Center for Behavioral Medicine
Fulton State Hospital
Hawthorn Children's Psychiatric Hospital
Metropolitan St. Louis Psychiatric Center
Northwest Missouri Psychiatric Rehabilitation Center
Southeast Missouri Mental Health Center
St. Louis Psychiatric Rehabilitation Center

Age 22-65 in DMH Psychiatric Hospitals

These clients are not eligible for MO HealthNet coverage, but there are special procedures in place to get them coverage once they are discharged.

Under age 21 and 65+ in a Vendor/Medicaid certified bed

For patients under the age of 21 who are in a Vendor/Medicaid certified bed or any patient age 65+ who are in one of the above institutions the following steps should be taken to submit an application:
If the client is under age 21 and not in a Medicaid Certified bed they will not be eligible until discharge.
The client must be under 21 when admitted in order to be covered; coverage will continue until their 22nd birthday.
Patients under age 21 at Hawthorn are eligible whether or not they are in a Medicaid Certified bed.

  1. Assist the DMH Consumer with completing the application
  2. Complete the MRT Packet with the client. Skip this if the client is 65+ and/or if the client receives SSD/SSI
  3. If the client is under 21 and in a Vendor/Medicaid Certified bed complete the IM-71. If this does not apply, skip this step.
  4. If the client is 65+ and in a Vendor/Medicaid Certified bed complete the DA124A/B and submit it to DHSSCOMRU (Central Office Medical Review Unit). If this does not apply, skip this step.
  5. Gather verification of income (other than SSD/SSI) and resources, including but not limited to
    • Bank accounts/patient accounts
    • Stocks, bonds, CDs, trusts
    • Income from pensions or other sources
  6. Regardless of age, if the client is in a Medicaid Certified bed submit all of this verification including the IM-71 where applicable to the appropriate FSD vendor office:
  7. If the client is age 65+ and not in a Medicaid Certified bed they should submit the application and verification with the Age 65+ Non-Vendor coversheet.
  8. Email DMH.MedicaidElibility@dmh.mo.gov notifying that the application has been submitted - use the subject line "Age 65+ Non-Vendor Application Submitted".

This change allows all of these applications to be processed by a special team and helps to make sure coverage will be established as quickly as possible.

Any time you have questions about the application process, case status, or general questions about MO HealthNet please email DMH.MedicaidElibility@dmh.mo.gov with the client’s name and DCN or DMH ID.

For more information about Nursing Home Coverage, please visit: https://mydss.mo.gov/ncare.

The Age 65+ Non-Vendor coversheet can be found here: Coversheet