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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M01 July 2020 Subchapter Subject Page ending with Page M0120 MEDICAL ASSISTANCE APPLICATION M0120.200 8
5. Adoption Assistance & Special Medical Needs Children a. IV-E A separate MA application is not required for a child who has been determined eligible for Title IV-E Adoption Assistance, regardless of which state has the adoption assistance agreement with the adoptive parents. IV-E Adoption Assistance children who have been placed for adoption through the Interstate Compact for Adoption and Medical Assistance (ICAMA) should have an ICAMA form 6.01 which verifies their Title IV-E eligibility for Medicaid. The ICAMA form 6.01 serves as the MA application form. b. Non-IV-E Non-IV-E Adoption Assistance children include Non-IV-E Special Medical Needs children.
1) Placed by a Virginia agency
An MA application is required for all non-IV-E Adoption Assistance and Non-IV-E Special Medical Needs children whose parents have adoption assistance agreements with a Virginia public or private child-placing agency. The child’s adoptive parent signs and files the application for the child. 2) Placed by another state
Non-IV-E Adoption Assistance children who have been placed for adoption through the Interstate Compact for Adoption and Medical Assistance (ICAMA) should have an ICAMA form 6.01 which verifies their adoption assistance status (IV-E or non-IV-E). The ICAMA form 6.01 serves as the MA application form and a separate application is not required when: • the other state is an ICAMA member state, and • the ICAMA member state reciprocates Medicaid coverage of Virginia Non-Title IV-E Adoption Assistance children. All states and territories EXCEPT Vermont, Wyoming, Puerto Rico and Virgin Islands are members or associate members of ICAMA. A list of the ICAMA member states and whether they reciprocate Medicaid coverage for Non-IV-E Adoption Assistance children is in M0120, Appendix 3. An MA application must be filed for Non-IV-E Adoption Assistance children from non-member states and ICAMA member or associate member states which do NOT reciprocate. The child’s adoptive parent signs and files the MA application for the child. D. Deceased Applicant An application may be made on the behalf of a deceased person within a three-month period subsequent to the month of his death if both of the following conditions were met: