Paying for care
How to pay for in-home care in Missouri
Most families in Missouri pay for non-medical in-home care one of five ways: private pay, long-term care insurance, VA benefits, Missouri Medicaid (MO HealthNet), or a mix. Medicare generally does not pay for this kind of care. Here is what each option covers, who qualifies, and how to start.
By Katie Stippec, COO & Co-Owner, Here at Home Healthcare
Side by side
Every option at a glance
Paying for care is the first thing most families worry about, and the information out there is confusing on purpose. This page lays it out straight. We are a local, family-run Missouri care team, and we would rather you understand your options than feel rushed into anything. If you want to talk it through with a real person, call 314-708-8716 any time.
- MedicareCovers home care: No (only short-term skilled care)Fits: Recovery after a hospital stay, doctor-orderedStart: Not a fit for ongoing personal care
- MO HealthNet (Medicaid)Covers home care: Yes, if you qualifyFits: Limited income and assets, nursing-home level of needStart: mydss.mo.gov / Family Support Division
- VA Aid & AttendanceCovers home care: Helps pay (adds monthly income)Fits: Wartime veterans and surviving spousesStart: va.gov / accredited VA rep, or ask us about VetAssist
- Long-term care insuranceCovers home care: Yes, usuallyFits: Anyone who bought a policyStart: Check your policy, bring it to your assessment
- Private payCovers home care: YesFits: Anyone, fastest to startStart: Call us for a complimentary assessment
Tap any row to jump to the details
Start here, it is the #1 question
Does Medicare pay for in-home care?
Usually, no
Short answer: usually no, not for the kind of care most families are looking for. Medicare pays for short-term skilled care at home (a nurse or therapist, doctor-ordered, when you are homebound). It does not pay for ongoing help with bathing, dressing, meals, companionship, or supervision. That day-to-day help is called custodial or non-medical care, and Medicare does not cover it.
What Medicare DOES cover at home
Medicare covers part-time, intermittent skilled care: skilled nursing, physical or occupational therapy, speech therapy, and a home health aide, but only when you also need that skilled care, are under a doctor's plan, and are certified as homebound. It is meant for recovery, not for the long haul.
What Medicare does NOT cover
- Help with bathing, dressing, grooming, or using the bathroom, when that is the only help you need
- Companionship, supervision, or memory-care presence
- Meal preparation, light housekeeping, errands, or laundry
- 24-hour care or live-in care
- Long-term, ongoing personal care
The honest part: the care Here at Home Healthcare provides is non-medical personal care and companionship. That is exactly the care Medicare does not pay for. So if you are looking for help with daily life at home, Medicare is not the answer, and the rest of this page is.
Missouri Medicaid
Missouri Medicaid (MO HealthNet)
Missouri Medicaid, called MO HealthNet, can pay for in-home personal care for people with limited income and assets who need a nursing-home level of care. It is the main public program that covers day-to-day help at home. Qualifying takes income, asset, and medical screening.
How it works in Missouri
MO HealthNet covers in-home help through a few programs, most commonly the Aged and Disabled Waiver and the state's Consumer-Directed Services (CDS) program. These can cover personal care, homemaker help, respite, and similar support so a person can stay home instead of moving to a facility.
Who qualifies (2026 figures, single applicant)
- Monthly income limit, about, for the Aged and Disabled Waiver
- $1,737Monthly income limit, about, for the Aged and Disabled Waiver
- Asset limit, about
- $6,068.80Asset limit, about
- Medical need: you must need a "nursing facility level of care," meaning the kind of daily help normally associated with a nursing home
- Limits are different for married couples and change each year
One thing worth knowing: Missouri's Consumer-Directed Services program lets eligible adults hire and direct their own caregiver, and in many cases that can include a family member (not a spouse), paid by the state.
How to start
Apply through Missouri's Family Support Division at mydss.mo.gov, or call them directly. Eligibility decisions are the state's, not ours, and the process takes time, so start early if you think you may qualify.
Veterans and surviving spouses
VA benefits for veterans and surviving spouses
If your loved one is a wartime veteran or the surviving spouse of one, the VA's Aid and Attendance pension can add money each month that you can put toward in-home care. In 2026 it pays up to about:
- a month for a single veteran
- $2,424a month for a single veteran
- a month for a married veteran
- $2,874a month for a married veteran
- a month for a surviving spouse
- $1,558a month for a surviving spouse
How it works
Aid and Attendance is an add-on to the VA pension for veterans and surviving spouses who need help with daily activities. It is tax-free monthly income. You decide how to use it, and paying for in-home care is one of the most common uses. Care costs you pay out of pocket can also reduce the income the VA counts against you, which can help you qualify.
Eligibility depends on wartime service, income, assets, and a medical need for help with daily activities. The VA also runs care programs of its own (Homemaker and Home Health Aide, and Veteran-Directed Care) through the VA health system.
How to start
Apply at va.gov/pension/aid-attendance-housebound, or work with an accredited VA benefits representative. Many families use the pension to pay privately for a care team like ours.
If there is a policy
Long-term care insurance
If your loved one bought a long-term care insurance policy, it very likely covers non-medical in-home care, which is exactly what we provide. This is one of the most common ways our families pay. We work with long-term care insurance and can help you with the paperwork.
How it works
Most long-term care policies start paying when a person needs help with a set number of daily activities (usually two of six: bathing, dressing, eating, toileting, transferring, continence) or has a cognitive condition like dementia. A few things to check on the policy:
What we do
We are used to working with long-term care insurance. We provide the visit notes and documentation insurers ask for, and we will walk you through what your policy covers before you commit. Bring the policy to your complimentary assessment and we will read it with you.
Three things to check on the policy
- 01Elimination period: a waiting period (often 30 to 90 days) where you pay first, then benefits begin
- 02Daily or monthly benefit: the cap the policy pays, for example a set dollar amount per day
- 03Reimbursement: most policies reimburse you after care is delivered and documented, so good records matter
Networks we belong to
Here at Home Healthcare is a CareScout Quality Network provider. The CareScout Quality Network signifies we are a high-quality provider that has met the rigorous quality standards of the CareScout Quality Network.
57insurance companies
We are also a contracted provider in the illumifin Provider Discount Program, which covers 57 long-term care insurance companies, including John Hancock, Prudential, Transamerica and Bankers Life.
Find your insurance companyThe fastest way to start
Private pay
Private pay means paying out of pocket, usually by the hour, and it is how most families start. In the St. Louis area in 2026, private-pay in-home care generally runs about $35 to $45 an hour depending on the hours and the level of help. We give you an honest rate at your complimentary assessment, in writing, the day we visit.
Why private pay is so common
It is the simplest and fastest way to begin. There is no application, no waiting period, and no eligibility screening. You decide how many hours and when, and you can start small and add hours as life changes. Many families combine private pay with one of the options above, for example using a VA pension or a long-term care policy to offset the cost.
How we price it
We do not hide our pricing or run you through a sales call. At your complimentary in-home assessment we build a care plan with recommended hours and give you a transparent rate on the spot. No surprises, no pressure.
Questions
What families ask us about paying for care
Does Medicare pay for in-home care in Missouri?
Generally no. Medicare covers short-term skilled care at home (nursing or therapy, doctor-ordered, when you are homebound). It does not pay for ongoing help with bathing, dressing, meals, or companionship. That non-medical care is what we provide, and families pay for it privately, through long-term care insurance, VA benefits, or Missouri Medicaid if they qualify.
How much does in-home care cost in the St. Louis area?
In 2026, private-pay in-home care in the St. Louis area generally runs about $35 to $45 an hour, depending on how many hours you need and the level of help. We give you an exact, written rate at your complimentary in-home assessment.
Does long-term care insurance cover your services?
Usually, yes. Most long-term care policies cover non-medical in-home care once a person needs help with daily activities. We work with long-term care insurance and provide the documentation insurers require. Bring your policy to your assessment and we will review it with you.
Will Missouri Medicaid pay for a caregiver at home?
Yes, for people who qualify. MO HealthNet covers in-home personal care through programs like the Aged and Disabled Waiver and Consumer-Directed Services, for Missourians with limited income and assets who need a nursing-home level of care. You apply through the state at mydss.mo.gov.
Can VA benefits help pay for home care?
Yes. The VA's Aid and Attendance pension adds tax-free monthly income that veterans and surviving spouses can put toward in-home care, up to about $2,424 a month for a single veteran in 2026. Many families use it to pay for private care.
What is the difference between home care and home health?
Home health is short-term skilled care (nursing, therapy) ordered by a doctor and often covered by Medicare. Home care, what we do, is non-medical help with daily life: personal care, companionship, and support at home. It is paid for privately, through insurance, or through the programs on this page.
Related reading: How to Pay for In-Home Care in Missouri: The Five Ways Families Actually Do It
Not sure which option fits your family?
That is the most common place to start, and it is exactly what the complimentary assessment is for. We will sit at your kitchen table, learn what is going on, and help you understand your real options, including the ones that are not us. No pressure, ever.
This page is general information, not legal, financial, or benefits advice. Eligibility for Medicare, Medicaid, and VA programs is decided by those programs, and rules change. For your specific situation, check with the program directly or a qualified advisor.