Medical Assistance (Title XIX) for Children in Foster Care 623-05-15-85

(Revised 8/15/06 ML #3025)

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The determination of Medical Assistance is the responsibility of County eligibility staff. Immediate communication between eligibility and Social Service staff is vital in order to properly open and maintain Foster Care cases.

 

At the time of eligibility determination for Foster Care, eligibility staff will also make determination for medical eligibility. Subsequent to that eligibility determination, eligibility will be determined monthly on VISION.

 

A Medicaid Identification Card is issued to each Medicaid recipient shortly after Medicaid eligibility has been established. The foster child will receive such a card. The Medicaid Identification Card must accompany the child if placements change, whether the child is in care in a family foster home, group home, or residential facility.

 

Case specific medical eligibility questions should be referred to the Medical Assistance division or county eligibility staff. Refer to North Dakota Department of Human Services Medicaid Eligibility Factors, Service Chapter 510-05.

 

Children eligible for Title IV-E Foster Care (AFDC rules of 7-16-1996) are by that determination considered Categorically Needy and eligible for Medical Assistance.

 

Children in foster care who do not meet Title IV-E, EA, or Regular Foster Care criteria, including those who receive SSI, are subject to the eligibility requirements for the Medically Needy as set forth in Service Chapter 510-05, Medicaid Eligibility Factors.

 

For Medical Assistance purposes, family foster care homes and foster care group homes are considered specialized facilities. The Medically Needy income level for an individual in a specialized facility can be determined by referring to Service Chapter 510-05.

 

In all cases, the family's insurance coverage must be utilized.

 

Foster care providers must be informed of the medical services available and procedures for obtaining authorizations for payment of medical care for foster children.

 

If foster care payments are closed and the child remains in licensed or approved foster care under supervision, the county social service board may keep the case open for Medical Assistance. Certification for continuing medical payments is subject to eligibility provision of the Medical Assistance Program. The determination of Medical Assistance eligibility is the responsibility of county eligibility staff. Close communication with social service staff will be vital in order to properly maintain foster care cases.