IM-144 December 7, 2022; IM-11 February 20, 2020; IM-43 May 1, 2015; IM-41 August 4, 2014
13 CSR 40-2.080(1) defines a public institution as a facility that provides shelter or care to a person and is managed or controlled (in whole or in part), by or through a public instrumentality, official or employee acting in an official capacity.
An inmate is defined as any person residing in an institution for the purpose of receiving inpatient care, whether he/she is committed to the institution, or there on a voluntary basis.
Persons who are inmates of the following types of public institutions are not eligible to receive benefits from any MO HealthNet program, and MO HealthNet recipients entering any of these institutions are not eligible to continue receiving benefits
- State, city, county, or private jails or correction facilities (including if he/she is being held involuntarily pending trial)
- County home (not leased)
- Mental hospitals if the participant is between the age of 22 and 64
- Missouri Veterans Homes
- Similar institutions (not including general hospitals or infirmaries that qualify as public medical institutions) operated by the city, county, State, or Federal government.
Note: Inmates of state, city, county or private jails and prisons are not eligible for medical benefits to be paid, but must have their MHN benefits suspended rather than closed when they become incarcerated. See 0840.020.00 Suspending Incarcerated Participants, and Family (MAGI) MO HealthNet, 1885.040.00 Suspension of MAGI Benefits for Incarcerated Individuals.
The following are not inmates and are eligible for MO HealthNet (if all other eligibility requirements are met):
- Inmates who are admitted inpatient for 24 hours or more to a medical facility. Eligibility is limited to the days the inmate is inpatient in the medical facility. See Family MO HealthNet (MAGI) policy for all MHN applications, 1802.010.80.15 MO HealthNet Applications for Incarcerated Individuals.
- Individuals released to a Community Release Center or Community Supervision Center, as long as the person has freedom of movement and association. He/she must have freedom to seek and accept employment, use community services such as a library, grocery store, etc., and to seek the medical care of his/her choice. A current list of Community Release or Community Supervision facilities can be found on the Department of Corrections website under Probation and Parole Offices.
- Individuals released to home confinement.
- Individuals released to a Halfway House, publicly, or privately operated, as long as the person has freedom of movement and association. He/she must have freedom to seek and accept employment, use community services such as a library, grocery store, etc., and to seek the medical care of his/her choice.
- Individuals residing in an institution voluntarily, such as a person living in a detention center temporarily after his/her case has been adjudicated and arrangements are being made for his/her transfer to a community residence.
- A person who is conditionally released from a public mental hospital since the person is free from continuous supervision by the hospital.