Missouri's July 2026 standards set an individual resource maximum of $6,220.50, a two-person resource maximum of $12,441, and an HCB income standard of $1,737 per month. For Vendor Care, income above the personal-needs allowance and permitted deductions gets applied straight to the cost of care; for regular aged and disabled Medicaid, Missouri also offers a spend-down route.
That mix is the real planning nuance here. A family shouldn't import an income-cap-state playbook wholesale, and a nursing-home income excess doesn't automatically mean a Qualified Income Trust is required the way it would in an income-cap state. That said, Missouri's HCBS manual does recognize a QIT — a Miller Trust — for an eligible program pathway, as long as the trust holds only the individual's income and includes the required state-payback terms.
On the title side, the same caution that applies to a beneficiary deed applies to planning generally: the five-year transfer look-back and the state's willingness to pull nonprobate property back into probate for recovery mean title decisions need individualized review, not a one-size-fits-all deed strategy.