Missouri Medicaid Income Limits 2026

Missouri's Medicaid program (MO HealthNet) doesn't work the way most families expect. Because Missouri is a Section 209(b) state, it sets its own eligibility thresholds rather than following the federal defaults — and the limits are different depending on which program your parent applies for.

Here are the current numbers as of July 1, 2026.

Income Limits by Program

MO HealthNet for the Aged, Blind, and Disabled (MHABD):

• Individual: $1,131/month
• Married couple (both applying): $1,533/month

Aged and Disabled Waiver (ADW):

• Individual: $1,737/month
• The non-applicant spouse's income is disregarded entirely

Structured Family Caregiving Waiver (SFCW):

• Individual: $1,131/month

Asset Limits

Single applicant: $6,220.50 in countable assets (updated July 1, 2026, up from $6,068.80)

Married couple (both applying): $12,441

What Counts as an Asset

Countable assets include bank accounts, stocks, bonds, certificates of deposit, non-primary real estate, and cash surrender value of life insurance policies exceeding $1,500 face value.

What Doesn't Count

Missouri exempts several categories from the asset calculation:

• Primary residence (as long as the applicant intends to return or a spouse still lives there)
• One vehicle
• Pre-need funeral trust (up to $9,999)
• Household furnishings and personal effects
• Burial plots and spaces

The Medically Needy Spend-Down

What sets Missouri apart from income-cap states: exceeding the income limit doesn't disqualify your parent. Instead, FSD calculates the difference between their income and the applicable limit — that difference is the monthly "spend-down" amount, essentially a deductible.

For example, if your parent receives $1,431/month in Social Security and the baseline limit is $1,131, their spend-down is $300/month. They meet this obligation through one of two methods:

Pay-In: Pay the $300 directly to MO HealthNet via the mymohealthportal.com portal, by check, or through automatic monthly bank draft. This secures full Medicaid coverage for the entire calendar month.

Incurred medical bills: Submit proof of medical expenses — doctor bills, prescriptions, dental care — using Form IM-29SDP. Coverage activates only on the day in the month when the spend-down threshold is reached, not retroactively to the first.

Income Deductions That Lower Your Spend-Down

FSD applies several deductions before calculating the spend-down amount:

• $20 personal income exemption
• First $65 of earned income
• Half of any remaining earned income
• All SSI payments
• Monthly health insurance premiums

Why Missouri Doesn't Need Miller Trusts

In income-cap states, seniors whose income exceeds 300% of the Federal Benefit Rate must deposit excess income into a Qualified Income Trust (Miller Trust) to qualify for Medicaid waivers. Missouri doesn't require this because it uses the spend-down framework instead. Any excess income is handled through the monthly deductible, not through a trust structure.

If an attorney or planner suggests your parent needs a Miller Trust in Missouri, that's a red flag — they may be applying rules from a different state.

Community Spouse Protections

When only one spouse applies for waiver or nursing home Medicaid, the community spouse can retain:

• Up to $162,660 in countable assets (Community Spouse Resource Allowance)
• At least $32,532 if their half of joint assets falls below this floor
• Monthly income transfer of up to $4,066.50 from the applicant's income if the community spouse's own income falls below $2,705/month

The Missouri Home Care Guide includes the full eligibility checklist, spend-down calculator worksheet, and community spouse asset protection strategies.

See more Missouri guides →