Missouri Medicaid Income Limits 2026: Eligibility & Assets

Missouri Medicaid income limits come with a twist: the asset limit isn't the $2,000 federal SSI standard. Missouri lets a single applicant keep $6,220.50 in countable assets and still qualify, more than three times the $2,000 SSI resource limit.1,2 Missouri sets its own resource standard, and it raised that standard on July 1, 2026. And if your income runs over the line, Missouri doesn't lock you out, it lets you spend down the difference.1,3

First, a fork in the road. Missouri runs two different income tests under the program it calls MO HealthNet, and the $6,220.50 asset limit belongs to only one of them. If you are 65 or older, blind, or disabled, or you are pricing nursing-home care, you are on the aged, blind, and disabled track, and that is the track this guide covers in depth: the asset limit, how the spend-down works, what a nursing-home resident keeps, what an at-home spouse is protected from, the five-year look-back, and how to apply through the Family Support Division.1,4 Everyone else, including adults under 65, parents and caretaker relatives, pregnant women, and children, is measured on a different test entirely, with no asset limit at all. The next section sorts out which one is yours.5

Which Missouri Medicaid income limits apply to you?

Missouri applies two separate income tests, and working from the wrong one gives you the wrong answer.

• The SSI-related aged, blind, and disabled (ABD) test. This is the test for people 65 or older, blind, or disabled, and the one behind nursing-home and other long-term care. It carries the $6,220.50 asset limit above, but its income side depends on the care: the spend-down income limit is $1,131/month for one person, with spend-down above it; nursing-home care has no monthly income limit; in-home care has a $1,737/month limit. The rest of this guide is about this test.1,3
• The MAGI test. Modified adjusted gross income (MAGI) governs everyone else: adults under 65 who are not enrolled in Medicare, parents and caretaker relatives, pregnant women, and children. It is set as a percentage of the federal poverty level, and federal law bars Missouri from applying any asset test to these groups.5

If you are under 65 and not on Medicare, or you are applying for a parent, a pregnancy or a child, the MAGI numbers below are the ones that apply.5,7

Missouri's MAGI income limits in 2026

The Family Support Division publishes its Benefit Program Income Limits chart with most programs' ceilings stated as a percent of the federal poverty level. As of April 1, 2026:6

Two figures on that chart are quoted two different ways elsewhere. The expansion adult group is written into federal law at 133% FPL, but federal rules subtract an amount equal to 5 percentage points of the poverty level when testing eligibility for the highest-income MAGI group, so the effective ceiling for expansion adults is 138% FPL.7 Missouri's chart lists a single combined children ages 1 to 18 category at 148% FPL, while the medicaid.gov national table shows 150% for the same children. That national table is a December 2023 snapshot, so go by the state's current chart.6

Parents and caretaker relatives: the pathway a grandparent would look to

If a grandparent is raising a grandchild and needs coverage in their own right, MO HealthNet for Families is the group they would look to. Whether a particular relative meets Missouri's definition of a caretaker relative is a determination the Family Support Division makes, so ask them rather than assume.

The income standard for this group is the strictest on the chart, and the reason is federal. Parents and caretaker relatives are a federally mandatory Medicaid group, but unlike children (whom states must cover to at least 133% FPL) and the expansion adult group (138% FPL effective), their mandatory coverage is pegged to the state's own old cash-welfare (AFDC) income standard rather than to a percentage of the poverty level. Federal rules set the floor at the state's May 1, 1988 AFDC standard, converted to a MAGI equivalent, and let a state set its standard higher, up to a federal ceiling.10,11 Missouri's standard is low. Its chart sets MO HealthNet for Families as a dollar figure, a legacy standard of roughly 15% FPL.6

In a state without the ACA expansion, that standard alone would decide whether a working parent qualifies.10 Missouri adopted the expansion, so it mostly does not bite: a parent or caretaker relative whose income is above the MO HealthNet for Families standard may qualify through the expansion adult group instead, up to about 138% FPL.6 One condition comes with that route: a parent or caretaker relative living with a child under 19 can be covered in the expansion group only if the child has coverage of their own, through Medicaid, CHIP or other minimum essential coverage, so expect to be asked about it.7 The exception is the person this publication exists for, and it is covered next.

No asset test applies on the MAGI side

Federal law bars a state from applying any asset or resource test to the MAGI groups. The statute expressly excepts the SSI-related ABD and long-term-care pathways from that rule, which is exactly why they do apply one.5 So Missouri's $6,220.50 countable-asset limit, the centerpiece of this guide, does not touch an expansion adult, a parent or caretaker relative, a pregnant applicant, or a child. Savings are irrelevant to those cases.1,5

The 65th birthday can end coverage without any change in income

Because Missouri adopted the expansion, the cliff applies here in full force. The expansion adult group is written for people under 65 who are not pregnant and not enrolled in Medicare, at 138% FPL effective, with no asset test.7,5 For one person in 2026 that ceiling is about $1,835/month: 138% of the $15,960/year federal poverty guideline for one person in the 48 contiguous states and DC (Alaska and Hawaii have their own guidelines).8,7

On the 65th birthday that pathway closes, and the same person is assessed on the SSI-related ABD track instead. Two things change at once:

• The income yardstick drops. It becomes Missouri's aged, blind, and disabled income standard, $1,131/month for an individual (effective April 1, 2026), rather than 138% of the poverty level.1
• An asset test appears where none could legally exist the day before: in Missouri, $6,220.50 for a single applicant.1,5

The gap between those two yardsticks is where families get caught. A 64-year-old whose income clears the $1,131 Missouri standard but stays under the $1,835 expansion ceiling is covered today and over the income standard on their birthday, without a dollar of income changing, and savings that were legally irrelevant the day before are now counted.1,7,5

Missouri cushions this in two ways. Its resource limit is more than three times the $2,000 federal SSI limit.2 And because Missouri's aged, blind, and disabled coverage uses a spend-down, being over the income standard does not lock the person out: medical bills the person incurs can bring countable income down to the standard. That is the subject of the next two sections.1,3 A 65th birthday still changes the math, and it is worth planning for before it arrives.

The $6,220.50 asset limit is the Missouri story

The federal SSI program caps countable resources at $2,000 for an individual.2 Missouri sits in a different place. The Missouri Department of Social Services sets its own resource standard for aged, blind, and disabled coverage, and effective July 1, 2026 that standard rose to $6,220.50 for a single applicant, up from the $6,068.80 limit that applied before. The state's chart also prints a $12,441.00 limit for two people under spend-down coverage, but not on its nursing-home or in-home rows: those print a single $6,220.50 limit applied after the spousal division of assets, so a married long-term-care applicant should not read $12,441.00 as the couple's limit.1

A couple of details people get wrong:

The limit isn't a flat $2,000 you'll see quoted in national guides. Missouri's number is more than three times that for one person, and it moves: the state raised it this July. Anyone who assumes they have to drain accounts to $2,000 before applying is working from the wrong figure.1

What counts matters as much as the number. Missouri's list of exempt assets sits in manual sections the state does not publish openly, so ask your Family Support Division office for it before you spend anything down.1,4 Two anchors are public. Missouri's eligibility chart sets a maximum home equity of $752,000 for nursing-home, in-home, or PACE coverage.1 And for SSI, Social Security does not count the home you live in, one vehicle used for transportation, or household goods and personal effects; confirm with the Family Support Division whether Missouri treats each the same way.2

How Missouri Medicaid income limits work for seniors: spend-down

For aged and disabled MO HealthNet coverage, Missouri sets a 2026 spend-down income limit of $1,131/month for one person and $1,533/month for two (effective April 1, 2026).1

Here's the part that trips people up. Being over that number does not disqualify you. Missouri's aged, blind, and disabled coverage uses a spend-down, sometimes called the medically needy model: an applicant whose income is over the limit can still qualify for Medicaid in a month by incurring medical bills that bring countable income down to the standard. Ask the Family Support Division which bills count and how your spend-down period is measured.3

Nursing-home care works differently again. For a nursing-facility resident, Missouri's eligibility chart sets no monthly income limit at all: the resident contributes income above the allowances toward the cost of care, so high income alone does not shut someone out of nursing-home MO HealthNet. In-home care is not the same. For home and community-based services, the same chart sets a monthly income limit of $1,737 for the applicant, not counting a spouse, effective January 1, 2026, so the no-income-limit rule for nursing homes does not carry over to care at home.1

Long-term care: what a nursing-home resident keeps

When MO HealthNet pays for nursing-facility care, the resident's income is paid to the facility, but not all of it. First comes the Personal Needs Allowance (PNA), money set aside for the resident's own small expenses such as clothing, a haircut, or a phone. In Missouri the PNA is $50/month, above the federal floor of $30.1,5 Missouri also deducts medical insurance premiums, allotments, and child support before the rest goes to the facility, so don't estimate a parent's monthly share as income minus $50.1

The same $6,220.50 asset limit applies to nursing-home applicants, after the spousal division of assets for a married applicant.1 And because Missouri sets no monthly income limit for nursing-home care, even a resident with substantial monthly income can qualify; they simply contribute more of it toward care.1 For the national picture on how the PNA works and what it does and doesn't cover, see our explainer on the Medicaid personal needs allowance.

The five-year look-back

Federal Medicaid law sets a 60-month look-back for long-term-care coverage, counted back from the date of the application, not from the date of the transfer.12 Giving away money or property for less than fair market value during that window, gifting a grandchild a down payment or signing a house over to a child for a dollar, can trigger a penalty period during which Medicaid won't pay for long-term-care services, even though you're otherwise eligible.

There are legitimate exceptions (transfers between spouses, transfers to a blind or permanently and totally disabled child, certain caregiver-child home transfers) and legitimate planning approaches, but anything done inside the five-year window deserves an elder-law attorney's review first.13 If long-term care is on the horizon for someone in your family, talk to a professional before moving assets. For the broader toolkit, see our guide to Medicaid planning strategies.

Protecting the spouse who stays home

When one spouse needs long-term care and the other remains at home, federal spousal-impoverishment rules keep the at-home spouse from being left destitute. Missouri applies the federal figures for 2026:1,9

So a married couple is in a very different position from a single applicant. The community spouse can hold up to $162,660 in countable assets (more only through a fair hearing or court order), and she keeps all of her own income while the other spouse receives Medicaid-funded care.9 Income is shifted from the applicant only to lift her to her maintenance floor: $2,705.00 a month, plus an allowance for high shelter costs, up to the federal maximum of $4,066.50.9,1 That maximum isn't absolute. A fair hearing can set the allowance higher if either spouse shows exceptional circumstances causing significant financial duress, and a court order for her support sets a floor of its own.9,1

After death: estate recovery

Like every state, Missouri runs a Medicaid estate-recovery program. It applies to certain participants who were 55 or older when they received MO HealthNet benefits or nursing-home (vendor) coverage; when such a participant dies and no exemption applies, the state seeks repayment from the estate through probate court.1 Under federal law, recovery is allowed only after any surviving spouse has died, and only when no surviving child is under 21, blind, or permanently and totally disabled. Each state must also have an undue-hardship waiver procedure.13 For how estate recovery works and where families have room to plan, see our Medicaid estate recovery explainer.

How to apply in Missouri

Missouri Medicaid is run by the Missouri Department of Social Services (DSS), and its Family Support Division takes applications for aged, blind, and disabled coverage.4 Application routes change, so confirm the current one with the Family Support Division before you file:

If the goal is care at home rather than in a nursing home, the Division of Senior and Disability Services also assesses whether the person meets a nursing facility level of care.15 Apply even if you think you're over the limit. Between the $6,220.50 asset rule and the spend-down pathway, someone who assumes they're disqualified may not be.1,3

Learn More

Find personalized help working through Missouri Medicaid eligibility for your family at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.