Revision 24-2; Effective April 1, 2024

The following, commonly referred to together as the Affordable Care Act (ACA), require states to extend Medicaid coverage to the population of youth who are between 18 and 26 and aged out of foster care at 18 or older.

  • 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).

The Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) for Patients and Communities Act, requires states to extend Medicaid coverage to youth who transitioned out of foster care in a state other than Texas if:

  • they turned 18 on or after Jan. 1, 2023; and
  • were receiving federally funded Medicaid when they aged out.

Before Jan. 1, 2023, to be eligible for FFCC, a person must have aged out of foster care in the state of Texas at 18 or older while receiving Medicaid. 

Note: A person who aged out of foster care in the state of Texas at 18 or older while receiving Medicaid is still eligible regardless of the year.

The Texas Health and Human Services Commission (HHSC) coordinates with the Texas Department of Family and Protective Services (DFPS), which administers the foster care program, to provide coverage to this population. When a child ages out of foster care, Medicaid eligibility for these youths is transferred from Foster Care Medicaid to Former Foster Care Medicaid (FFCC). DFPS certifies initial FFCC eligibility for youth aging out of foster care and HHSC is then responsible for determining their future Medicaid eligibility.

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

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

Revision 24-2; Effective April 1, 2024

To be eligible for FFCC, a person must be 18 to 26 and:

  • have aged out of foster care in any state at 18 or older;
    Note: A person who turned 18 before Jan. 1, 2023, must have aged out of foster care in the state of Texas.
  • received federally funded Medicaid when they aged out of foster care; and
  • meet all other Medicaid eligibility criteria, including Texas residency and U.S. citizenship or alien status.

Specialized staff process all FFCC case actions.

Related Policy

Verification Requirements, E-140

E—112 Application Processing

Revision 24-2; Effective April 1, 2024

Centralized Benefit Services (CBS) receives:

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

CBS staff are notified by DFPS or HHSC Quality Assurance when a referral or interface is not completed. In cases where a DFPS referral or interface is not completed, CBS staff contact DFPS to determine the reason and confirm if eligibility criteria is met for FFCC. If the person meets the eligibility criteria, CBS staff certify the person for FFCC without requiring an application.

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

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

A person denied ongoing FFCC benefits may experience gaps in coverage. When there is a gap in coverage, the person must apply using any of the Medical Programs application channels.

The following question must be marked Yes on the application for eligibility to be considered for FFCC. 

  • Were you in foster care at 18 or older? 

If the FFCC question is marked yes, the following questions must also be answered.

  • If yes, who?
  • In which state?

If the person turned 18 on or after Jan. 1, 2023 and aged out of foster care in a state other than Texas, verify the person’s former foster care status and Medicaid enrollment status from the other state.

Follow the steps below to locate the out-of-state agency contact information and make collateral call(s) to verify former foster care and Medicaid enrollment statuses for youth who aged out of foster care on or after Jan. 1, 2023.

  1. Enter the following link in a web browser: https://www.medicaid.gov/about-us/contact-us/index.html. 
  2. Select the appropriate state from the “Contact Your State Medicaid Agency” drop-down and then select “go”.
  3. Identify the best contact number and attempt to make collateral call(s) to get verification. If collateral call is:
    1. Successful, answer the former foster care related question in the Individual – Individual Information LUW in TIERS, select “contacted out of state agency” as the verification source in the new "Verification of Medicaid Enrollment” drop down, and document the state agency contact person’s name, phone number and any other information in the mandatory text box field. 
    2. Unsuccessful, answer the former foster care related questions in the Individual – Individual Information LUW in TIERS, select “Not Verified” in the new "Verification of Medicaid Enrollment” drop down. Send Form H1020, Request for Information or Action.
  4. Document any failed collateral call attempts in Case Comments.

Note: Follow the current policy when an applicant recently received benefits in another state, including verifying the last month the benefits were issued.

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

Related Policy 

Application Requests and Submissions, A-113
New Texas Residents, A-720
Type of Assistance (TA) 82 - Medical Assistance - FFCC, E-111
Verification Sources, E-140

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).