The Missouri Medicaid program for Missouri residents covers a variety of health care related services for low income and low asset Missourians. Eligibility requirements for each of the separate programs varies from Medicaid program to Medicaid program, but all programs are based upon lack of financial ability to personally private pay for the healthcare services and are under the applicable asset limits. In the state of Missouri, the Medicaid program is run by the state agency Mo Healthnet. The Missouri Family Support Division, under the Missouri Department of Social Services (DSS), administers the many programs for low income families, including managing the application process and processing Medicaid applications.
The most common Mo Healthnet programs applicable to Missouri seniors are Medicaid’s assistance for home and community based services (HCBS) and nursing home care (in residential care facilities) and health coverage related to these services. Medicare does not cover these care needs such as long term care and in-home services and personal care services, so the federal and state Medicaid/Mo Healthnet services provided these senior services for those that cannot afford them. Under these programs, the Medicaid program will pay the providers and nursing homes directly for those who achieve enrollment; in many cases, the care recipient is required to spend down a portion of Social Security and other monthly income as a co-pay before the state provided services begin for those who exceed the applicable income limit. For in-home services, Medicaid will directly pay the caregiver and/or the caregiver home care agency (this process involves a “waiver” from other services in order to allow the individual to remain in-home. In the case of care in a nursing facility for nursing home costs, the state will pay the care provider directly. The reimbursement would be made to the appropriate healthcare provider, depending on the level of care needed by the Medicaid recipient.
Show-Me state Medicaid recipients can also receive Medicaid coverage for ancillary care needs, medical expenses and come other costs. For example, nursing home residents receiving Medicaid services can also qualify as a Qualified Medicare Beneficiary (QMB), in which case all Medicare deductible and co-pays are covered by the state. Additionally, Mo Healthnet allows for Medicare premiums and health insurance premiums to be paid directly from any monthly income due to the nursing home as a monthly co-pay.
In sum, Missouri seniors in need of care and other people with disabilities have a variety of Medicaid programs available for a variety of assistance sources for those who meet Medicaid eligibility requirements. Please contact QMC to learn more about ways to receive assistance for care at home, in assisted living, or in nursing home today.