2819 Former Foster Care Medicaid

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

Former Foster Care Medicaid

Effective Date:

November 2020

Chapter:

2800

Policy Number:

2819

Previous Policy Number(s):

MT 50

Updated or Reviewed in MT:

MT-62

Requirements

The Affordable Care Act allows Medicaid coverage to be extended to individuals who age out of foster care, or age out of Chafee Independence Program, and were receiving Medicaid to the last day of the month they turn 26 years of age. Applicants may not be determined ineligible based on a diagnosis or pre-existing condition.

Basic Considerations

The Former Foster Care Medicaid became effective January 1, 2014, and retro coverage is not available prior to this date.

Former foster youth may apply for Former Foster Care Medicaid through the Gateway Customer Portal or at any Division of Family and Child(ren) Services (DFCS) office.

The eligibility month is the month following the closure of Chafee Medicaid.

Basic Eligibility Criteria

The following basic eligibility criteria must be met to qualify for Former Foster Care Medicaid:

  • Age: A youth must have been in foster care the month of his/her 18th birthday and be under the age of 26. The child could have been in foster care in any state.

  • Self-attestation of receipt of Foster Care in another state at the time the youth turned 18 or aged out of the foster care system is acceptable.

  • Enumeration

    Enumeration is not a requirement for Emergency Medical assistance (EMA). Refer to 2054 Emergency Medical Assistance; Reference 2220 Enumeration.

  • Residency, Reference 2225 Residency;

  • Citizenship/Immigration Status/Identity.

    Individuals who were in foster care under Title IV-B or Title IV-E of the Social Security Act are exempt from providing additional documentary evidence of citizenship/immigration status/identity as long as they were in Foster Care in Georgia.

  • Third Party Liability, Reference 2230 Third Party Liability;

  • Application for other benefits, Reference 2210 Application for Other Benefits.

There are no income or resource limits for Former Foster Care Medicaid.

Other Considerations

Former Foster Care Medicaid Cases are reviewed on an annual basis until the recipient turns 26.

Former Foster Care Medicaid recipients are eligible for retroactive Medicaid. EMA is available under Former Foster Care Medicaid.

Former Foster Care recipients are enrolled in Amerigroup as their CMO enrollment.

Non-MAGI recipients who are former foster children may request a Class of Assistance change to Former Foster Care Medicaid.

Procedures

For determining eligibility for Former Foster Care Medicaid on new applications, complete the following steps:

  • Verify that the individual was in foster care on his or her 18th birthday and receiving Medicaid by screening in SHINES or,

  • Self-attestation of receipt of Foster Care in another state at the time the youth turned 18 or aged out of the foster care system is acceptable.

  • Assume the individual who ages out of care with the State of Georgia meets citizenship/immigration status/identity unless information to the contrary is known to the agency. No additional citizenship/immigration status or identity documents are required.

    Individuals who were in foster care under Title IV-B or Title IV-E of the Social Security Act are exempt from providing additional documentary evidence of citizenship/immigration status/identity as long as they were in Foster Care in Georgia.

  • Verify citizenship/immigration status/identity for individuals who were in foster care in other states and request Former Foster Care Medicaid in Georgia after their 18th birthday.

  • Accept the client’s statement as to Georgia residency

  • Complete the DMA 285 – Third Party Liability

Ongoing Cases

Former Foster Care Medicaid cases are hard case owned by Revenue Maximization staff and will have no active or pending related case associated to the Medicaid case.

Former Foster Care Medicaid Cases are required to have an annual review.

Court orders and existing foster care documentation must be retained in the closed foster care case record and may NOT be cleansed when transferred to another county DFCS office.

Continuing Medicaid Determinations

If applicant ages out of Chafee (Age 21), the RMS will CMD the applicant to Former Foster Care and maintain the record.

If applicant aged out of Foster Care at 18 but opted to return until age 21 (Foster Care Medicaid Age 18 - 21), the Rev Max Specialist will CMD into Former Foster Care .

Case Records for Children with Expired Eligibility

Closed Cases – Foster Care case records for recipients for whom eligibility has expired, i.e. where the recipient has turned age 26, should be maintained in Rev Max closed files following the retention schedule found in 2760 Case Record Maintenance. Court orders and existing foster care documentation must be retained in the Chafee Medicaid case record and may not be cleansed.

Retention of Case Records – Due to IV-E Foster Care and Medicaid regulations, Former Foster Care and Medicaid case records must be retained in their entirety (both IV-E FC material and Medicaid material) for a period of three years from the recipient’s 26th birthday (i.e. no earlier than the recipient’s 29th birthday).