Finding the right support for yourself or a loved one who needs additional care can be overwhelming. And in the search for the correct services, you may have heard about “Medicaid waivers” from doctors, schools, service coordinators, or other families, but may not fully understand why everyone recommends them or how they fit into your situation
Most Medicaid waiver programs assess both medical and functional needs of people with disabilities and older adults, making sure the right services match each person’s support requirements. Instead of forcing people with needs into nursing homes or care facilities, these waivers give in-home care, community support, and services that help people stay independent.
When you understand how Missouri Medicaid waiver programs work, the path forward becomes less overwhelming. Follow this guide to access the everyday support you need for you or your family.
Your MO Medicaid Waiver Guide
Medicaid is a joint federal and state program that provides health coverage and extra support for people who need long-term care. It goes beyond standard health care by providing additional support for people who need long-term care through Home and Community-based Services (HCBS) waivers.
Structured Family Caregiving Waiver (SFC)
The Structured Family Caregiving waiver helps adults in Missouri with Alzheimer’s or related dementias. With SFC, a family member or trusted caregiver living with the person can become a paid caregiver, providing daily support and care.
The caregiver is employed through a provider agency and receives a stipend for the daily support they provide. The focus is on home and community-based services (HCBS) instead of moving the person into a nursing facility.
SFC Eligibility
To qualify for SFC, you must
- Be 21 or older.
- Have an official diagnosis for Alzheimer’s disease or related disorder.
- Live in the same household as your caregiver.
- Meet the “Nursing Facility Level of Care” requirement.
- Be enrolled in Missouri Medicaid (MO HealthNet) and have the correct eligibility code.
- Have income up to approximately $1,109 per month and assets up to $6,068.80 for a single applicant (2025).
- Not be enrolled in any other Missouri HCBS waiver service while using SFC.
MO Partnership for Hope Waiver (PFH)
The Partnership for Hope Waiver (PFH) helps both children and adults in Missouri who need help with everyday activities. Through PFH, you can receive help with tasks like personal care, therapies, and transportation.
As part of this waiver, you get home modifications, equipment, and day programs to help learn skills and stay involved in society. Additionally, they provide crisis support for challenging behaviors, including Applied Behavior Analysis (ABA) when needed. PFH helps people who need regular assistance at home or in the community, with extra help available during emergencies or high-need situations.
PFH Eligibility
- Be enrolled in Missouri Medicaid (MO HealthNet).
- Meet the Division of Developmental Disabilities (DD) criteria.
- Meet the (ICF/ID) level of Care standards.
- Live in a county that participates in the PFH program.
- Meet the crisis criteria (risk of harm), like having needs beyond what a primary caregiver can handle.
MO Developmental Disability Comprehensive Waiver
The DD Comprehensive Waiver is one of Missouri’s most flexible programs for people with the most complex support needs. Unlike other waivers that provide only a few services, it offers all-around support from daily personal care, therapies, skill-building programs, supported employment, and even more
This is flexible because the program has no fixed annual cap, and it allows different living arrangements, whether it means staying at home with family or moving into a group home.
The Missouri Developmental Disability Comprehensive Waiver is part of the Missouri DD waivers and supports people with an IDD diagnosis, Intellectual and Developmental Disability (IDD) condition, which affects thinking, learning, movements, and social skills. Examples include autism spectrum disorder, Down Syndrome, and cerebral palsy.
DD Eligibility
- Have a confirmed IDD diagnosis.
- Should be enrolled in Missouri Medicaid (MO HealthNet).
- Require an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID) level of care,
- which means they need daily care, medical supervision, or specialized services.
- Have needs that cannot be fully met by other Missouri DD waivers.
Community Support Waiver
The Community Support Waiver is designed for people who live with family or on their own but still need some extra help. You can get help in learning new skills or going to appointments. This is perfect if you don’t need 24/7 care but want some support and live independently.
Eligibility
- Meet the Intellectual or Developmental Disability (IDD) standard.
- Can live with family, independently, or in a community setting.
- Be enrolled in Missouri Medicaid (MO HealthNet).
- Must live in a county that participates in the Community Support Waiver Program.
- Does not need constant care but needs help from time to time.
Missouri Children with Developmental Disabilities Waiver
The MOCDD Waiver, a part of the MO Medicaid waiver programs for disabled kids, gives children under 18 with developmental disabilities the chance to get the help they need. It covers things like speech therapy, skill-building activities, ABA analysis, and respite care.
Built just for kids, starting support early helps them master daily skills and make progress that continues as they grow.
MOCDD Eligibility
- The child must be under 18.
- Have a developmental disability that meets the level of care needed for an (ICF/IID) facility.
- Live with their parents or family.
- Be on Missouri Medicaid (MO HealthNet).
- The waiver considers only the child’s income, not the parents when deciding eligibility.
How To Apply for Medicaid Waiver in Missouri
Here’s a simple guide to the MO Medicaid waiver application process
- Step 1: Check Medicaid eligibility
Make sure you or your family member is enrolled in MO HealthNet. Medicaid approval takes 30-45 days, though emergency cases can be pushed through. - Step 2: Contact your regional DD office
They will connect you with a support coordinator who will guide you through the process. You can also reach out to UCP Heartland to understand the available waivers to fit your care. - Step 3: Meet with your coordinator
You need to prepare medical records, recent evaluations, Insurance cards, and related documents. - Step 4: Go through an assessment
The coordinator evaluates the person’s abilities, daily needs, and requirements to find a suitable waiver. Be honest about your challenges and needs, and if possible, have family members present with you. - Step 5: Choose the right waiver
Based on the assessment, age, and type of support needed. - Step 6: Submit your application
The coordinator will gather and submit all required documents. Reviews usually take 2-4 weeks, so stay in contact with your coordinator during this time. - Step 7: Create a service plan
If approved, your coordinator will contact you to create a plan that includes the services and supports that will be provided.
Conclusion
Every family that is looking into Medicaid waivers wants the same thing: steady support they can trust. As you start the process, stay informed, ask questions, and get guidance from people who understand how Missouri programs work. A supportive partner like UCP Heartland can connect you with programs and point you towards services that match the needs of your loved one.
UCP Heartland has helped thousands of Missouri families successfully access Medicaid waiver services. You can also connect with us directly to be guided every step of the process.