MR #17.18: Former Foster Care Medical Benefits

HFS LogoDHS Logo

10/24/17

Obsoletes Former Foster Care Medical Benefits policy memorandum dated 10/03/13

Summary

  • Creates a new section in the policy manual for Former Foster Care medical benefits;
  • Revises Former Foster Care eligibility based on updated federal guidance;
  • Lists the revised Former Foster Care eligibility factors:
    • Foster care services from IL Department of Children and Family Services (DCFS) ended when aging out at age 18 or older,
    • Federally funded medical benefits authorized by DCFS ended when aging out at age 18 or later,
    • Age 19 through 25,
    • Illinois resident,
    • Meets non-financial eligibility requirements (Social Security Number and citizenship/immigration),
    • Income and resources are not considered for Former Foster Care;
  • Identifies the MANGP codes in MMIS for foster care and federally funded medical benefits; and
  • Provides procedures for opening a Former Foster Care case when DCFS closes the foster care case.

  1. Enrollment into Former Foster Care Medical Benefits
    1. Central Enrollment
    2. Self-Initiated Applications
      1. Identifying Federally Funded Medical for Foster Children Using MMIS
      2. IES Hints
  2. Renewals
  3. Unaccompanied Refugee Minors (URM) & Former Foster Care
  4. Examples
  5. Manual Revisions
  6. Forms Referenced

Effective January 1, 2014, the Affordable Care Act (ACA) established a new federal eligibility group for medical coverage for adults who lose medical coverage as a result of aging out of (exiting) foster care at the age of 18 or older. Public Act 98-0104 authorizes Illinois to provide medical coverage to these adults. Eligible adults meet the following criteria:

  • Foster care services from Illinois DCFS ended when they aged out at age 18 or older;
  • Federally funded medical benefits authorized by DCFS ended due to aging out at age 18 or older;
  • Age 19 through 25;
  • Illinois resident; as described in PM 03-02-00
  • Has a Social Security Number (SSN) or proof of application for an SSN as described in PM 03-11-00;
  • Meets U.S. citizenship or immigration requirements as described in PM 03-01-00; and
  • Income and resources are not considered for Former Foster Care.

Generally, youth who exit foster care at age 18 or older will receive up to 12 months of continuous eligibility beginning with the month they exit foster care until their 19th birthday.

Individuals who received KinGap (subsidized guardianship) or adoption assistance through DCFS and aged out at age 18 or older are not Former Foster Care eligible but may qualify for ACA Adult or other medical program.

Some noncitizen youth may have received IL foster care and were legal permanent residents in the U.S. less than 5 years as described in PM 03-01-02-g or lawfully present as described in PM 03-01-02-j.  To qualify for Former Foster care as adults, they must meet the immigration requirement.  If they do not meet the immigration requirement, deny the request.  They will be referred to the Federally Facilitated Marketplace (FFM).

Enrollment into Former Foster Care Medical Benefits

Enrollment in Former Foster Care will come from two sources:

  • Central enrollment of DCFS foster care individuals who are losing their foster care coverage and medical benefits due to aging out; and
  • Self-initiated applications from individuals who aged out of foster care in Illinois but are not yet age 26.

Central Enrollment

DCFS provides a monthly file to the All Kids unit of youth aging out of foster care services.  The All Kids unit reviews the youth for Former Foster Care and opens the case if the youth qualifies. The All Kids unit routes the approved Former Foster Care case to the appropriate Family Community Resource Center (FCRC). 

Self-Initiated Applications

Self-initiated applications may arrive at the FCRCs or in the All Kids unit. The foster care question appears on the following applications:

  • Form IL444-2378B Request for Cash Assistance-Medical Assistance-Supplemental Nutrition Assistance Program (SNAP) on page 2;
  • Form HFS 2378ABE Application for Health Coverage  & Help Paying Costs on page 5; and
  • Through the online Application for Benefits Eligibility (ABE) which will appear in the IES Worker Portal ABE application pdf document.

If applicants report on the application that they lost foster care at age 18 or older, confirm that they received foster care and federally funded medical coverage by checking MMIS for the MANGP code in the table below. Individuals who aged out prior to 01/01/2014 and have not yet reached age of 26 may qualify for Former Foster Care.

Identifying Federally Funded Medical for Foster Children Using MMIS

  • Find the applicant's RIN.  It can be found in IES in the following locations, through Left Navigation:
    • Go to Inquiry/Individual-search for the individual and click on the individual's name to bring up the Individual Summary screen; or
    • Go to Data Collection/Individual Information/Individual Household;
  • Go to BlueZone and open the IPACS Inquiry System (otherwise known as PACIS or IMSA). 
  • MMIS is located in the function key PF8/F8. 
  • Locate the MANGP code in MMIS by entering the individual's RIN in the RECIP ID field.  Locate the column headings REGULAR ELIGIBILITY and MANG P. 
REGULAR ELIGIBILITY MANGP Code
Case ID Category is 98 Foster care eligible codes: TA, XA, XC, XK, XO, XR, XS, XT, XX, XZ, X2

Individuals who received assistance through the following DCFS Programs upon attaining age 18 are not eligible for Former Foster Care but may qualify for ACA Adult or other medical benefits:

  • KinGap (subsidized guardianship);
  • Adoption Assistance;
  • Child of 'Youth in Care' (formerly known as Child of Ward); and
  • Youth released from a corrections facility to a foster care setting but are still in IDOC custody (DOC).

IES Hints

In IES on the Living Arrangements/Domicile-Details screen, answer yes to the question "Did the individual lose Medicaid due to Aging out of Foster Care at age 18?" to process the application for Former Foster Care. The EDG Summary will show ACA Adult.

In Wrap Up-Eligibility Summary, click on one of the approved months, then click on the Notice Reasons tab to find the Former Foster Care designation. Note: the Certification Summary will show ACA Adult.

Renewals

Individuals receiving Former Foster Care must cooperate with the renewal process once every 12 months.  Individuals in Former Foster Care will likely qualify for the auto-REDE process described in MR #16.08 Auto-REDE for Medical Programs. When an individual reaches age 26, review eligibility for other programs such as ACA Adult, FamilyCare, Moms & Babies or AABD before closing the Former Foster Care case.  IES will review eligibility for other programs as part of the normal cascade.

Unaccompanied Refugee Minors (URM) & Former Foster Care

Certain noncitizen refugee children may be designated as unaccompanied refugee minors (URM). These individuals would have arrived in the U.S. as documented refugees but not accompanied by a caretaker relative. If an applicant claims to have been a URM, contact HFS medical policy at 217-557-7158 for guidance on Former Foster Care eligibility. 

Examples

Example 1: Mr. A, age 23, applies for medical benefits.  He reports he received foster care through IL DCFS through age 18.  DCFS ended his medical coverage at age 20. Staff review MMIS, and it shows Mr. A had MANGP code XK at age 18.  Mr. A meets all of the other Former Foster Care requirements.  In the IES Living Arrangement/Domicile screen, answer 'YES' to the foster care question.  IES will show Mr. A as an ACA Adult EDG. Approve Mr. A for medical benefits.  Confirm Former Foster Care by reviewing the Notice Reasons tab in Wrap Up Eligibility Summary.

Example 2:  Ms. B received adoption assistance through IL DCFS through age 18 as verified by MANGP code TE in MMIS.  DCFS ended her medical coverage at age 19.  Ms. B is not Former Foster Care eligible because she was not receiving foster care services at age 18. Review eligibility for ACA Adult and other medical programs.

Example 3: Mr. C received foster care through Indiana's child welfare agency but now lives in IL.  Mr. C is not eligible for Former Foster Care because Former Foster Care eligibility requires that he received foster care through IL DCFS.  Review eligibility for ACA Adult and other medical programs.

Example 4: Ms. D received foster care through IL DCFS through age 18 but is living in Iowa.  Ms. D is not eligible for Former Foster Care because she is not an IL resident.

Manual Revisions

[signed copy on file]

James T. Dimas

Secretary, Illinois Department of Human Services

Felicia F. Norwood

Director, Healthcare and Family Services

Forms Referenced

HFS 2378ABE

L444-2738B