Page 113

Title 8: Medicaid Page 109 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Nonfinancial MAGI-Related Eligibility Revised October 10, 2025 Adoption Adoption Legal reference: 441 IAC 75 (Rules in Process) When a mother intends to place her child for adoption shortly after birth, the child is considered as living with the mother until the legal release of custody is signed and custody is actually relinquished. Iowa law requires that when a child is voluntarily placed for adoption, a release of custody cannot be signed less than 72 hours after the child’s birth. The adoption does not sever a biological relationship. Joint Custody Legal reference: 441 IAC 75 (Rules in Process) A child can receive Medicaid in one household only. Living with a parent or other caretaker implies the existence of a relationship involving an accepted responsibility on the part of the caretaker for the primary care of the child. A non-parental caretaker must attest to having primary responsibility for the child’s care. In joint custody situations, the child shall be considered to be living with the custodial parent or other caretaker (which is determined as follows) when a child lives in the home of one parent or other caretaker some of the time and also lives in the separate home of the other parent or another caretaker:  As specified in a court order or binding separation, divorce or custody agreement, or,  If there is no such order, the parent or other caretaker with whom the child spends most nights shall be considered the custodial parent or other caretaker. • When a child spends equal amounts of time in the home of each parent and both parents apply for Medicaid for the child, the parents must decide which parent will continue with the application. Likewise, when a child spends equal amounts of time in the home of a parent and the home of another caretaker, the parent or other caretaker must decide which caretaker will continue with the application. • If the parents, or the parent and other caretaker, cannot reach a decision, the department will make the determination based on the totality of the available circumstances.