How to apply for Home & Community Based Services (Nursing-Home-Level Care at Home) in Missouri

Who it's for

Missouri's HCB waiver lets people 63 and older who need nursing-facility-level care get that care at home instead — personal care, home-delivered meals, respite, home modifications, adult day care, and transportation for essential activities. For 2026, the eligible person's monthly income must be $1,737 or less, with resources of $6,220.50 or less (after Division of Assets for married couples). A DHSS in-home assessment establishes the level-of-care need. Start with a referral at 1-866-835-3505 or the online referral form.

What you'll need

• Referral by phone or the online DHSS referral form
• In-home assessment by the Division of Senior and Disability Services (respond within 10 days)
• MO HealthNet enrollment

Where to apply

What to say when you call

"Hello, I'm calling to ask about Home & Community Based Services (Nursing-Home-Level Care at Home). I'd like to know whether I may qualify, what documents I need, and whether I can apply online, by mail, by phone, or in person. I understand I may need referral by phone or the online DHSS referral form, in-home assessment by the Division of Senior and Disability Services (respond within 10 days), mO HealthNet enrollment — is anything else required? What is the best next step?"

Tip: have a pen ready, ask for the person's name, and write down any case or reference number they give you.

Step by step

1. Call 1-866-835-3505 or complete the online DHSS referral form to start your application for Home and Community Based Services.
2. Respond to the Division of Senior and Disability Services within 10 days to schedule your in-home assessment. This visit determines whether you meet the nursing-facility level of care requirement.
3. Complete the in-home assessment with the DHSS assessor. Be ready to describe your daily care needs, health conditions, and living situation.
4. Gather financial documents that show your monthly income and resources. For 2026, the income limit is $1,737 per month and the resource limit is $6,220.50 or less. Married couples will go through a Division of Assets process.
5. Enroll in MO HealthNet as part of the financial eligibility review. The agency will guide you through this step after your assessment.
6. Respond promptly to any requests from DHSS or MO HealthNet for additional information to keep your application moving forward.

What to expect: After submitting your referral and completing the in-home assessment, DHSS and MO HealthNet will review both your care needs and your financial eligibility. Processing times vary, so ask the agency for an estimate when you call. If approved, you can receive services such as personal care, home-delivered meals, respite, home modifications, adult day care, and transportation for essential activities — all provided at home instead of in a nursing facility. Keep in mind that services are capped by a cost maximum tied to nursing-home costs, so the specific services available to you may vary. Enrollment is reviewed annually, so you will need to complete a renewal each year to continue receiving benefits.

Renewals

annual