At FreedomCare, we believe in empowering individuals to live on their own terms—especially when it comes to healthcare choices. For many low-income adults with disabilities in Missouri, accessing care at home rather than moving to a nursing home can significantly enhance quality of life and maintain independence. The Missouri Aged and Disabled Waiver (ADW) is a Medicaid program designed to help make this possible. By understanding how the ADW works, who qualifies, and what services it covers, you and your family can make more informed decisions about care options that meet your unique needs.
Want care from someone you know and trust? FreedomCare can help you access the support and financial assistance you deserve. Check if you qualify for the Missouri Aged and Disabled Waiver (ADW)
Click here if you would like more information on how to get paid as a family caregiver in Missouri
What Is the Aged and Disabled Waiver in Missouri?
The ADW is a specialized Medicaid program that “waives” certain traditional Medicaid rules, making it possible for eligible Missourians to receive home and community-based services (HCBS) instead of nursing home care. It’s tailored to support two main groups:
- Seniors who are 63 years or older.
- Adults with disabilities aged 18 to 62.
Unlike institutional care, the ADW allows participants to remain in their own homes, or the homes of relatives or friends, and still receive the care they need. This approach prioritizes personal choice and autonomy, letting participants decide how, when, and from whom they receive support. Whether you prefer a state-approved agency or want to hire and manage your own caregivers, including certain family members, the ADW is all about putting you in the driver’s seat.
At FreedomCare, we know how important that sense of control can be. We’re here to help guide you through the ADW’s requirements, benefits, and processes, ensuring that you can live where you feel most comfortable.
Who Is Eligible for the ADW?
To participate in the ADW, you must meet certain qualifications:
- Residency and Citizenship: You must be a Missouri resident, a U.S. citizen, or a qualified alien, and you must have a valid Social Security number.
- Age and Disability Requirements: If you’re 63 or older, you can qualify based on age. If you’re between 18 and 62, you must have a disability.
- Financial Criteria: Your income and assets need to be within the limits set by MO HealthNet (Missouri’s Medicaid program). As of 2023, a single elderly or disabled applicant’s monthly income limit is $903 and the asset limit is $5,000. For married applicants, the monthly income limit is $1,215 and the asset limit is $10,000. Certain exclusions and disregards may apply, so it’s worth discussing specifics with a qualified professional.
- Level of Care Requirements: You must meet the nursing home level of care criteria. This is determined by a professional assessment that considers your functional abilities, medical needs, and cognitive status. Scoring at least 21 points (on a scale of 0–60) is generally required.
- Living Situation: You need to live at home or in another community-based setting—not in an assisted living facility or adult foster care home.
- Service Need: At least one ADW service must be necessary to help you safely remain at home.
FreedomCare understands navigating these requirements can be overwhelming. We can help break down the eligibility criteria and guide you through the application process, ensuring that you feel confident and well-prepared every step of the way.
Services and Supports Available Under the ADW
The ADW offers a wide range of services designed to help participants maintain a safe, comfortable, and fulfilling life at home:
- Adult Day Health Care: Supervised care in a group setting, offering social activities, personal care, health monitoring, and nutritious meals.
- Chore Services: Occasional help with tasks that maintain a clean and healthy home environment, like pest control or carpet cleaning.
- Home-Delivered Meals: Up to two nutritious meals per day, delivered right to your door.
- Homemaker Services: Regular assistance with everyday tasks like laundry, meal prep, and shopping.
- Respite Care: Temporary relief for the unpaid family member who usually provides your care, giving them a well-deserved break.
- Personal Care: Help with tasks like bathing, dressing, grooming, toileting, and mobility.
- Specialized Medical Equipment and Supplies: Items like wheelchairs, walkers, or oxygen equipment that help maintain health and independence.
- Environmental Accessibility Adaptations: Home modifications—like ramps, grab bars, or widened doorways—to improve accessibility and safety.
All ADW participants work with case managers who ensure that all services align with their individual needs and goals. At FreedomCare, we can help you understand and choose the right combination of supports to maintain your lifestyle and autonomy.
Can Family Caregivers Get Paid Under the ADW?
One of the most common questions we hear at FreedomCare is: “Can I be paid to care for my loved one or family member in Missouri?” Under the ADW, the answer can be yes—if you choose the self-directed option.
The ADW offers two service delivery models:
- Agency-Directed: You select from a list of approved agencies that employ qualified caregivers.
- Self-Directed: You manage your own workers, who can be friends, neighbors, or even certain family members (except spouses or legal guardians).
For families who prefer a more hands-on approach, the self-directed model can be a game-changer. It gives you the freedom to hire the caregivers you trust the most, ensuring that care feels personalized, consistent, and compassionate.
However, self-direction also comes with responsibilities. You must be willing and able to act as an employer—recruiting, hiring, training, and supervising your chosen caregiver. You’ll also need to manage employment-related tasks like payroll and comply with tax and labor laws. A fiscal intermediary can assist with these administrative duties, and an electronic visit verification system helps track service delivery.
If you meet all the necessary conditions, you can pay a family member to provide care under the self-directed model. Rates are set by the state and depend on factors like the number of authorized hours and available funds in the ADW budget. As of 2023, the hourly pay rate for self-directed workers in Missouri is $12.50 for regular hours and $18.75 for overtime, though these figures may change with state regulations and budget adjustments.
At FreedomCare, we can help you understand self-direction, walk you through the responsibilities involved, and show you how to ensure that your family caregiver gets the appropriate compensation. Our goal is to help you create a supportive, nurturing care environment that respects both your loved one’s needs and your family’s unique circumstances.
Putting It All Together with FreedomCare
The Missouri Aged and Disabled Waiver has the potential to open doors for seniors and adults with disabilities who want to remain at home, rather than move into a nursing home. By offering comprehensive supports and allowing for family caregiver compensation under certain conditions, the ADW empowers participants and their loved ones to shape their own care experience.
At FreedomCare, we’re committed to making sure you have the information, resources, and confidence to navigate programs like the ADW. From understanding eligibility requirements to exploring the self-directed option, we’ll stand by your side every step of the way. Together, we can help you or your loved one maintain independence, improve quality of life, and enjoy the comfort of home for as long as possible.
Interested in learning more about the Missouri ADW or other home and community-based care options?
Want care from someone you know and trust? FreedomCare can help you access the support and financial assistance you deserve. Check if you qualify for the Missouri Aged and Disabled Waiver (ADW)
Click here if you would like more information on how to get paid as a family caregiver in Missouri