Orlando Harmon
In Texas, foster youth are eligible for free Medicaid insurance, which covers most aged-out foster youth. To qualify, specific criteria must be met, including age, conservatorship by Texas' CPS, prior receipt of foster youth Medicaid, US citizenship or legal permanent residency, Texas residency, and income level. Different STAR insurance plans, such as Blue Cross Blue Shield and Sendero, are also available depending on the county. Understanding eligibility and navigating insurance options can be complex, especially for those with immigration-related concerns, and seeking guidance from caseworkers and resources like the Texas Foster Youth Justice Project is recommended.
| Characteristics | Values |
|---|---|
| Insurance type | Medicaid insurance |
| Insurance program | Former Foster Care Children’s (FFCC) Program |
| Insurance coverage | Until the end of the month of the 26th birthday |
| Eligibility | US citizens or legal permanent residents (green card holders) under the age of 21 |
| Income requirements | Household income at or below 400% of the Federal Poverty Level |
| State-specific | Texas |
| Insurance plans | STAR insurance plans, including Blue Cross Blue Shield and Sendero |
| Immigration status | CPS helps foster youth obtain legal immigration status before aging out of foster care |
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What You'll Learn
Eligibility criteria for Medicaid insurance for foster kids
Nearly all children and youth in foster care are eligible for Medicaid. This eligibility is provided through categorical pathways under Title IV-E of the Social Security Act, Medicaid eligibility based on household income, or expanded Medicaid eligibility for former foster care youth. Children who are eligible for Title IV-E supports are automatically eligible for Medicaid.
Once enrolled in Medicaid, states must determine the most appropriate service delivery program for the child—standard MMC, specialized MMC, or FFS. This decision is based on various criteria, such as out-of-home placement status, health complexity, and geographic location. Some states operate multiple Medicaid service delivery programs, and the selection of a particular program is typically based on the child's specific needs and preferences.
After aging out of foster care, most individuals remain eligible for Medicaid coverage until the age of 26, regardless of their income. This eligibility is provided through the Former Foster Care Children eligibility group. However, to maintain coverage, individuals must remain in the same state or move to a state that covers out-of-state former foster youth. Some states have expanded Medicaid, so even if an individual moves to a state that does not cover out-of-state former foster youth, they may still be eligible under another category.
It is important to note that individuals who have aged out of foster care may face barriers to enrolling and maintaining Medicaid coverage. For example, they may miss important communications due to frequent address changes or avoid seeking assistance due to a lack of trust in state agencies. To address these challenges, some states collaborate with trusted organizations that supported the individuals while they were in foster care or use text messaging to reach them.
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Different insurance plans available
Foster children are eligible for different insurance plans, depending on their age, citizenship, and county of residence. Here are some of the insurance plans available for foster children in Texas:
STAR Health Plan
The STAR Health Plan is a type of health insurance offered by the state of Texas for current and former foster youth. It covers individuals until the end of the month of their 26th birthday. To be eligible, one must have been in the conservatorship of Texas' Child Protective Services (CPS) on their 18th birthday and be a US citizen or legal permanent resident with a Green Card. This plan is available to those with household incomes at or below 400% of the Federal Poverty Level. The STAR Health Plan website, www.fostercaretx.com, provides resources and important phone numbers and allows users to search for doctors who accept this insurance.
Former Foster Care Children's (FFCC) Program
The FFCC Program is a type of free Medicaid insurance that covers most aged-out foster youth until the end of the month of their 26th birthday. To be eligible, one must be a US citizen or legal permanent resident under the age of 21, have been receiving foster youth Medicaid when they turned 18, and currently live in Texas.
Medicaid for Transitioning Foster Care Youth (MTFCY) Program
The MTFCY Program is another Medicaid option for former foster youth who did not receive Medicaid when they turned 18. It covers individuals until their 21st birthday, after which they will need to obtain health insurance from another source. Eligibility requirements include being under the age of 21, a US citizen or legal permanent resident, having inadequate health coverage, and living in Texas.
It is important to note that undocumented aged foster youth are not eligible for the Medicaid programs mentioned above. However, CPS is required to assist foster youth in obtaining legal immigration status before they age out of foster care.
The availability and specifics of insurance plans can vary by county, so it is essential to review the providers, services, and "value-added" services offered by each plan in your specific county.
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How to switch insurance plans
Foster children in Texas are covered by Medicaid insurance. There are two types of Medicaid insurance for former foster children: the Former Foster Care Children's (FFCC) Medicaid Program and the Medicaid for Transitioning Foster Care Youth (MTFCY) Program. To qualify for either of these programs, you must meet the following requirements:
- Be a US citizen, a legal permanent resident (green card holder), or fall under a specified immigrant category
- Have a household income at or below 400% of the Federal Poverty Level ($49,960 per year for a household of one in 2019)
- Live in Texas
- Be under the age of 21 (MTFCY) or under the age of 26 (FFCC)
- Have been in the conservatorship of Texas' Child Protective Services (CPS) on your 18th birthday
- Have been receiving foster youth Medicaid when you turned 18 (FFCC only)
If you meet these requirements, you can apply for Medicaid through the Texas Foster Youth Justice Project. Once you have qualified for either the FFCC or MTFCY Program, you will be enrolled in a specific health care plan, such as STAR Health, which covers aged-out foster youth between the ages of 18 and 20 as well as current foster youth.
If you move to a new county in Texas, you may need to switch your insurance plan. Different counties offer different STAR insurance plans, such as Blue Cross Blue Shield and Sendero. You can find information about the STAR plans available in your county on the Texas Medicaid website. When deciding whether to switch plans or choosing a new plan, you should carefully review the providers on each plan. Check if your doctor accepts the plan and if there are providers and services near where you live. Also, look into what extra services, or "value-added" services, are offered by the plan.
If you are an undocumented aged foster youth, you are not eligible for the Medicaid programs for aged out foster youth. However, CPS is required to help foster youth obtain legal immigration status before they age out of foster care. If this has not been taken care of for you yet, you should contact the Texas Foster Youth Justice Project for guidance about your eligibility for insurance.
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What to do if you don't have insurance
If you are a foster youth in Texas, you may be eligible for the Former Foster Care Children's (FFCC) Program, a type of free Medicaid insurance that most foster youth are covered by until the end of the month of their 26th birthday. If you are under 21 and do not qualify for the FFCC program, you may qualify for the Medicaid for Transitioning Foster Care Youth (MTFCY) Program.
If you are uninsured, you may face unaffordable medical bills if you seek care. Nearly half of uninsured adults face difficulty in affording healthcare costs, and more than six in ten uninsured adults report having healthcare debt. Uninsured adults are more likely to face negative consequences due to healthcare debt, such as using up their savings, having difficulty paying other living expenses, or borrowing money. Hospitals frequently charge uninsured patients higher rates than those paid by private health insurers and public programs. Unaffordable medical bills can quickly translate into medical debt, especially for uninsured adults.
Since 2018, there has been no fee or tax penalty for not having health insurance. However, doctors have the right to refuse patients without insurance or the ability to pay out-of-pocket expenses. While federal and state laws require certain hospitals to provide some level of charity care, not all eligible patients benefit from these programs.
If you are uninsured, it is important to be aware of the potential financial implications and risks associated with seeking medical care. Unexpected illnesses or accidents can lead to poor credit or even bankruptcy, as medical debt is the most common type of third-party collection on consumers' credit reports.
To mitigate these risks, you can explore options for obtaining health insurance, such as enrolling in a Qualified Health Plan (QHP) or researching state-specific programs and exemptions. Additionally, public hospitals, community clinics, health centers, and local providers that serve underserved communities provide an important healthcare safety net for uninsured people.
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How to obtain legal immigration status for undocumented foster kids
Undocumented foster children in the United States may have a pathway to legal immigration status and permanent residency through the Special Immigrant Juvenile Status (SIJS). SIJS eligibility criteria include being a current dependent of the Juvenile Court, having experienced abuse, neglect, or abandonment, and having a best interest not to return to their country of nationality or last habitual residence. Once a child is deemed eligible for SIJS, a referral is made to the Special Immigrant Status (SIS) Unit, which provides immigration services and collaborates with immigration attorneys to help the child obtain lawful permanent resident status and a "green card".
Another option for undocumented children is the U non-immigrant status (U visa), which allows the undocumented person to remain legally in the United States for three years, after which they can apply for lawful permanent residency. To be eligible for a U visa, the child must have experienced or have information about substantial physical or mental abuse related to a crime that occurred in the US and be willing to cooperate with law enforcement in the investigation or prosecution of the crime.
Additionally, undocumented children who are victims of abuse, neglect, abandonment, or exploitation may be eligible for other forms of immigration relief, such as T-Visas and VAWA. T-Visas are for undocumented immigrants who have been subjected to forced prostitution or labour, while VAWA permits an abused undocumented child of a US citizen or lawful permanent resident to self-petition for a legal resident card, even if the child was not abused, as long as the parent qualifies for VAWA.
In terms of adoption, only children can be adopted for immigration purposes, and the adoption must be finalized before the child turns 16 years of age. For a child to obtain a green card through adoption, the adopting parent must have had legal and physical custody of the child for at least two years while the child was a minor, and the child must have lived with the adopting parent for at least two years before filing the required I-130 petition.
It is important to note that the information provided here may not cover all possible options, and that specific circumstances may require additional considerations. Seeking the advice of an immigration attorney or other qualified professionals is always recommended for personalized guidance.
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Frequently asked questions
Former foster youth who meet the following criteria are eligible for the FFCC Program:
- Under the age of 26
- Were in the conservatorship of Texas' CPS on their 18th birthday
- Were receiving foster youth Medicaid when they turned 18
- Are US citizens or, if under the age of 21 and not a citizen, are a legal permanent resident or have a green card
- Currently live in Texas
The Former Foster Care Children’s (FFCC) Program is a type of free Medicaid insurance that most aged-out foster youth are covered by.
To apply for the FFCC Program, you need to provide proof that you meet the eligibility criteria. You can do this by providing the following documents:
- Birth certificate
- Social Security card
- Proof of income
- Proof of residency in Texas
The FFCC Program provides free or low-cost health insurance to former foster youth, covering a range of medical services, including doctor's visits, hospital stays, prescription drugs, and more.
