Medicaid Policy
Medicaid Policy
A. Application & Confirmation of Foster Care Status
DHHS Referrals
1. When an individual is about to leave foster care because she is 18 or older, DHHS will work with her to help her enroll in the Former Foster Care program with DWS. DHHS will ask the youth to sign a signature page, and send this form to DWS.
2. Upon receipt of a referral with current information about the youth from DHHS, open Former Foster Care Medicaid.
a. DHHS will forward the signed signature page to DWS if they secured one from the youth.
b. If DHHS refers a youth to DWS to enroll in Former Foster Care, but the youth did not sign a signature page, DWS is to enroll the youth in Former Foster Care if eligible, and then request the signature page.
c. DWS must give the youth 30 days to provide a signed signature page.
Youth applying on their own
1. An individual who left foster care in the past, but is not currently open on Medicaid, may apply for Medicaid using any of the approved application methods described in section 703-1.
2. Accept the client's statement that he was in foster care at 18 or older. Then perform a post-eligibility verification by contacting the appropriate Utah foster care agency, or calling the foster care program in the state where the applicant lived and verify by phone the applicant received Medicaid coverage in the last month they were in DCFS foster care, tribal foster care or URM foster care through CCS on or after their 18th birthday. This will require that the individual sign a release of information form. We will allow 30 days from the eligibility date to complete the post-eligibility verification. If the agency is not able to verify prior foster care status through a collateral contact, give the individual notice that he must provide the agency with verification. Give the individual 30 days to verify.
3. Youth in foster care through CCS or with a tribal foster care program can be moved to the Former Foster Care Medicaid without a new application when their eligibility for Child Medicaid ends. They must be Medicaid eligible and in foster care when they turn 18. DWS needs to request a signed signature page and current address information from these youth and allow them 30 days to return it.
B. Eligibility Criteria
This coverage group is for individuals who are in foster care under the responsibility of the state or a tribe when they turn 18 or older, and are under age 26. It includes children placed in foster care by Catholic Community Services (CCS) under the Unaccompanied Refugee Minor (URM) program who turn age 18 while in that foster care program.
1. To qualify for Former Foster Care, an individual must meet the following criteria:
o Is age 18 to 26. Eligibility runs through the month she turns 26,
o Was concurrently enrolled in Medicaid and foster care at some point during the foster care period in which they turn age 18.
o Was in the custody of DHHS with DCFS as the lead or case management agency, Catholic Community Services URM program, an Indian tribe, or the equivalent of these agencies throughout the United States when foster care ended. Individuals in the custody of Juvenile Justice Services are not eligible.
2. There is no income or asset test.
3. Approve Former Foster Care if an individual meets the criteria listed above regardless of whether they could be eligible for any other coverage group. Individuals who qualify for Former Foster Care and are not currently receiving another medical program cannot qualify for any other medical program until they no longer meet the criteria listed above.
4. Approve Former Foster Care if the member has sufficient evidence to approve that coverage. If an individual who qualifies for Former Foster Care is already on another medical program, continue their coverage on other medical programs until they no longer qualify for any other medical programs.
5. Individuals must have been on Medicaid and in foster care at the time they turned 18 to qualify for Former Foster Care Medicaid. (354-4)
6. Individuals eligible on the Foster Care Independent Living program can be moved to Former Foster Care Medicaid at review or when they turn 21.
7. The Former Foster Care coverage in Utah for youth that aged out in another state or who were placed in Utah, but were receiving Medicaid through a different state, goes into effect on February 1, 2016. Coverage can begin retroactively in January 2016.
C. Effective Date and Retroactive Coverage
Eligibility can begin the month after the foster care Medicaid ends. individuals can receive retroactive eligibility based on the date of application if the individual meets the criteria in Section A. in the retroactive months.
D. Signature and Assignment of Rights
The individual must sign the review form or an application signature page to complete Assignment of Rights requirements, the TPL requirements and to acknowledge the individual has received the information about Medicaid rights and responsibilities. This can occur after moving a current recipient to the Former Foster Care group. Allow the member 30 days to complete this process.
E. Medical Support Requirement
A parent with a minor child living with her who receives Medicaid is required to cooperate with Medical Support enforcement unless she can show good cause for not cooperating (227).