9. Can I give away assets to qualify for Medicaid in Missouri?
Gifting assets can violate the Medicaid Look-Back Period, resulting in a penalty period of ineligibility. It’s important to consult with a Medicaid planner before making any asset transfers.

10. How can income-partners.net help me navigate Medicaid eligibility?
income-partners.net connects you with strategic partnership opportunities to increase your income while structuring it to comply with Medicaid requirements. They also offer expert guidance and customized solutions to balance income growth and healthcare coverage.