There are a number of challenges that face the elderly population in Missouri, particularly those who choose to continue living at home rather than taking up residence in an assisted living or long-term care facility. If you or an elderly individual you love has decided to stay at home rather than pursuing other options, below are some important considerations:


●   Many homes in Missouri are not handicap accessible.

●   Many older individuals cannot currently afford their housing.

●   Older individuals may feel isolated living at home.

What At-Home Caregivers Can Provide

At-home caregivers can provide many important services to their patients to overcome the challenges they face, depending on the level of care that’s needed. Patients who are ambulatory and who maintain adequate cognitive skills may need less help than others, but at-home caregivers still provide essential, valuable assistance even to individuals who are more capable. Some of the services that at-home caregivers provide include the following:


●       Meal preparation

●       House cleaning and arrangement of home maintenance or lawn care services

●       Dietary management (at-home caregivers ensure that their patients eat high quality, healthy food to ensure maximum health and well being)

●       Errand running (grocery shopping, picking up the mail, etc.)

●       Making sure the patient takes their medication at the appropriate times

●       Personal care (help with dressing, bathing, etc.)

●       In-home health care (wound dressing, medical equipment management, etc.)

●       Assistance with activities such as financial management, letter writing, etc.


In addition to receiving help with the activities listed above, it’s also worth noting that in Missouri, elderly and disabled individuals are not required to go to a nursing home if they are receiving at-home care.


Though most at-home caregivers are qualified to provide all of the above services, there are certain cases where a more highly trained caregiver is needed. The majority of at-home caregivers are Personal Care Aides (PCAs) and are trained to provide all of the tasks above (except complex medical care). Registered nurses may in some cases provide their services as at-home caregivers when a patient has undergone major surgery or when they need more intensive medical care. Other types of at-home caregivers include Home Health Aides (HHAs), Physical Therapists (PTs), Occupational Therapists (OTs), Speech-Language Pathologists (STs), and Medical Social Workers (MSWs).


The job description of a caregiver is complex. Besides providing assistance with various household and personal tasks, an at-home caregiver is also expected to offer emotional support to their patient. Because hiring an at-home caregiver requires that you invite another person into your home to care for you, caregivers must be sensitive and empathic in addition to providing high quality general care and assistance.

Does Missouri Medicaid cover home health care?

Missouri Medicaid, also known as MO HealthNet, does cover home health care of all kinds. Seniors and disabled individuals who are Missouri residents and who qualify for Medicaid in Missouri will be able to receive home health care that is covered by Missouri Medicaid. There are many ways to receive home health care, and the Consumer Directed Services (CDS) program is becoming one of the most popular choices for Missouri residents.


The CDS program is a way for seniors and disabled individuals in Missouri to receive home health care from an individual of their choosing in the way that they indicate. Whereas other home health care providers do not allow the patient to choose the way in which they receive care (or the individual who provides it), CDS lets the patient choose. In addition, family members of a patient are permitted to sign up as caregivers with the CDS program, meaning that the patient may receive care from a family member, and also that the family member may be reimbursed for their time that they spend caregiving.


Missouri Medicaid covers the cost of medical bills as well as the cost of caregivers. As a part of the CDS program, most home caregivers make $10 per hour. Because so many families with elderly or disabled members struggle to pay the bills and provide quality care for their loved ones, the CDS program has been extremely helpful to many families and individuals alike. The CDS program allows patients to hire family members, friends, or other specified individuals of their choosing, as long as the specified caregiver is not a spouse or legal guardian.


Patients who receive care from a CDS caregiver are also able to dictate the way in which they’d like to receive care. For example, individuals with strict religious practices or dietary guidelines may appreciate the freedom and ability to communicate with their caregiver about their requirements. This may not be possible when patients receive care provided by other caregiver services on Missouri Medicaid. If the patient themselves is unable to direct and train the caregiver, a representative may be appointed to do so on their behalf.


In addition to home health care (with or without the CDS program), Missouri Medicaid may also cover the following related expenses:


●       Primary care physician services

●       Disease testing and treatment

●       Cost of certain medications

●       Transportation to and from medical establishments

●       Emergency room visits

●       Cost of certain medical equipment and medical equipment repair services

How many hours does Missouri Medicaid pay for home health care?


Caregivers are paid $10 per hour under the CDS program, and all of their costs incurred are covered by Missouri Medicaid. Caregivers who work outside the CDS program are paid a minimum of $10 per hour, but may be paid more depending on their specialization or level of responsibility. While certain medications, pieces of medical equipment, or visits to the doctor or hospital may occasionally require the patient to pay a copayment or small fee, Missouri Medicaid does not require recipients to pay copayments on home health care services. Thus, there is not a strict limit on the number of home care hours that Missouri Medicaid will cover.


However, it is important to keep in mind that although home health care must be covered for needy individuals, Missouri Medicaid only offers coverage of these services under certain circumstances. Seniors who are eligible to receive home health services must meet the following qualifications:


●       You are age 63+

●       Meet the monthly income requirements (outlined in the section below)

●       Require similar levels of care to those that would be provided in a nursing home

●       Have been authorized by Senior Services to receive home health care services


Individuals with disabilities may refer to this page for more information about the requirements for non-seniors who require home health care in Missouri.

How to Sign Up for Home Health Care in Missouri


Step 1: Before you can sign up for CDS, you have to be eligible for Medicaid (known as MO HealthNet). If you are not currently on Medicaid in Missouri, call 855-835-3505 for information about how to enroll.


To be eligible for MO HealthNet, you must meet certain income, age, and asset requirements listed below:


●       Own less than $4000 in assets if you’re married ($2000 if you’re single)

●       Have a total income less than $1198 per month if you’re married ($885 per month if you’re single or widowed).


Note that some of your assets may not count toward your eligibility requirements. For example, the home that you live in permanently does not count as an asset if it is worth less than $585,000. And your vehicle and other personal items also don’t count toward the total amount you own in assets.


Step 2: After you have enrolled in MO HealthNet, you can apply for at-home services through the Missouri Division of Health and Senior Services. This process will involve a pre-screening along with a home assessment to determine level of care and any other requirements that must be met in order for you to receive high-quality care.


Step 3: To work with CDS, you must be willing to personally hire, train, and provide direction for your caregiver. The caregiver you choose to work with can be a friend or a relative as long as they are not a spouse or legal guardian. Our caregivers provide only non-medical care to help you do tasks that you can no longer do yourself due to disability or aging. Below are the types of tasks that your caregiver may be asked to perform:


●       Bathing and personal hygiene

●       Toileting

●       Grooming

●       Assistance with moving from place-to-place inside the home

●       Laundry

●       Cleaning

●       Taking medications at the appropriate time

●       Cooking

●       Shopping

●       Essential transportation


To work with CDS, you do not have to be a senior citizen, but you do have to meet certain other requirements listed below:


●       You must be above 18 years of age

●       You must be a Missouri resident

●       You must have a physical disability that makes it impossible for you to perform daily activities like the ones listed above.

●       You must require a level of care that might be offered in a nursing facility.

●       You must be able to give your caregiver training and directions on your care needs.


For more information about CDS or to simply ask questions or learn about the application process, contact FreedomCare directly to talk to a representative at 816-281-1359 or visit the DHHS website.