Because of CDS, I live as I choose and not in a nursing home.

CDS Participant Support

Consumer Directed Services are available to those who qualify for Medicaid and who are eligible to receive personal care assistance in their homes after an initial assessment by the Department of Health & Senior Services (DHSS).

  • Participants receive resources for finding caregivers to provide support in everyday activities, such as cooking and cleaning.

  • The participant is the EMPLOYER - they choose who they recruit, hire, train, and maintain as their employee. This can be a person of your choosing, including a family member or friend.

  • MOCIL paid personal care attendants more than $1.9 million on behalf of CDS employers for money management services, training and case management.

Medicaid Eligibility vs Active Medicaid  

If you meet the guidelines, you may be eligible for Medicaid. You must meet all of the guidelines. Qualifying for Medicaid does not automatically mean you will have Active Medicaid that will pay for a caregiver through a Home and Community Based Services (HCBS) program. 

There are different types of Medicaid. 

The Family Support Division (FSD) uses codes to determine which type of Medicaid you have.  As a general rule, you will not know your Medicaid code.  Any HCBS provider you use will be able to determine what your code is and if you qualify for services under that code.   

  • If you have Medicaid as part of Blind Pension or State Aid to the Blind, you will have some services that are not covered by your Medicaid.   

  • If you have prescription coverage only, you will not qualify for Medicaid that pay for someone to come into your home as a Personal Care Attendant, also known as a caregiver. 

  • If you are a Qualified Medicare Beneficiary (QMB), you will qualify only after that code has changed – this usually occurs when a Spend Down is involved.  Once the Spend Down is paid, your code will change and you should qualify for Home and Community Based Services.   

You may have Active Medicaid but still not be eligible for HCBS. 

Eligibility Codes

There are more than 30 Medicaid codes that are eligible for Consumer Directed Services (CDS).  Only the following three codes are not eligible for CDS. 

  • 55- Qualified Medicare Beneficiary (QMB) 

  • 82- MoRX (Medicare Part D Wrap-Around Benefits) 

  • 91- Gateway to Better Health 

Your participation in a state-waivered program, such as the Independent Living Waiver (ILW), Aged & Disabled Waiver (ADW) or the Adult Day Care Waiver (ADCW) may make you ineligible for CDS.   

Your local Center for Independent Living can help you make that determination.   

MOCIL locations

Find a location near you.

Missouri has 21 locations to serve participants and their caregivers.
Enter your zip code to find your closest location. MOCIL is happy to support you.

 
 
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BEVERLY’S STORY

“Having an aide has allowed me to stay in my home. She does the small house chores that I would not be able to do without her, like cooking. If it was not for this program I would not be able to still be living in my own home.”

What is Spend Down?

MO HealthNet for the Elderly, Blind, and Disabled with a Spend Down allows consumers with incomes greater than the maximum level allowed by the program to still qualify for coverage. The Spend Down amount is the additional income that is above the maximum level. For 2020 the income limit for the elderly and disabled is $885 for an individual and $1,198 for a couple.  For those who have a Spend Down, this amount must be paid or reached each month before you can have MO HealthNet coverage.  It is similar to an insurance premium. 

There are three ways in which you can reach your Spend Down each month to get coverage; you must choose only one option. 

  1.  You may send a payment (check, money order, or cashier’s check) to the MO HealthNet Division.  You will have coverage for the whole month in which you pay. 

  2. You may have your payment taken directly out of your bank account on the 10th of each month by the MO HealthNet Division to pay for your spend down for the following month.   

  3. You may get medical services by using the Spend Down amount.  When the cost of the services you are personally responsible for reaches your Spend Down amount, you must give the bills you are personally responsible for to your eligibility specialist at your local Family Support Division office. The eligibility specialist will put your coverage for the month in the system.  Coverage will start the day you reach your Spend Down amount. For the day you reach your Spend Down amount, MO HealthNet will only pay for services over your Spend Down amount. You will be responsible to pay this amount to the providers that gave you the services.   

Paying your Spend Down is optional, but you will not have MO HealthNet coverage for the months that you do not pay or reach your Spend Down. 

Additional questions?

We offer a list of everyday questions to help guide you make the right choice in choosing a caregiver.