Presumptive Eligibility (PE) Programs Manual

1900.020.60 Former Foster Care Youth (FFCY-PE)

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:

  • Not eligible for PE for Pregnant Women (either TEMP or SMHB-PE) or PE for Parents/Caretaker Relatives (MHF-PE);
  • Have been in:
    • Missouri foster care and received alternative care MO HealthNet on, or 30 days prior to, their 18th birthday;
    • Foster care in another state for at least six months and received Medicaid during that period of time.

NOTE: ME codes used for Foster Care would have been 07, 08, 36, 37, 56, or 57.

  • Not be receiving full MO HealthNet coverage;
  • Must be under the age of 26; and
  • Not have received PE within 12-months starting with the effective date of the initial PE period.

Screen any individual who indicate that he/she was previously in Foster Care according to the above eligibility requirements.