Page 2

MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL Division of Welfare and Supportive Services Medical Assistance Manual 24 Jan 26 MTL 02/24 C-105.1 GENERAL ELIGIBILITY REQUIREMENTS INDIVIDUALS PLACED IN AN OUT-OF-STATE INSTITUTION When a competent individual leaves the facility in which the individual is placed by a State, the individual’s State of residence, for Medicaid purposes, is the State where the individual is physically located. Note: Children who receive Title IV-E adoption assistance or foster care payments are considered residents of the State in which the child lives. C-105.2 Individuals Under the Age 21 The State of residence for individuals under age 21 who are not receiving Title IV-E payments and not receiving a State supplement is as follows: a. An individual capable of indicating intent and who is emancipated from his or her parents or who is married, the State of residence is the state where the individual intends to reside or has entered the State with a job commitment or seeking employment. b. An individual not capable of indicating intent, not living in an institution, not receiving Title IV-E and not receiving a State Supplementary Payment the State of residence is: 1. the State where the individual resides; or 2. the State of residency of the parents or caretaker with whom the individual resides. c. For any individual under the age of 21 who is institutionalized and, neither married nor emancipated, the State of residency is determined as follows: 1. the parent’s or legal guardian’s State of residence at the time of placement; or 2. the current State of residence of the parent or legal guardian who files the application if the individual is institutionalized in the State; or 3. the State of residence of the individual or party who filed an application is used if the individual has been abandoned by his or her parent(s), does not have a legal guardian, and is institutionalized in that State. NOTE: A legal guardian must be appointed by the court, and the parental rights terminated. When the legal guardian applies on behalf of the institutionalized individual, the State of residence of the guardian is used instead of the parents’ State of residence. C-105.3 Individuals Age 21 and Over The State of residence for an individual residing in an institution that became incapable of indicating intent before age 21 is: