The state of Missouri is a state in the Midwestern part of the United States. Missouri is the 18th most populated state in America with an estimated 6.1 million people. It has an area of 69,704 square miles and is the 21th largest state in the nation. The state density is 18th in the nation with 87 people per square mile.
With the 20th highest percentage of senior citizens at 15.37%, is the “Show Me State” a good choice for a senior looking to retire?
Costs of Assisted Living in Missouri
The cost for Assisted Living Care in Missouri state averages almost $2,500 per month, (close to $30,500 a year). The costs vary greatly from city to city - for example, Assisted Living in Springfield, Missouri costs $2,100 monthly, while those living in St. Louis pay almost $4,000 per month. The costs also may fluctuate from facility to facility for Missouri seniors with dementia and Alzheimer's.
The U.S. average cost for Assisted Living is $3,293 per month, and Missouri's assisted living is quite a bit less expensive at $2,500. Nursing homes in Missouri are much more expensive than assisted living facilities - with semi-private rooms costing over $51,000 per year, and a private room carrying a cost of over $55,000 annually.
Adult Day Health Care in Missouri averages $1,600 per month or around $19,500 per year. A Home Health Aide in Missouri costs, on average $3,500 a month, over $41,000 annually. This is almost $11,000 more than the cost of an Assisted Living Facility in Missouri. The cost of a Home Health Aide is based on a 44-hour-week, whereas Assisted Living provides 24-hour care. To receive similar care at your own residence you would need 3.8 Home Health Aides per week which would cost around $13,000 every month. Home Health Aides usually do not do housekeeping nor do they come with licensed nurses that you find in Assisted Living Facilities. It is estimated that by the year 2030, Assisted Living in Missouri will cost almost $45,400 per year – an increase of around $15,400.
Within Missouri itself, the costs of Assisted Living Care vary as well, for example, these are the latest approximate costs of a monthly stay in an Assisted Living Facility in Missouri:
- Springfield, Missouri - $2,100;
- St. Joseph, Missouri - $2,300;
- Cape Girardeau, Missouri - $2,320;
- Jefferson City, Missouri - $2,700;
- Joplin, Missouri - $2,940;
- Kansas City, Missouri - $3,000;
- Columbia, Missouri - $3,810;
- St. Louis, Missouri - $3,970.
Who pays for Assisted Living Care in Missouri?
Most often, Missouri Assisted Living care costs are paid for by Missouri Assisted Living Residents or their families. The state of Missouri has quite a few waiver programs for Home and Community Based Services (HBCS) and Long Term Care Facility Services for residents of different categories:
- Aged and Disabled Waiver – this waiver helps Missouri seniors 63 years of age or older who need services without which they would be eligible for nursing home care. Eligibility for this program includes:
- The individual requires nursing level of care;
- 63 years of age or older;
- Has been certified by the Department of Health and Senior Services to receive Home & Community Based (HCB) waiver services;
- Maximum income limit of $1,281 – this amount changes annually;
- Is eligible for MO HealthNet for Seniors (discussed later in the article), MO HealthNet for the Blind and Visually Impaired, or MO HealthNet for People with Disabilities;
- Restricted on transferring property with some exceptions; and
- A married couples’ resources must be less than $1000 after Division of Assets;
- Independent Living Waiver – much like the Consumer-Directed State Plan Personal Care program and requiring the same eligibility, this waiver offers more personal assistance services than the state plan does. These services include, environmental adaptations for easier accessibility, case management, financial management, and specialized medical equipment and supplies;
- Medically Fragile Adult Waiver – this waiver program is for those Missouri residents who have serious medical needs, but are no longer eligible for services under any children or youth programs. A person must be 21 years of age or older and have been assessed that without services they would require placement in an ICF/MR facility. Services included are attendant care, private duty nursing services, and specialized medical supplies;
- AIDS Waiver – available to those who have been diagnosed as having AIDS or HIV-related illness and have been assessed to need nursing home level care without these services. Services included are personal care, private duty nursing, attendant care, as well as supplies such as diapers, gloves, and underpads;
- Adult Day Care Waiver – this waiver offers care for disabled adults between the ages of 18 and 63 who would otherwise require nursing home level care. These services are provided in a licensed adult day care setting and include help with activities of daily living, group activities, food and nutrition services, skilled nursing services as necessary, and transportation to and from the adult day care facility;
- DD Comprehensive Waiver – this waiver is for those with intellectual disabilities or developmental disabilities and who, without these services, require placement in an Intermediate Care Facility for the Intellectually Disabled (ICF/ID).
- Partnership for Hope Waiver – used to prevent or delay institutionalization for those who require minimum services so that individuals can remain in the community. This waiver is available in 94 of the 114 counties in Missouri.
Other waiver programs that are offered by the state but are not targeted to seniors are the DD Community Support Waiver, Autism Waiver, and the Missouri Children with Developmental Disabilities Waiver.
Helpful State Programs for Seniors & Senior Living in Missouri
Missouri has quite a few programs to help seniors, many of these programs are coordinated by the ten Missouri Area Agencies on Aging, which is under the umbrella of the Missouri Aging Information Network. The other agency that Missouri senior citizens need to know is that of the Missouri Ombudsman. There are Ombudsman Offices located throughout the state, but you can contact the state Ombudsman in Jefferson City, Missouri at (800) 309-3282 or LTCOmbudsman@health.mo.gov.
MO HealthNet (Medicaid) for Seniors is the public assistance program that provides healthcare for those Missouri seniors who are 65 years of age or older and meet the following requirements:
- Must be 65 years of age or older;
- Must live in and intend to remain in Missouri;
- Must be a United States citizen or an eligible qualified non-citizen;
- If single, the senior can’t have resources that are worth more than $1,000; or, if married and living with their spouse the resources can’t be greater than $2,000. Note: certain resources are exempt, including the home that the person or their spouse or dependents live in, one automobile, household goods and certain other property;
- The senior's net income can’t be greater than $834 per month and for a couple this amount is $1,129. If the monthly income is greater than this amount, then the person may become eligible when their medical expenses are so great that it makes the monthly income below this amount (this is called “Spend Down.)” Note: this amount changes yearly; and
- The senior can’t be a resident of a public, private, or endowed institution, except for a public medical institution.
Missouri also provides the following services for elderly Missouri residents:
- Home-Delivered Meals – available to those who are eligible. The individual or a family member is interviewed to determine eligibility. In most states, to be eligible to receive meals, you must be unable to prepare meals by yourself;
Legal – legal or protective programs, both physical and emotional – that are available to Missouri State seniors:
- Adult Protective Services – provides services for elderly adults who are physically and/or mentally impaired. If you think someone is being abused or neglected call 1-800-392-0210;
- Missourians Stopping Adult Financial Exploitation (MOSAFE) – a program to educate financial institutions and consumers on how to stop attempted or occurring financial exploitation on Missouri senior citizens. There are videos, brochures, and a slide show to help teach people to recognize and report financial exploitation. If you believe that someone is being exploited financially, know that this is a form of abuse and you can call the Abuse and Neglect Hotline at 1-800-392-0210;
- Missouri Seniors’ Legal Helpline – for Missouri elders aged 60 and over;
- Alzheimer’s Safe Return Program – in a partnership with MedicAlert, a program is available in Missouri that allows a caregiver to call 911 and then MedicAlert if someone with dementia goes missing. Not only will the police be alerted, but a local Alzheimer’s chapter will be as well, to try and located the missing person. There is a cost associated with this as you must purchase a MedicAlert bracelet or necklace;
- Show Me Falls Free MO – slips and falls by aged people are the leading cause of injury deaths for those 65 and older and the rate of injury in the state of Missouri is 31% greater than the national average. Falls are preventable and should not be thought of as a part of the normal aging process. The Show Me Falls Free program is a combination effort by more than 50 organizations to help seniors to prevent falls; and
- Silver Haired Legislature – also called SHL – this is an elected body of people 60 years of age or older that help to promote legislative advocacy for Missouri’s senior citizen population. All members serve on a voluntary basis.
Pros and Cons of Senior Living in Missouri
Here are some things to consider for seniors when choosing whether to retire to Missouri:
- Affordability – Missouri has a low cost of living, the 16th best in the nation;
- Health Care – although the state overall rates poorly in health care, there are places where it is far above average. For example, St. Louis has at least two medical schools and the Barnes-Jewish hospital is known for its quality geriatric health care. The Branson area has three regional hospitals that all rank above average, and Kansas City is considered above average for health care.
There are also six medical schools in Missouri, including the world’s first school of osteopathic medicine in Kirksville, Missouri. Two schools are in St. Louis – St. Louis University School of Medicine and Washington University School of Medicine, and two are in Kansas City – Kansas City University of Medicine and Biosciences and the University of Missouri – Kansas City School of Medicine;
- Missouri is Veteran-Friendly – both federal and state assistance is available to veterans throughout Missouri and those who are active duty can maintain close ties with veterans and veteran retirees. Whiteman Air Force Base has an office that helps retirees and families with benefits for which they are eligible and Fort Leonard Wood offers base housing to service retirees and their families. Missouri also does not tax military pensions;
- Varied geography – although most of us think of St. Louis, Kansas City, or even Branson, Missouri is far more rural than it is urban; and
- Colleges – there are 67 colleges and universities in Missouri – 13 public universities, 39 private four-year universities, and 13 community colleges. The University of Missouri is the state university we think of the most with the University of Missouri in Columbia, University of Missouri-Kansas City in Kansas City, Missouri University of Science and Technology in Rolla, and the University of Missouri in St. Louis. This allows seniors to take classes that you may not have had time for when you were younger, as well as to bring the college atmosphere to your home area.
Financial Information for Seniors
Missouri has a state income tax that covers 11 different brackets and ranges from 0 to 6%. There is a state sales tax of 4.225% and the state does not allow city or local areas to add to that amount.
Property taxes are assessed by the Missouri Tax Commission. Property is based on its usage. For example, residential is assessed at 19% of value, agricultural is 12%, and commercial is 32%. The Missouri Property Tax Credit Claim is a program which gives credit to certain senior citizens and those who are 100% disabled for a percentage of real estate taxes or rent that they have paid during the year.
Missouri does not have an Inheritance Tax, nor does it have an Estate tax.
Missouri is a moderately-friendly state for seniors, due to the following:
- Income from Social Security is partially taxed;
- Withdrawals from retirement accounts are fully taxed;
- Wages are taxed at normal rates, in Missouri the rate is 6.0%;
- Public pension income is partially taxed; and
- Private pensions are fully taxed.
Missouri is a low-price state. For example, what you could purchase for $100 in Missouri is what you would expect to spend $111.86 on in another state. The cost of living is lower in Missouri overall than it is in other states in every category with housing being the biggest difference. Out of 100 points, Missouri came in with a cost of living of 89.60. Missouri rated lower in grocery (97.2), transportation (97), overall (90), health (96), miscellaneous (98), housing (73); but higher in utilities (102).
Places of Interest for Seniors Living in Missouri
There are many things that might be of interest for senior citizens in Missouri State. Some of the more interesting things that seniors, and those who visit them, may enjoy in Missouri include:
- National World War I Museum and Memorial – located in Kansas City, Missouri;
- St. Louis Zoo – located in St. Louis, Missouri;
- Missouri Botanical Garden – located in St. Louis, Missouri;
- Gateway Arch – located in St. Louis, Missouri;
- National Tiger Sanctuary – located in Chestnutridge, Missouri.
- The Magic House – located in St. Louis, Missouri;
- The Butterfly Palace – located in Branson, Missouri;
- Harry S. Truman Library and Museum – located in Independence, Missouri;
- Jesse James Birthplace Museum – located in Kearney, Missouri; and
- Big Joel’s Safari – located in Wright City, Missouri.
Some cities to consider for Missouri Senior Living:
As everyone has different preferences for what they want in a retirement location, we have picked a total of 10 best places for senior living in Missouri. Five of these picks are more urban and five are more rural.
- Oakland, Missouri – located in St. Louis County, Missouri. It is a small community so there may not be many activities within Oakland itself; however, it is in St. Louis County so you would be close to the attractions St. Louis, Missouri offers. The population is less than 1,500 with 32.1% over the age of 65. Last year, Oakland rated #1 out of 196 “Best Places to Retire in Missouri,” #4 out of 196 of “Best Places to Buy a House in Missouri,” and #38 out of 118 of the “Safest Suburbs in St. Louis Metro;”
- Memphis, Missouri – located in Scotland County, Missouri. Scotland County, Missouri has an interesting history, with Carthage, the county seat, the site of the first official engagement of the Civil War. Additionally, Joplin, Missouri is in Scotland, County. The population is around 2,000 people with 23.3% seniors over the age of 65;
- Pleasant Valley, Missouri – located in Clay County, Missouri. Clay County, was settled by migrants from Kentucky, Tennessee, and Virginia who brought slaves with them and began to grow crops like hemp and tobacco. This led to the area being known as “Little Dixie.” The population is around 3,100 with 11.4% of the population being seniors over the age of 65. Last year, Pleasant Valley rated #2 out of 196 of the “Best Places to Retire in Missouri,” #16 out of 73 of the “Best Suburbs to Buy a House in Kansas City Metro,” and #14 out of 51 of the “Safest Suburbs in Kansas City Metro;”
- Albany, Missouri – located in Gentry County, Missouri. There is a lot of history in this country and a few structures are listed on the National Register of Historic Places in Albany, including the Gentry County Courthouse and the Albany Carnegie Public Library. The population is around 1,700, 25.6% of which are over the age of 65;
- Higginsville, Missouri – located in Lafayette County, Missouri. This small town was the former site of the Missouri Confederate Soldiers’ Home and, after the final Confederate Veteran died, the 135-acres was turned into a Confederate Memorial Cemetery and is listed on the National Register of Historic Places. The population is less than 5,000 with 20.2% senior citizens over the age of 65. Last year, Higginsville ranked #5 out of 196 of the “Best Places to Retire in Missouri,” #5 out of 162 of the “Safest Places to Live in Missouri,” #5 out of 110 of the “Safest Suburbs in Missouri,” and #30 of 73 of the “Best Suburbs to Buy a House in Kansas City Metro;”
- Lancaster, Missouri – located in, and the county seat of, Schuyler County, Missouri. This small town is the home to the William P. Hall House, which was the home of William Preston Hall, an American showman and a circus businessman. The home is now on the National Register of Historic Places. The population is less than 1,000 people of which 20.2% are over the age of 65. Lancaster is part of the Kirksville Micropolitan Statistical Area;
- Chesterfield, Missouri – located in St. Louis County, Missouri. Chesterfield is a Western suburb of St. Louis. There are quite a few private schools in this town, such as Barat Academy, Chesterfield Day School, Ascension School and others. The Logan College of Chiropractic is also in Chesterfield and offers many different courses. The population is a little less than 50,000 with 20% of the population who are senior citizens 65 years of age or older. Last year, Chesterfield ranked #6 out of 196 of the “Best Places to Retire in Missouri,” #8 out of 196 of the “Healthiest Places to Live in Missouri,” #9 out of 196 of the “Best Places to Live in Missouri,” and #9 of 162 of the “Best Suburbs to Live in St. Louis Metro;”
- Osceola, Missouri – located in, and the county seat of, St. Clair County, Missouri. The town is on the Osage River, and in 1861 the town was burned and the courthouse looted. This incident later became the movie “The Outlaw Josey Wales” in 1978, starring Clint Eastwood. The population of Osceola is estimated to be right around 1,000 people with approximately 20% of whom are 65 years of age of older;
- Nevada, Missouri – located in, and the county seat of Vernon County, Missouri. Nevada, Missouri is home to “Cottey College” which is an independent college for women specializing in liberal arts and sciences. Cottey College is the only nonsectarian college in America which is both owned by and supported by women. The population was estimated to be around 8,100 a few years ago, of which an estimated 18% were over the age of 65. Last year, Nevada ranked #12 of 196 of the “Best Places to Retire in Missouri,” and #99 of 196 of the “Most Diverse Places to Live in Missouri;” and
- Brookfield, Missouri – located in Linn County, Missouri. The town on Brookfield holds the “Great Pershing Balloon Derby” on Labor Day weekend. Marceline is known to Disney fans because Walt Disney spent time in the town in his younger years. The population of Brookfield is estimated to be around 4,400, with an estimated 25% who are seniors 65 years of age or older.