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Title 8: Medicaid Page 38 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Residency Revised October 10, 2025 Determining Residency for Persons Aged 21… Residency policies for a person who is under aged 21 depend on whether or not the person lives in an institutional or foster care setting. Not in an Institution or in Foster Care Legal reference: 441 IAC 75.10(2) When the person under age 21 is not institutionalized and is not in foster care, the state of residence depends upon the person’s situation:  For a person who is emancipated or married and capable of expressing intent, the state of residence is the state where the person is living with intent to remain there permanently or indefinitely. This applies even if the person is temporarily absent from that state.  For a person whose Medicaid eligibility is based on blindness or disability, the state of residence is where the person is living.  For children receiving adoption assistance under Title IV-E, the state of residence is the state where the child lives. A baby whose adoption is being done by an Iowa adoption agency is not considered an Iowa resident if neither the biological mother nor the adoptive parents are Iowa residents. But if either the biological mother or the adoptive parents are Iowa residents, the baby is an Iowa resident. Once adopted, the baby’s residency is that of the adoptive parents.  For any other noninstitutionalized person, use MAGI-related residency rules to determine state of residency. See Nonfinancial MAGI-Related Eligibility: Residency. In an Institution or in Foster Care Legal reference: 441 IAC 75.10 When the person under age 21 is institutionalized or in foster care, the state of residency depends upon whether or not a state arranged the placement:  If a state arranged placement, the state of residency is that state. However, a Title IV-E-eligible child placed out of state by HHS is eligible for Medicaid from the other state. A Title IV-E-eligible child placed in Iowa by another state is eligible for Iowa Medicaid.  If a state did not arrange the placement, the state of residence for an institutionalized person under 21 is: • The parent’s or legal guardian’s state of residence at the time of placement, or