Presumptive Eligibility (PE) Programs Manual

1900.020.60 Former Foster Care Youth Ages 19 up to but not including age 26

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, to be eligible for the Former Foster Care Youth coverage individuals must:

  • Have been in Missouri foster care and received alternative care MO HealthNet on, or 30 days prior to, their 18th birthday;
  • Must have been covered by MO HealthNet while in Foster Care;
    • ME codes used for Foster Care would have been 07, 08, 36, 37, 56, or 57.
  • Be ineligible for any other MO HealthNet PE program.
  • Not be receiving any regular MO HealthNet coverage.
  • Must be under the age of 26; and
  • Not have received presumptive eligibility 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.

NOTE: Hospitals are the only qualified entities who can determine eligibility for PE for former Foster Care Youth.