Revision 17-1; Effective January 1, 2017

 

 

E—110 Medicaid for Former Foster Care Children (FFCC)

Revision 15-4; Effective October 1, 2015

 

The Patient Protection and Affordable Care Act (Public Law 111-148) and the Health Care and Education Reconciliation Act of 2010 (Public Law 111-152), commonly referred to together as the Affordable Care Act (ACA), requires states to extend Medicaid coverage to the population of youth who are between ages 18 and 26 and aged out of foster care at age 18 or older.

The process to cover these individuals is coordinated between the Texas Department of Family and Protective Services (DFPS), which administers the foster care program, and the Texas Health and Human Services Commission (HHSC). When a child ages out of foster care, Medicaid eligibility for these youths is transferred from Foster Care Medicaid to FFCC. DFPS certifies initial FFCC eligibility for youths aging out of foster care and HHSC is then responsible for determining their future Medicaid eligibility.

Note: There may be situations in which HHSC processes the initial certification.

 

E—111 Type of Assistance (TA) 82 – Medical Assistance – FFCC

Revision 15-4; Effective October 1, 2015

 

In order to be eligible for FFCC, individuals must:

  • have aged out of foster care or the Unaccompanied Refugee Minor Resettlement Program in the state of Texas at age 18 or older;
  • be ages 18 up to 26;
  • have received federally funded Medicaid when they aged out of foster care; and
  • meet all other Medicaid eligibility criteria such as U.S. citizenship, alien status, and Texas residency.

Centralized Benefit Services (CBS) staff is responsible for processing all FFCC applications and redeterminations, along with any other associated active Eligibility Determination Groups (EDGs). The FFCC program is identified in the Texas Integrated Eligibility Redesign System (TIERS) as TA 82, Medicaid for Former Foster Care Children.

Customer Care Center (CCC) staff is responsible for processing changes for FFCC.

Note: Federal regulations require states to provide Unaccompanied Refugee Minors (URMs) with the same range of medical benefits and services as those available to children who were in foster care. CBS is responsible for ensuring URMs continue to receive medical services through the end of their 26th birthday if they meet all eligibility criteria.

 

E—112 Application Processing

Revision 17-1; Effective January 1, 2017

 

Centralized Benefit Services (CBS) receives:

  • a new FFCC case/Eligibility Determination Group (EDG) via an interface with the Texas Department of Family and Protective Services (DFPS); or
  • an application completed by an individual who aged out of foster care.

Note: DFPS provides a notice of eligibility to each individual.

CBS staff are notified by DFPS or HHSC Quality Assurance when a referral/interface is not completed. In cases where a DFPS referral/interface is not completed or processed, CBS staff must contact DFPS to determine the reason why the individual was not sent to HHSC via the interface and confirm whether eligibility criteria is met for FFCC. If the individual meets the eligibility criteria in Section E-111 , Type of Assistance (TA) 82 - Medical Assistance - FFCC, CBS staff certify the individual for FFCC without requiring an application.

There are instances when an individual is denied ongoing FFCC coverage and must submit a new application for benefits. An individual may be denied ongoing FFCC coverage if the individual:

  • voluntary withdraws;
  • moves out of state; or
  • fails to return verification during a renewal.

Individuals denied ongoing FFCC benefits may experience gaps in coverage. When there is a gap in coverage, individuals must apply using any of the Medical Programs application channels explained in A-113, Application Requests and Submissions.

One of the following questions must be marked Yes on the application for eligibility to be considered for FFCC.

  • Were you in foster care at age 18 or older?
  • Were you in an approved Unaccompanied Refugee Minor’s Resettlement Program at age 18 or older?

If ineligible for FFCC, the individual will be considered for eligibility under other Medical Programs.

 

E—113 Requesting an Application

Revision 15-4; Effective October 1, 2015

 

Applicants may request to apply for FFCC as explained in A-113, Application Requests and Submissions.

Related Policy
Registering to Vote, A-1521

 

E—114 Authorized Representatives (AR)

Revision 15-4; Effective October 1, 2015

 

An individual may designate an individual or organization as an AR, following the policy explained in A-170, Authorized Representatives (AR).

 

E—120 Office Procedures

Revision 15-4; Effective October 1, 2015

 

 

E—121 Filing an Application

Revision 17-1; Effective January 1, 2017

 

individuals who wish to apply for FFCC, can;

  • submit an application as explained in A-113, Application Requests and Submissions; and
  • sign an application as explained in A-121, Application Signature.

 

 

E—122 File Date

Revision 17-1; Effective January 1, 2017

 

The file date is the day an application is received in one of the following ways:

  • by an HHSC eligibility determination office;
  • online through YourTexasBenefits.com;
  • by telephone through 2-1-1; or
  • through an account transfer from the Marketplace.

The file date for cases received through the DFPS interface is the date the interface is received. To be a valid application, it must contain the applicant's name, address, and appropriate signature/electronic signature. This is day zero in the application process. 

Advisors must document why a certain file date was used to determine eligibility when:

  • The file date used differs from the received date on the application, or
  • The application has two received dates (stamp dates).

Note: For applications received outside of normal business hours, the file date is the next business day.

Related Policy
Application Signature, A-122.1

 

E—130 Interviews

Revision 15-4; Effective October 1, 2015

 

 

E—131 General Policy

Revision 15-4; Effective October 1, 2015

 

An interview is not required when applying for or renewing an application for the FFCC program. Schedule a phone interview only if the individual requests an interview. The State Portal Scheduler does not support scheduling for the FFCC program. Any requests for an interview must be scheduled manually.

Note: Advisors must continue determining eligibility, rather than denying the application, if the applicant misses the interview.