Does Missouri Pay for Home Health Care?

MCO is part of Missouri’s Medicaid program, and it’s structured as a managed care option for seniors who need home health care. Covered benefits include home nursing, visits from home health aides who work for an approved state agency and several non-medical home support services, such as caregiver assistance and home modifications.

To enroll in MCO, seniors in Missouri must qualify for Medicaid and have a need for care that qualifies for placement in a nursing home. A Medicaid-approved physician must write a recommendation for program services as medically necessary and submit a plan of care for the beneficiary. MCO services may continue for as long as the enrollee needs the support. This is an entitlement program, like the rest of Medicaid, so there are no waiting lists or other restrictions for care outside of Medicaid’s standard eligibility criteria.

Seniors in Missouri may apply for home health services through two waiver programs: the Aged and Disabled waiver (ADW) and the Supplemental Nursing Care (SNC) waiver. These overlap somewhat, but many beneficiaries enroll in both to get comprehensive in-home support services. The ADW is open to seniors who have medical needs that rise to the level of nursing home care, but it primarily delivers non-medical support, such as caregiver assistance and chore help. Adult day health care, respite care and other facility-based medical supports are provided through the ADW.

Missouri’s SNC waiver works with the ADW to provide needed home health care from paramedical professionals. This can include home health aide services, wound care and medical education from a personal-service nurse and durable medical equipment. Both the ADW and SNC waivers can be accessed with a doctor’s recommendation, through the Medicaid program itself or via an in-person application with a local Area Agency on Aging.