Medicaid

There are two nursing care programs in Missouri: supplemental nursing care (SNC) and MO HealthNet vendor payments.

Supplemental nursing care provides monthly cash benefits. An eligible adult living in a licensed nursing facility (NF) and found medically eligible may receive a maximum of $390. If not found medically eligible while living in a nursing facility, or if living in a licensed assisted Living (ALF) or residential care facility II (RCF-II) an eligible adult may receive a maximum of $292 monthly. If living in a licensed residential care facility the maximum is $156. Persons eligible for these cash benefits also receive a $30 personal needs monthly allowance unless such needs are being met by the Department of Mental Health (DMH).

MO HealthNet vendor payments do not provide a direct cash benefit. Instead, this program pays the nursing facility directly for nursing care charges above the amount the resident is expected to pay. A resident covered under this program is expected to use all available income to pay for care except for a personal needs standard (usually $30 per month). The participant may also keep enough to pay medical insurance premiums. In some cases, the participant may allot some or all income to a spouse or dependents who remain outside the nursing facility (see Prevention of Spousal Impoverishment).

 

Who Is Eligible?


For supplemental nursing care (cash benefits) the person who:

is 21 years of age or older and is living in a licensed facility;
is determined to need the specific level of care if residing in a nursing facility;
meets the other eligibility requirements outlined under MO HealthNet for the Aged, Blind and Disabled .
For vendor payments, the person who:

is certified for nursing facility care or state mental hospital care;
has been screened before entry into a MO HealthNet-certified nursing facility;
is 65 years or older for state mental hospital care;
has not given away, sold, or transferred real or personal property within the period prescribed by law without receiving fair and valuable consideration, and
meets the other eligibility requirements outlined under “MO HealthNet for the Aged, Blind and Disabled ”
A special provision applies to married couples when one spouse enters a nursing facility and the other spouse does not live in a nursing facility. This provision allows for protection of a portion of the couple’s assets for the spouse remaining at home (see “Prevention of Spousal Impoverishment”).

For information regarding medical coverage included with nursing care, see Medical Services-MO HealthNet.

Some nursing care partcipants may also be eligible for Qualified Medicare Beneficiary or Specified Low-Income Medicare Beneficiary benefits.