Missouri State Plan Personal Care and Consumer Directed Services
MO HealthNet state plan personal care pays for help with daily activities at home, through an agency or Consumer Directed Services (CDS). This page is part of our Missouri Long-Term Care Medicaid guide.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Medicaid state plan personal care benefit |
| Who runs it | Missouri DHSS, Division of Senior and Disability Services |
| Age | Medicaid members |
| Care need | Nursing facility level of care |
| Missouri 2026 income rule (long-term care) | No fixed cap for nursing home care: income goes to the facility, minus allowances |
| Missouri 2026 asset limit (single applicant) | $6,220.50 (from July 1, 2026) |
| Waiting list | No |
Missouri personal care in brief
Put simply, responsibility for Missouri personal care sits with Missouri DHSS, Division of Senior and Disability Services. Its target group is medicaid members; on care need, the rule is: Nursing facility level of care. As for waiting: No. The sections below repeat these points with more detail, and our state guide covers the Missouri rules that apply to every long-term care program. Families weighing Missouri personal care against other Missouri options can use the related pages at the end to compare programs side by side.
What the program is
DSDS assesses the person and authorizes state plan personal care: basic personal care, advanced personal care for more medical tasks, and authorized nurse visits. Services can be given by an agency or through Consumer Directed Services (CDS), in which the participant hires and supervises their own attendant and a vendor handles payroll. Personal care can also be given to residents of residential care facilities and assisted living facilities.
Missouri personal care is part of Missouri’s regular Medicaid benefits rather than a waiver. There is no cap on how many people can use a state plan benefit, which means no waiting for a slot once need is shown. It is narrower than a waiver, though: the focus is help with daily activities, not the broader range of waiver services. See In-home care.
Who qualifies in 2026
Eligibility for Missouri personal care comes down to these points. The person:
- Has MO HealthNet
- Needs a nursing facility level of care
- Lives in Missouri and is a U.S. citizen or qualified non-citizen
Financial eligibility. The person must have MO HealthNet. The table’s figures are Missouri’s 2026 long-term care numbers, taken from our state guide. MO HealthNet’s countable assets do not usually include the home (within the equity limit, if the applicant or a spouse lives there or intends to return), one car, personal belongings and a small burial fund. When one spouse applies for Missouri personal care and the other stays at home, the spouse at home keeps a protected share of the couple’s assets and may receive part of the applicant’s income. See Spousal impoverishment rules.
How the care assessment works. MO HealthNet’s assessment covers daily activities, from bathing and dressing to toileting and medications, plus memory and safety. A nurse or social worker working with MO HealthNet usually does it in person, wherever the person is living. Families should describe the worst days honestly and bring a list of conditions and medicines. See Nursing home level of care and Activities of daily living.
What services it can pay for
What a participant receives under Missouri personal care follows the care plan. Possible services include:
- Basic personal care
- Advanced personal care
- Authorized nurse visits
- Consumer-directed personal care
No program pays for everything. Missouri personal care services are based on assessed need, and a family caregiver who is already helping is usually counted when the plan is written. A change in health is a reason to request a reassessment.
Directing your own care and paying family
Under CDS, the participant hires workers.
How to apply
There are two tracks, a financial one and a care one, and both must say yes. The usual path for Missouri personal care is:
- Use DSDS’s online HCBS referral.
- Assessment.
- Choose agency or CDS.
Before contacting MO HealthNet, see Applying for a waiver and the documents checklist for what to gather.
Waiting lists
State plan personal care has no waiting list.
See Waiver waiting lists for general tips.
How it relates to nursing home Medicaid
Missouri uses the nursing facility level of care for its in-home services. Personal care is often the core service, with the ADW adding more. MO HealthNet’s nursing home rules are in our state guide.
Where the nursing home rules still apply. Most money rules carry over from nursing home Medicaid. The five-year look-back for gifts generally applies, so a gift or transfer for less than fair value can cause a period when Medicaid will not pay for long-term care services. MO HealthNet can also use estate recovery to seek repayment for long-term care services received after 55. Under Missouri personal care, income above an allowance may go toward the cost of care each month.
Income in a nursing home. In 2026, Missouri lets a nursing home resident keep $50 a month for personal needs; the rest of their income mostly pays toward care. The state guide explains the nursing home side.
Tips for families
- Begin before it is urgent. Every step of Missouri personal care takes time, and an early request protects your place.
- Keep copies of every Missouri personal care form, notice and letter, and write down the name of each person you speak with and the date.
- Use your appeal rights. Notices that deny or reduce services explain how to request a fair hearing; acting quickly can protect current services.
- Tell MO HealthNet about changes in money, address or household as they happen.
- Expect yearly reviews of both Medicaid eligibility and the care assessment. See Renewals.
- Get help with complex Missouri personal care cases, such as a spouse at home or past gifts. A certified Medicaid planner or a legal aid office can review how Missouri’s rules fit a family’s situation.
Common questions
Can family be paid? Through CDS, family members other than a spouse can be hired.
Can I get personal care in assisted living? Yes, some personal care services can be given in residential care and assisted living facilities.
Is there a waiting list? No.
Related pages
- Missouri Long-Term Care Medicaid guide
- Missouri ADW
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.