25.8.1 Interstate Compact on Adoption and Medical Assistance (ICAMA)

The Interstate Compact on Adoption and Medical Assistance (ICAMA), Sections 453.500-453.503 RSMo (, requires states to provide Medicaid coverage to eligible adoption subsidy children when families move across state lines. A child who is eligible for Title IV-E benefits is automatically eligible to receive Medicaid in the receiving state. However, a child who receives state-funded adoption assistance does not automatically qualify for Medicaid in the receiving state unless the sending state has a reciprocal agreement with the receiving state to provide state health care services. MO HealthNet services will be opened on all children who move from any state with an adoption subsidy agreement (full reciprocity for IV-E and state only adoption subsidy which meet eligibility requirements). (

All states except Wyoming are members of ICAMA. The territories of Puerto Rico and the Virgin Islands are also non-members.

The Compact Administrator (Division Director) and Deputy Compact Administrator (Interstate Unit Program Manager) are designated in each member state and approved by the national ICAMA Office. ICAMA Coordinators work together with Coordinators in other states to process the required paperwork so Medicaid eligibility can be established in the adoptive family’s current residence state.

The following forms are to be used to share information between member states:

  1. ICAMA Form 7.00, Notice of Medicaid Eligibility/ Case Activation. This form is completed by the adoption subsidy worker who forwards it, and the following paperwork, to the state’s ICAMA Coordinator to open a case:
    • One copy of the current Adoption Subsidy Contract and Amendment (mandatory)
    • One copy of the adoption decree (optional) and
    • One copy of the child’s birth certificate (optional).
  2. ICAMA Form  7.02, Notice to Families and ICAMA Form 7.02b, Important Information For Families.  This form is completed by the ICAMA Coordinator to notify a family that a case has been opened.
  3. ICAMA Form  7.5, Information Exchange – Cases Opened with ICAMA 6.01 and ICAMA Form 7.5b.   The ICAMA 7.5 form is completed by the adoption subsidy worker in Missouri to notify ICAMA of any updated information on the family to include address changes and closures. The ICAMA Form 7.5b is an informational attachment for the individual completing the ICAMA 7.5.

Chapter Memoranda History: (prior to 1/31/07)

Memoranda History: