---
type: Concept
title: MO HealthNet and Long-Term Care in Missouri
description: How Missouri's Medicaid program pays for long-term care and how federal spousal-impoverishment rules protect the at-home spouse.
resource: https://nemolegal.com/mo-healthnet-medicaid-your-guide-to-missouri-long-term-care/
tags: [mo-healthnet, medicaid, long-term-care, spousal-impoverishment, csra, mmmna]
timestamp: 2026-06-18
jurisdiction: Missouri
author: Patrick Nolan
---

# Summary

MO HealthNet is Missouri's Medicaid program. For nursing-home and long-term care, eligibility turns on income and countable assets. Federal spousal-impoverishment rules protect the spouse who remains at home so that one spouse's care does not impoverish the other.

# Protecting the community spouse

Under federal spousal-impoverishment rules (42 U.S.C. §1396r-5) and Missouri's implementation, the at-home spouse is protected by a Community Spouse Resource Allowance (CSRA) and a Minimum Monthly Maintenance Needs Allowance (MMMNA). These set aside a portion of assets and income for the spouse who is not in care.

# Transfers and the look-back

Transfers made within the look-back period can trigger a penalty (42 U.S.C. §1396p). See the look-back concept.

# Decision rule

If one spouse is entering long-term care while the other stays home, map the CSRA and MMMNA before any spend-down, so the at-home spouse keeps enough assets and income to live.

# Related

- [The Medicaid Look-Back Period](/okf/elder-law-medicaid/look-back-period.md)
- [Trusts and Medicaid](/okf/trusts-probate-avoidance/medicaid-and-trusts.md)