Office of Children and Family Services

Health Services for Children in Foster Care

Former Foster Care Youth and the Affordable Care Act (ACA)

(En Español)

The Affordable Care Act (ACA)

The Affordable Care Act (ACA) is a comprehensive new federal health insurance program designed to provide more people with access to health insurance coverage and establish legal protections for consumers.

What is the Affordable Care Act provision for former foster care youth (FFY)?

One of the most popular provisions of the ACA allows children under age 26 to stay on their parent’s health insurance. Recognizing that children who are discharged from the foster care system do not have the option to remain on their parent’s insurance, the ACA includes a provision for young adults who are discharged from foster care to remain on Medicaid until age 26, regardless of income or resources.

Who is eligible?

To be eligible a youth must meet all of the following criteria:

  • The final discharged youth must have been in the custody of a Commissioner of a local department of social services or the Commissioner of the Office of Children and Family Services on their 18th birthday; AND
  • The youth must have been in receipt of Medicaid on their 18th birthday or the day of their final discharge.

This provision applies to any youth who meets this criteria and was discharged after January 1, 2007.

Are FFY who meet the criteria still eligible if they returned to their families or were adopted after discharge?

Yes. Any youth who meets the criteria outlined above is eligible, regardless of their living arrangements after discharge.

Are there any income or resource tests?

No. There are no income or resource tests.

When does this provision take effect?

This provision takes effect January 1, 2014. Youth who were discharged from foster care may apply for Medicaid at any time before they reach age 26.

Are FFY eligible for this provision in every state?

Yes.  States must cover all FFY who were discharged out of foster care in the state and continue to reside in the state. States can choose to cover FFY who meet the eligibility criteria but were discharged out of foster care in another state. See below.

Will youth who were in foster care outside of New York be eligible for this coverage?

Yes. New York opted to cover youth who were in foster care in another state but now live in New York.

Youth who were in foster care in New York but now live in another state will need to check with the Medicaid program in the state where they now reside to determine what health insurance program they qualify for in that state.

How should FFY enroll in Medicaid under this provision?

FFY should contact the Department of Social Services in the county where they currently live to enroll. A directory is available here or on the OCFS website.

Youth may also go to New York State of Health, New York’s health care marketplace, to enroll.

What documentation will FFY need to enroll?

FFY do not need to have documentation with them when they contact a county to enroll. The counties will handle verification and notify the FFY when their eligibility is confirmed.  The process will be quicker if youth can provide one of the following documents:

  • A statement from state or county agency verifying that individual was in their custody at age 18.
  • A statement from agency responsible for placement verifying that individual was in the custody of the state or county at age 18.
  • A copy of court order verifying that the individual was in the custody of the state or county at age 18.
  • A copy of their Foster Care Transition Plan that includes foster care and Medicaid status.

Does a FFY who is already enrolled in Medicaid have to do anything?

FFY who are already enrolled in Medicaid do not need to do anything. The Medicaid system will adjust their status to keep them enrolled.

What steps should be taken to enroll youth who are leaving foster care between now and January 1, 2014?

Currently there should be NOchange in how youth are discharged out of foster care. OCFS will provide additional guidance to local districts when it becomes available.

What should happen to ensure that youth discharged from the foster care system after January 1, 2014 receive this benefit?

Youth will be enrolled in Medicaid when they complete their transition plan at discharge and will be able to remain enrolled until they reach age 26.

Special thanks to the Schuyler Center for Analysis and Advocacy and Casey Family Programs for compiling this information.

 


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