Home Care in Missouri

The average starting cost of home care in Missouri is $31 per hour, according to A Place for Mom’s proprietary data. Based on our ranking methodology, the top-rated home care agencies in Missouri are Seniors Helping Seniors of Ozarks, Senior Services Options - Belton, MO or BrightStar Care of Columbia, MO. Home care can help older adults stay in familiar surroundings while receiving support with companionship, meals, errands, and personal care.

Whether your loved one lives in St. Louis, Kansas City, Springfield, Columbia, O’Fallon, or a smaller community, the right agency should fit their daily needs, schedule, comfort level, and budget.

Home care helps with nonmedical needs at home, including bathing, dressing, meal preparation, light housekeeping, and companionship. Home health care is different because it involves medical services delivered by licensed health professionals. Some providers offer both types of care, but A Place for Mom’s network focuses on nonmedical home care agencies. A Place for Mom partners with 151 home care agencies in Missouri to help families explore options in their area.

Home care in Missouri costs $31 per hour, compared with the national rate of $32. Rates aren’t the same throughout the state, with costs in Kansas City generally trending higher than in St. Louis and Springfield.^[01] What your family pays will also depend on the agency, the services provided, and how often your loved one receives care.

The care schedule has the greatest effect on the monthly total. Occasional visits may provide enough time for companionship, errands, meal preparation, or light housekeeping. Someone who needs regular help with bathing, dressing, mobility, or other personal care may require visits more often. The estimates below use Missouri’s average hourly home care rate:

Part-time care (20 hours/week): $2,663 per month

Full-time care (44 hours/week): $5,859 per month

Home care rates in Missouri may also be affected by:

• The type and amount of help your loved one needs
• Specialized support, such as dementia care
• The number and length of visits
• Evening, overnight, weekend, or holiday schedules
• 24-hour or live-in care
• Caregiver experience and training
• The local availability of caregivers
• Agency minimum-hour requirements

Missouri families may use private funds, public benefits, or both to pay for nonmedical home care. Depending on eligibility, VA benefits or services available through MO HealthNet, Missouri’s Medicaid program, may help cover some in-home support.

Private pay options

Private pay is often the first place families start because it gives them more control over the agency, schedule, and type of care their loved one receives. Common private payment sources include:

• Social Security benefits
• Savings, investments, or pensions
• Proceeds from selling a home, real estate, or personal property
• Long-term care insurance
• Certain kinds of life insurance policies
• Reverse mortgages

Some Missouri families combine several payment sources or share costs among siblings or relatives, depending on how often their loved one needs care. Learn more about whether long-term care insurance covers in-home care and how Social Security benefits may help pay for in-home care.

VA benefits

Veterans and surviving spouses in Missouri may be able to use benefits from the U.S. Department of Veterans Affairs (VA) to help cover care at home. VA support can look different from family to family, but it may help with everyday activities, temporary relief for family caregivers, or additional pension payments that can be used toward care.

Veterans enrolled in VA health care may qualify for home- and community-based services, including:^[02,03,04]

• Homemaker and Home Health Aide Care, which may provide help with bathing, dressing, eating, mobility, and other daily activities
• Respite Care, which provides short-term support while giving family caregivers time away from their caregiving responsibilities

Eligibility and availability can vary based on the veteran’s needs and local VA resources. Some veterans may also have a copay.

VA Aid and Attendance provides additional monthly pension payments to eligible veterans and survivors who need help with daily activities or are largely confined to their homes. Families may be able to use these funds toward the cost of nonmedical home care.^[05]

Missouri families can contact the Missouri Veterans Commission for help understanding state and federal benefits or connecting with a Veterans Service Officer.^[06]

Read more: Home Care Options for Veterans: Eligibility and Services

Missouri Medicaid

Medicaid is a state and federal program that helps eligible people pay for health care and long-term services. In Missouri, the program is called MO HealthNet. It may help eligible residents pay for nonmedical support at home through Personal Care Services and certain home- and community-based services (HCBS) waiver programs.

Personal Care Services (PCS) is part of Missouri’s regular Medicaid plan. Depending on the person’s approved care plan, services may include help with bathing, dressing, grooming, mobility, meal preparation, household tasks, and transportation. Missouri also offers waiver programs that can provide additional support.^[07]

The PCS program operates two models for home care:

• Agency Model In-Home Services, in which a home care agency employs and manages the caregiver
• Consumer Directed Services, which allows eligible participants who have physical disabilities to hire and manage their own caregiver

Caregiver eligibility rules differ between the two models, and all caregivers must pass a background check.^[07,08]

Missouri also offers waiver programs that may help eligible residents remain at home. The Aged and Disabled Waiver serves people age 63 or older whose unmet needs are significant enough that they could otherwise require nursing home care. In-home services may include:^[07]

• Homemaker services
• Chore services
• Home-delivered meals
• Respite care

The Structured Family Caregiving Waiver supports eligible adults who have Alzheimer’s disease or a related dementia and who live with a primary caregiver. The caregiver may be a relative, spouse, legal guardian, or another qualified person. Approved services may include homemaker help, assistance with personal care, and transportation to necessary appointments.^[09]

To qualify for Missouri HCBS, a person generally must be enrolled in MO HealthNet, have unmet personal care needs, meet the program’s level-of-care requirements, and complete an assessment. The assessment determines how much help the person needs to complete daily activities and remain safely at home. Additional requirements vary by program.^[10]

Read more: Medicaid Home Health Care and Nonmedical Home Care: Your Questions, Answered

Medicare

Medicare is a federal health insurance program for adults 65 and older and some younger people with disabilities. It may cover limited help with bathing, dressing, grooming, or toileting when your loved one is also receiving qualifying skilled care through Medicare’s home health benefit. Medicare generally doesn’t pay for ongoing personal care, companionship, meal preparation, or housekeeping when those are the only services needed.^[11]

Read more: Does Medicare Cover Home Health Care?

Missouri doesn’t license private-pay nonmedical home care agencies, sometimes called private-duty or private-pay companies. Providers that receive MO HealthNet reimbursement must follow separate program requirements, while home health agencies that provide skilled medical services are licensed by the Missouri Department of Health and Senior Services.^[12]

Does Missouri require home care agencies to have a license?

No. Missouri doesn’t issue a state home care agency license to private-pay nonmedical companies. If a company also provides services that meet Missouri’s definition of home health care, it must be licensed for those medical services.^[12]

Does Missouri conduct inspections of home care agencies?

No. Missouri doesn’t conduct licensing inspections of private-pay nonmedical home care companies because the state doesn’t license or oversee them through its home health agency system. Licensed home health agencies and providers that receive MO HealthNet reimbursement are subject to separate oversight requirements.^[12]

What are hiring practices for home care agencies in Missouri?

Missouri doesn’t set statewide training requirements for caregivers employed by private-pay nonmedical home care agencies. Because screening, onboarding, and training practices can vary by provider, families should ask each agency how it evaluates caregivers before they begin working with clients.^[13]

Different requirements apply to personal care aides employed by agencies that receive MO HealthNet reimbursement. These aides must complete 12 hours of training, including six hours before working with their first client, and demonstrate competency in 13 areas. They must also complete five hours of continuing education each year.^[13]

Missouri doesn’t set a minimum training requirement for consumer-directed workers. However, caregivers participating in Missouri’s Medicaid programs must pass a background check.^[08,13]

When comparing private-pay agencies, ask about background checks, reference checks, caregiver training, supervision, backup care, and how the agency handles complaints or missed visits.

Choosing a home care agency in Missouri is easier when you know how care will be arranged and what happens if your loved one’s needs change. Look for a provider that communicates clearly, explains its policies, and can offer the services and schedule your family needs. Consider the following as you compare agencies:

• Review caregiver training. Ask what caregivers learn before working with clients and whether they receive ongoing education.
• Read reviews and testimonials. Look for patterns in feedback about reliability, communication, compassion, and caregiver consistency.
• Request clear pricing information. Ask about hourly rates, minimum service requirements, weekend or holiday rates, overnight care, cancellation fees, and additional charges.
• Confirm available services. Make sure the agency can provide the support your loved one needs, such as companionship, bathing, dressing, meal preparation, light housekeeping, transportation, or dementia care.
• Ask how care is supervised. Find out who manages the care plan, how often supervisors check in, and whom your family should contact if your loved one’s needs change.
• Plan for backup care. Ask what the agency does when a scheduled caregiver is sick, late, or unable to visit.
• Meet potential caregivers. A good personality fit can help your loved one feel more comfortable receiving support at home.

A Place for Mom helps families compare home care agencies and find providers that match their loved one’s care needs, budget, and preferences. In states that require nonmedical home care agencies to be licensed, A Place for Mom verifies the licensing status of agencies in its network twice each year.

Read more: How to Choose a Home Care Agency