Nursing Home Coverage

Nursing home residents may qualify for MO HealthNet nursing home coverage, also known as “vendor coverage.” A resident covered under this program is expected to use all of his or her available income to pay the nursing home, minus a personal needs allowance of $50 and any health insurance premiums the resident pays. If the resident has a spouse or other dependents living in the community, some of that income can also be allotted to them (see “Prevention of Spousal Impoverishment”). After the resident pays his or her portion of the nursing home costs, the state pays the rest.

The Supplemental Nursing Care (SNC) program is available primarily for residents of licensed residential care facilities (RCF) and assisted living facilities (ALF). The SNC program provides an actual cash payment to the resident of up to $156 per month for RCF residents, and $292 per month for ALF residents. SNC recipients also get a $50 personal needs allowance. Additional payments are technically available for nursing home residents, but the benefits of nursing home coverage, which pays for all of the care the resident cannot afford, usually outweigh those of SNC.

Who Is Eligible?

For nursing home coverage, the person who:

  • is screened for and certified by the Department of Health and Senior Services (DHSS) for nursing facility care or state mental hospital care;
  • has not given away, sold, or transferred real or personal property for less than fair market value in the five years before the date s/he applies, and
  • meets the other eligibility requirements for MO HealthNet for seniors, for the disabled, or for the blind and visually impaired.
  • For coverage while living in a state mental hospital, the resident must be age 65 or older.

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 Supplemental Nursing Care, the person who:

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

Some RCF, ALF or nursing home residents may also be eligible for Medicare Cost Savings Programs.

Nursing Home Information

General Information

Starting & Maintaining Coverage

Authorization Forms

MO HealthNet Nursing Home Transition

Other Helpful Resources for Providers