Missouri's Guide to Home and Community Based Services

HOW DO I QUALIFY?

How you qualify for home and community services differs from program to program. Generally speaking, most of the programs have functional and financial requirements you must meet. An evaluation will be completed to determine if you are eligible for services.

FUNCTIONAL ELIGIBILITY

An evaluation will be completed to determine if you meet functional eligibility guidelines required by the program which best assists you to live independently. Certain programs may require medical documentation to support your functional eligibility.

FINANCIAL ELIGIBILITY

Financial eligibility for Medicaid funded programs is determined by the Family Support Division (FSD), formerly the Division of Family Services (DFS). Income limits may be adjusted annually. A provision has been provided called the Medicaid Spenddown for incomes higher than the income limit.

Medicaid Spenddown sometimes allows for individuals or married couples whose income exceeds the limits, mentioned above, to qualify for state assistance. It recognizes that people still need medical help, even if their income is over a certain limit. This means that if your income is over the limit, but your monthly medical bills reduce that income to below the non-spenddown income limit, you may still be eligible to receive Medicaid funded services

Income includes, but is not limited to: wages, social security benefits, veteran's benefits, pension and annuities, interest income, and disability benefits. Resource limits are $999.99 or less and couples $2,000 or less. Resources include, but are not limited to: cash on hand, bank accounts, stocks, bonds, mutual funds, life insurance and vehicles. In addition, the Aged and Disabled Waiver allows for greater income and resource limits for persons age 63 or older. It also allows for a Division of Assets which is a way to set aside a certain portion of a married couple's assets to help prevent spousal impoverishment.

Some programs do not have a financial requirement or may charge a small co-payment to receive services. Discuss these options with your case manager or social worker to see what services might be available to you.

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Missouri's Guide to Home and Community Based Services' Quick Links
[ Cover Page | Table of Contents | Introduction | What Are My Options? | How Do I Qualify? | Applying for Services | Appeal Process | What is Consumer Directed Care? | Other Program Available for Non-Medicaid Eligible Individuals | Questions for Nursing Facility Residents or Individuals in an RCF or ICF/MR | Aged and Disabled Waiver | AIDS Waiver | Independent Living Waiver | Lopez Waiver | MR/DD Comprehensive Waiver | MR/DD Community Support Waiver | Physical Disability Waiver | Consumer Directed State Plan Services | DHSS HCY State Plan Services | Other State Agencies to Contact | Agencies and Terminology | Numbers to Know ]