10-144-332 Me. Code R. § 3-3

Current through 2024-51, December 18, 2024

Section 144-332-3-3 - OTHER NON-MAGI ELIGIBILITY GROUPS

Other special coverage groups refers to various special groupings created by federal and/or state legislation. Specifically, IV-E Eligible and State Adoption Assistance:

I.Move-In from Out of State

An individual under the age of 21, who is receiving Title IV-E funds from another state or is covered by a State Adoption Agreement from another state and moves to Maine, is eligible for Medicaid. The income and assets of the child and parents are not considered to determine eligibility for this child.

There must be an assignment of rights to medical support and the Department must be provided with a Social Security number for the child.

There are three groups of children who fall into this category:

A. Children whose medical and financial circumstances qualify them for federal IV-E adoption assistance;

B. Children whose medical and financial circumstances qualify them for federal IV-E foster care assistance; and

C. Children whose medical and financial circumstances qualify them for state adoption assistance.

The foster or adoptive parents in Maine are provided with a written explanation of their status by the state of origin which usually serves as verification of their status.

II.Maine Residents

The following children are eligible for Medicaid:

A. Foster children;

B. Children named in a Federal (IV-E) or Maine State Adoption Assistance Agreement;

C. Children who are placed in Permanency Guardianship by the State of Maine, as defined in 22 M.R.S. §4038-C.

III.Former Foster Care Children

An individual is eligible to enroll in Medicaid if they:

A. Are under age 26;

B. Are not enrolled in another mandatory Medicaid coverage under 42 C.F.R. §§ 435.110 through 435.118 or 42 C.F.R. §§ 435.120 through 435.145; and

C. Effective January 1, 2023 were in foster care in any state in the United States and were enrolled in Medicaid at age 18. Prior to January 1, 2023 only individuals in foster care in the State of Maine were eligible under this coverage group.

The income and assets of the individual (or anyone else in their household) are not considered to determine eligibility for the individual.

10-144 C.M.R. ch. 332, § 3-3