IM-95 November 22, 2023; IM-150 December 29, 2022; IM-51 May 18, 2017
The Patient Protection and Affordable Care Act of 2010 established presumptive eligibility (PE) criteria to include former Foster Care Youth ages 19 up to but not including age 26. In addition to the eligibility requirements in section 1900.020.00 Eligibility Requirements, to be eligible for the Former Foster Care Youth coverage individuals must meet the specific criteria.
Section 1002(a)(2) of the Support Act became effective January 1, 2023 changing the way eligibility is determined for individuals who aged out of foster care in a state other than Missouri. These individuals fall into two separate groups based on when they reach the age of 18:
Individuals who turned 18 before January 1, 2023
- Under age 26; and
- Not eligible for PE for Pregnant Women (either TEMP or SMHB-PE) or PE for Parents/Caretaker Relatives (MHF-PE); and
- Not currently receiving full MO HealthNet coverage; and
- Not received PE within 12 months; and
- Declare that they were in Missouri foster care and received alternative care MO HealthNet on, or 30 days prior to, their 18th birthday or in foster care in a state other than Missouri for at least 6 months prior to aging out of care.
Individuals who turned 18 on or after January 1, 2023
- Under age 26; and
- Not currently receiving full MO HealthNet coverage; and
- Not received PE within 12 months; and
- Declare that they were in Missouri foster care and received alternative care MO HealthNet on, or 30 days prior to, their 18th birthday or in foster care in a state other than Missouri for at least 6 months prior to aging out of care.
NOTE: ME codes used for Foster Care are 07, 08, 36, 37, 56, or 57.
Screen any individual who indicates that they were previously in Foster Care according to the above eligibility requirements.