The Missouri Supplemental Nursing Care (SNC) Program is a vital initiative designed to provide monthly financial assistance to elderly individuals and adults with disabilities residing in licensed assisted living facilities (ALFs), residential care facilities I (RCFs), and residential care facilities II. This program is specifically structured to help alleviate the costs associated with living in these supportive environments. The amount of financial aid offered through the SNC Program is determined by the type of facility in which the individual resides. Notably, those living in assisted living facilities are eligible for nearly double the cash assistance compared to those in residential care facilities. Beyond the monthly cash benefit, program participants also receive a small Personal Needs Allowance each month, and their healthcare requirements are addressed through Missouri Medicaid.
The SNC program operates as an entitlement program. This means there is no limit imposed by the state on the number of individuals who can receive assistance, ensuring that all eligible applicants can benefit. However, it is important to note that availability of beds in specific residential care facilities or assisted living facilities can lead to facility-based waitlists.
It’s crucial to understand that the Missouri Supplemental Nursing Care Program is an integral part of Missouri Medicaid, known as MO HealthNet. Specifically, it falls under the umbrella of MO HealthNet for the Aged, Blind, and Disabled (MHABD), the Medicaid program dedicated to supporting elderly and disabled individuals.
While the Supplemental Nursing Care (SNC) Program does offer financial support, up to $390 per month, for nursing home care in non-Medicaid certified facilities, it’s generally more advantageous to consider Medicaid-funded nursing home care. This is because Medicaid can cover up to 100% of the costs for eligible individuals in certified nursing homes, whereas SNC covers only a portion. Therefore, this article will primarily focus on the Supplemental Nursing Care Program as it relates to assisted living and residential care facilities, rather than nursing homes.
Understanding the Benefits of the Supplemental Nursing Care Program
In 2025, the Supplemental Nursing Care (SNC) Program delivers essential financial support to those who qualify. Individuals living in residential care facility I can receive up to $156 per month, while those in residential care facility II or an assisted living facility may receive up to $292 per month. In addition to this direct financial aid, each participant is granted a $50 Personal Needs Allowance monthly. It’s important to understand that these payments are made directly to the program participant, empowering them to manage their funds, rather than being paid directly to the facility. Furthermore, SNC program participants gain eligibility for comprehensive medical care services through Medicaid / MO HealthNet. This includes crucial services such as hospitalization, laboratory work, x-rays, and consultations with physicians.
Who is Eligible for the Supplemental Nursing Care Program?
To be eligible for Missouri’s Supplemental Nursing Care (SNC) Program, applicants must be Missouri residents aged 21 years or older and must reside in a state-licensed residential care facility or assisted living facility. Beyond these basic criteria, there are specific financial and medical requirements that must be met to qualify for the SNC program.
Financial Eligibility Criteria: Income, Assets, and Homeownership
Income Requirements: The SNC program does not set a strict income limit. Instead, the key income criterion is that an applicant’s monthly income must be less than the total monthly cost of residing in their chosen assisted living facility or residential care facility. For married applicants, only the income of the applicant is considered. The income of a non-applicant spouse is not factored into the eligibility determination.
It is important to note that unlike some other Home and Community Based Services Medicaid programs, the Missouri Supplemental Nursing Care Program does not allow a non-applicant spouse to retain a greater share of a couple’s combined income or assets. In contrast, programs like Missouri’s Aged and Disabled Waiver and Nursing Home Medicaid offer provisions such as a Monthly Maintenance Needs Allowance and a Community Spouse Resource Allowance to protect the financial security of the non-applicant spouse.
Asset Limits: In 2025, the asset limit for a single applicant is set at $5,909.25. For married couples, regardless of whether one or both spouses are applying, the combined asset limit is $11,818.45. It is crucial to understand what counts towards these asset limits.
However, certain assets are considered exempt and are not counted towards Medicaid’s asset limit. These typically include an applicant’s primary residence, standard household furnishings and appliances, personal belongings, and a single vehicle.
While many Medicaid programs, particularly Nursing Home Medicaid and home and community-based services via Medicaid Waivers, employ a 60-month Look-Back Rule to review past asset transfers, this rule is not applicable to the Supplemental Nursing Care Program.
If you are unsure whether your assets might exceed Medicaid’s countable limits, and you wish to estimate the potential excess, you can utilize a Medicaid Spend Down Calculator. This tool can help you assess your financial situation in relation to Medicaid eligibility.
Home Ownership Considerations: For many Medicaid applicants, their home represents their most valuable asset, leading to concerns about potential loss. For SNC eligibility, Medicaid provides certain protections for the home, deeming it exempt (non-countable) under specific conditions:
- If the applicant currently lives in the home or has a documented “Intent to Return” to the home, and in 2025, their home equity interest is $730,000 or less. Home equity is defined as the current market value of the home minus any outstanding mortgage balance. Equity interest is the applicant’s ownership portion of the home’s equity value.
- If the applicant has a spouse who continues to reside in the home.
- If the applicant has a child who is under 21 years old and lives in the home.
- If the applicant has an adult child (aged 21 or older) who is certified as blind or disabled (permanently and totally) and resides in the home.
For a more detailed understanding of the circumstances under which Medicaid might potentially claim a home, further information is available on Medicaid and Home Ownership.
Medical Eligibility: Functional Needs Assessment
While many long-term care Medicaid programs necessitate a formal Nursing Facility Level of Care (NFLOC) determination, the Supplemental Nursing Care Program has a different requirement. Applicants for SNC who reside in assisted living facilities and residential care facilities only need to demonstrate a need for assistance with Activities of Daily Living (ADLs). ADLs encompass essential self-care tasks like bathing, dressing, eating, toileting, and mobility. This functional need assessment is conducted using an Initial Assessment – Social and Medical form. Importantly, for individuals with conditions like Alzheimer’s disease or related dementias, cognitive and behavioral issues, such as disorientation and wandering, are also taken into consideration during the assessment. However, a dementia diagnosis alone does not automatically guarantee fulfillment of the functional need requirement.
For a broader perspective on long-term care Medicaid options within Missouri, you can explore additional resources on Medicaid Eligibility in Missouri.
Qualifying for SNC When You Are Over the Financial Limits
It is important to know that exceeding MO HealthNet’s / Medicaid’s income and/or asset limits does not automatically disqualify an individual from receiving Medicaid benefits. Various strategic planning methods are available to assist individuals who might otherwise be ineligible to meet the necessary criteria for Medicaid qualification. Some of these strategies are relatively straightforward to implement, while others are more intricate. Below are some of the most frequently utilized strategies.
While MO HealthNet features a Spenddown Program that allows Medicaid applicants to use “excess” income on medical expenses to meet income limits, this specific pathway is not permitted for qualifying for the Supplemental Nursing Care Program.
For individuals with assets exceeding the allowable limits, Irrevocable Funeral Trusts (IFTs) present a viable option. These are pre-funded trusts designated for funeral and burial expenses, and Medicaid does not count them as countable assets. Another common strategy is to “spend down” excess assets on items that are classified as exempt from Medicaid’s asset limits. Examples of exempt asset expenditures include home renovations or additions, home safety modifications, the purchase of home furnishings, and personal items like clothing. Numerous additional options exist for individuals whose assets surpass the Medicaid limit.
Inadequate planning or improper implementation of Medicaid planning strategies can lead to application denials or delays in receiving MO HealthNet benefits. Professional Medicaid Planners possess specialized knowledge of Missouri’s Medicaid planning strategies. They can provide expert guidance on navigating financial eligibility criteria without compromising Medicaid eligibility. Furthermore, while the 60-month Look-Back Rule does not apply to the Supplemental Nursing Care Program, it is relevant to Nursing Home Medicaid and other long-term care Medicaid programs. If future application to one of these programs is possible, it is crucial to avoid violating the Look-Back Rule. Ideally, Medicaid planning strategies should be implemented with careful consideration and well in advance of needing long-term care services. However, workarounds are sometimes available, and Medicaid Planners are knowledgeable in these areas. Therefore, consulting a Medicaid Planner is highly recommended for assistance in qualifying for Medicaid when income and/or assets exceed the established limits. Resources for finding a Certified Medicaid Planner are available here.
How to Apply for the MO HealthNet Supplemental Nursing Care Program
Steps to Take Before You Apply
Before submitting an application for the Supplemental Nursing Care (SNC) Program, it is essential to confirm that you meet the program’s eligibility requirements. Applying while exceeding income and/or asset limits will result in application denial. The American Council on Aging offers a Medicaid Eligibility Test as a helpful tool to assess potential Medicaid eligibility.
As part of the application preparation, gathering necessary documentation is crucial. Examples of required documents include copies of Social Security cards, Medicare cards, life insurance policies, property deeds, pre-need burial contracts, recent bank statements, and income verification. A common cause of application delays is missing or untimely submission of required documentation.
The Application Process
To apply for the Supplemental Nursing Care Program, individuals must first be eligible for MO HealthNet. Applications can be submitted online through the myDSS portal, via phone by contacting the Family Support Division (FSD) at 1-855-373-4636, or in person at a local family support office / resource center. When completing the application, it is important to check the box indicating residency in a nursing home or similar facility.
Individuals already enrolled in MO HealthNet should complete the “Addendum to MO HealthNet Application: Request for Optional Cash Benefits.” This form, designated as form number IM-1MAC, can be accessed here by searching for “IM-1MAC.” When filling out this form, be sure to check the Supplemental Nursing Care box.
Further details about the Supplemental Nursing Care Program are available here. You can also contact the FSD at 1-855-373-4636 for information and assistance.
The Family Support Division (FSD), operating within the Missouri Department of Health and Senior Services (DHSS), is responsible for administering the MO Supplemental Nursing Care Program.
Understanding the Approval Process and Timeline
The complete Medicaid / MO HealthNet application process, from initiation to receipt of an approval or denial determination letter, can take up to 3 months or potentially longer. Initially, applicants typically require several weeks to finalize the application and compile all necessary supporting documentation. Incomplete applications or missing documentation will lead to processing delays. While federal law mandates Medicaid offices to review and either approve or deny applications within 45 days (or up to 90 days for disability-based applications), delays beyond these timeframes can still occur.
