Frequently Asked Questions

Why should I choose Alliance as my care provider?

You should choose Alliance because we will provide you with “quality care with a personal touch”. We have an excellent reputation and proven track record. Many of our clients have been with us for years. We have a reputation with case managers as one of the strongest and capable agencies out there. We treat our clients and employees better than our competitors.

Am I eligible to receive services?

Individuals age 65 or older who qualify for Medicaid benefits may be eligible to receive services through Home and Community Based Services (HCBS). The goal of the HCBS program is to provide long term care services to enable individuals to remain in their homes.

Eligibility criteria include:

      • Must be age 65 or older. Other criteria such as physical disability or traumatic brain injury may allow individuals under the age of 65 to qualify for services

      • Must be assessed by a qualified case manager and determined to need long-term care services

      • Your countable assets cannot exceed $2000 (a home and vehicle are not included in total)

Even if you think you might not qualify for services, give us a call. There are many ways we can help get you approved for the help you need.

How can I sign up for services?

Just give us a call. If you are already approved for Medicaid we can help you fill out the necessary forms and submit them to the state of Missouri for you.

When can I expect to be approved for services?

Service approval can take as little as 2 weeks or as long as 2 months. This is entirely up to the Missouri Department of Social Services and is out of the control of Alliance.

What services will I receive?

The services you receive will be based on your specific need. The case manager will determine this during your assessment. The individual services as well as the number of hours of weekly services provided will be based entirely on your specific daily living requirements.

Who pays for the services?

If your approved to receive services they are paid for by the Missouri state Medicaid program.

What happens if my caregiver does not show up for their shift?

The Alliance office staff will begin working right away finding you a replacement caregiver for that day. We promise to contact you with updates on a consistent basis until your replacement caregiver is identified.

Can I ask for a different caregiver if I’m not satisfied with the one assigned?

Of course, you can. Alliance wants you to be comfortable and happy. We will make every attempt to find you the right caregiver on the first try. If we do not quite hit that mark, we will do everything we can to find you the right one, no matter how many times it takes. Matching a caregiver to a client is as much an art as a science. Clear, constructive feedback is vital.

Does the agency oversee the quality of care clients are receiving in their homes?

Absolutely! Alliance assigns a nurse to ensure each client is receiving the type of services required by the plan of care and that the quality of care provided exceeds the client’s expectations.

Corrective action is taken any time an issue is identified. Alliance office and field staff are dedicated to ensure that each client’s needs are being satisfied.

What is a Spend Down/Client Obligation?

In certain cases, clients receive more monthly income (social security, pension, retirement) than the program allows. In those rare cases, each month clients are responsible for paying the difference between what they receive and what the program income limit is, regardless of how many hours of service they receive. For example if a client receives $800 per month, and the program limit is $700 per month, they will be responsible for paying $100 per month back to the State of Missouri. This is called a spend down or client obligation.


  • Please keep in mind, Client Obligations are not controlled by Alliance.   Spend Down payments are instituted, controlled and mandated by the state of Missouri.  The $ amount is calculated by your Case Manager and the State of Missouri.  Alliance is simply responsible for collecting the payment.
  • If clients do not pay their spend down, their services may be suspended and their case closed.