Medicaid to 26 FAQs: Young Adults Still In Care

This FAQ represents the interpretation of Juvenile Law Center. We will update this FAQ as we learn new information, so please check back frequently for updates. While these questions and answers are Pennsylvania-specific, many could apply in other states.

If you're a child welfare professional with questions, visit our child advocate FAQ's page.

If I am about to discharge from foster care at age 18 or older, do I have to fill out a new application to get Medicaid coverage as a former foster youth?

It depends. In some states, if you are currently in foster care and will be discharging when they are age 18 or older, you will be enrolled automatically in Medicaid under the former foster care category upon discharged. In other states, you may need to apply. Please check with your state children and youth agency to see what policies apply so you can make sure you are covered.

What can I do to make sure I am covered when I leave care?

Your county child welfare worker should do the work to make sure you are covered under the former foster youth category, but there are a few things you can do to help make sure your health insurance is in place when you leave care.

• Make sure your transition plan states that your child welfare worker will complete your state’s process for getting you enrolled in Medicaid or will help you enroll if you do not have a process in place.
• Ask that the court document that your eligibility in the former foster youth category has been establishedand the person responsible for enrolling you. Many states have court rules mandating that your transition plan must contain specific information about your health insurance coverage.
• Ask for a copy of your state’s discharge form so you have proof that your case was closed so you have documentation of your former foster care status if needed in the future.
• Ask the court to issue an order at your transition hearing that explains that you were in foster care at age 18and enrolled in Medicaid. This can serve as additional proof of your former foster care status.

Do I get to keep my same insurance card when I leave care?

It depends. In some states, you will keep the same insurance plan and card. In some states, you will receive a new card. Talk to your case planning team and make sure your transition plan includes: information about your health plan, your health care providers, documentation that you have been given your insurance card, and information about any steps you need to take to maintain your eligibility for insurance.

After I leave care what actions do I have to take to make sure I keep my insurance coverage as a former foster youth until age 26?

It depends. In some states, young adults are automatically re-enrolled each year until age 26. In other states, young adults will have to complete a renewal application each year. Make sure you know your state’s practice so you can comply with all renewal procedures so you do not lose your coverage.