Transitional Medicaid
Youth are provided information on
Transitional Medicaid during the Preparation for Adult Living Classes. The PAL
Coordinator and the child's caseworker will also provide this information. At
the time the youth ages out of care, the child's caseworker is responsible for
notifying the FPS eligibility worker of the child's status. The eligibility
worker makes the necessary contact with DHS. The youth is provided with the
phone number of the DHS Centralized Benefits Section, who will assist youth if
there are nay problems in the system or if there are address changes etc. DHS
staff will send the youth a yearly application. The youth must submit this
application in order to renew their Medicaid. Youth are potentially eligible
through the month of their 21st birthday and must continue to meet the
eligibility criteria in order to remain eligible.
Medicaid for Young People Transitioning from Foster Care
It’s the Law
Senate Bill 51 was passed and signed into law, effective September 1, 2001. This law requires the state to provide uninterrupted Medicaid coverage to young people who age out of foster care at age 18 through the month of their 21st birthday.
Certification Process
The Department of Family and Protective Services (DFPS) is responsible for initially certifying young people who are eligible for Transitional Medicaid coverage as they age out of foster care, which provides them with uninterrupted Medicaid coverage.
If you are age 18 or 19 and leave foster care voluntarily, your caseworker must notify the eligibility specialist within three days after you leave care. The eligibility specialist will then determine if you meet the Transitional Medicaid eligibility requirements based on the eligibility list, below. You are initially certified for Transitional Medicaid when the foster care eligibility specialist ends your foster care eligibility and opens your Medicaid eligibility.
Eligibility Requirements
You are eligible for continuous Medicaid coverage through the month of your 21st birthday if:
· You have aged out of foster care at age 18 or older
· You are a current Texas resident between 18 and 21 years of age
· You are a U.S. citizen, a legal permanent resident, or other qualified alien
· You have no private comprehensive medical insurance through a family member or work, or other Medicaid coverage through SSI, TANF, or another HHSC (formerly the Department of Human Services, or DHS) Medicaid program
· Your total resources are valued at less than $10,000
· Your income is below 400 percent of the current federal poverty level for one person, which is $3104 per month for 2005. To obtain federal poverty levels, go to www.aspe.hhs.gov/poverty/
The following items are not considered income or resources:
· The value of one vehicle
· Any financial benefit used for the purpose of educational or vocational training, such as scholarships and student loans or grants
· Any financial benefit used for the purpose of housing
· Any grants or subsidies obtained as a result of the Foster Care Independence Act of 1999
Changes in Eligibility
You must continue to meet the eligibility requirements in order for coverage to continue. You will receive a renewal application before the end of your 12-month eligibility period until you reach age 21. You must report all changes that might affect your eligibility. And you will be responsible for completing the renewal application and returning it by mail. This will help to ensure you receive your Medicaid card.
Contact Information
Call Centralized Benefits Services and ask to speak to someone about Medicaid for young people transitioning from foster care.
Toll Free 1-800-248-1078
Toll Free Fax: 1-866-246-8444
Austin Fax: (512) 908-9525 or (512) 908-9515
You may call your local HHSC office for assistance.
You may also call your regional Preparation for Adult Living (PAL) staff or CPS worker.