Medical Assistance for Families with Children and Adults

2.2.2.1.3 Former Foster Care Youth Basis of Eligibility

A person who left foster care at 18 years of age or older, and who was enrolled in Medical Assistance or another state’s Medicaid program when they left foster care, may be eligible for Medical Assistance under the former foster care youth basis of eligibility (MA-FFY), without regard to income or assets.

Basis of Eligibility

To be eligible for MA-FFY, youth must meet the following criteria:

• Be under age 26
• Aged out of foster care in any state, District of Columbia, or United States territory at age 18 or older.

• Aging out of foster care means youth are no longer in a foster care placement because of their age.
• In Minnesota, foster care may end at age 18, or youth may qualify for extended foster care up to age 21 if they meet the eligibility criteria for the program.
  • Youth in extended foster care in Minnesota continue to qualify for MA under the foster care basis of eligibility (MA-FC) so are not eligible for MA-FFY. Once extended foster care ends at or before age 21, the youth qualifies for MA-FFY.
  • A youth who aged out of an extended foster care program in another state, District of Columbia, or U.S. territory before moving to Minnesota qualifies for MA-FFY.

• Were enrolled in Minnesota MA or another state’s Medicaid program when they aged out of foster care at 18 or older.
• Meet all MA non-financial eligibility criteria including Minnesota residency and post-eligibility cooperation requirements.

 

Financial Eligibility

Youth eligible for MA-FFY are not subject to income or asset requirements.

Verification

Self-attestation of foster care and MA or Medicaid history is acceptable, unless the person’s attestation is inconsistent with other information provided by the person or known to the agency. See EPM 1.3.2.4 Inconsistent Information.

MA verification policies for citizenship, immigration, and Social Security number apply.

Former Foster Care Youth with a Disability

Youth enrolled in MA-FFY who have been determined disabled by the Social Security Administration (SSA) or State Medical Review Team (SMRT) continue to use the MA-FFY basis of eligibility, even when receiving home and community-based waiver services. They do not need to use the disabled basis of eligibility.

Youth enrolled in MA-FFY with Medicare must also be determined for Medicare Savings Programs.

Eligibility Begin Date

MA-FC to MA-FFY Redetermination

For a youth who ages out of foster care, MA-FFY eligibility begins the month following the month that eligibility for MA under the foster care basis of eligibility (MA-FC) ends, without a break in coverage. Aging out of foster care is a change in circumstance, and eligibility must be redetermined for MA-FFY. Agencies may only request information needed to redetermine eligibility. The MA eligibility worker must coordinate with the child welfare agency to facilitate this redetermination.

Application

Youth formerly in foster care must complete an application if they are a new resident of Minnesota or in the event they need to re-enroll in MA due to a break in coverage.

For a youth who must submit an application, MA-FFY eligibility begins the first day of the month of application, with up to three months of retroactive eligibility if requested and eligible. See EPM 1.2.5 Retroactive Eligibility.

Eligibility End Date

MA-FFY eligibility ends the last day of the month of the youth’s 26^th birthday. The enrollee must be notified that eligibility under the FFY basis is ending with at least 10 days advance notice. See EPM 1.3.1.5 Notices.

Turning age 26 is a change in circumstance. Eligibility must be redetermined for all other MA bases or Insurance Affordability Programs without interruption in coverage. See EPM 1.3.2.1 Change in Circumstance for more information.

Post-Eligibility

Renewal

MA-FFY eligibility is renewed annually. MA-FFY eligibility must be automatically renewed as long as the youth is under age 26 in the renewal month. See EPM 2.2.4.2 Renewals for more information.

Changes in Circumstance

Changes in circumstance that impact eligibility or delivery of services must be reported and acted on, including but not limited to:

• Minnesota state residency status
• Address changes
• Access to and/or enrollment in other health insurance
• Change in citizenship or immigration status
• Changes in Third Party Liability

Changes in circumstances that do not impact MA-FFY eligibility, such as tax filing status or income changes, may impact another household member’s eligibility. When information is needed to determine eligibility for another household member, failure to provide that information does not impact the former foster care youth’s eligibility.

Third Party Liability (TPL)

Former foster care youth are subject to Third Party Liability policy, including Cost-Effective Health Insurance, Medical Support, and Other Third Party Liability.

Health Care Delivery

All youth eligible for MA-FFY receive MA health care services through managed care plans unless they meet a reason for an exclusion. See Prepaid Minnesota Health Care Programs Manual for more information about managed care exclusions. For additional information on health care delivery and cost of services, refer to EPM 2.2.4.1 MA FCA Health Care Delivery.

Legal Citations

SUPPORT Act (Public Law 115-271)

Centers for Medicare & Medicaid Services (CMS) State Health Official letter re: Coverage of Youth Formerly in Foster Care in Medicaid (Dec. 16, 2022), at https://www.medicaid.gov/federal-policy-guidance/downloads/sho22003.pdf

Code of Federal Regulations, title 42, section 435.150

Minnesota Statutes 256B.055, Subd. 17

Published: August 28,, 2024