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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 January 2024 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.107 6

2. Adoptive Placement While in adoptive placement, the child may continue to be treated as a foster care child. However, once the interlocutory or the final order of adoption is entered, the child must be treated as a Non-IV-E adoption assistance child; see 3. below. 3. Non-IV-E Adoption Assistance- Interlocutory or Final Order Entered For applications received prior to October 1, 2013 and renewals completed prior to April 1, 2013, financial eligibility is determined using the assistance unit procedures in subchapter M0520, which require the inclusion of the child’s adoptive parent(s) and sibling(s). An adoption assistance child must have his/her eligibility determined by counting or deeming (as appropriate) his/her parent’s and sibling’s income. For applications received on or after October 1, 2013, use the policies and procedures contained in chapter M04. 4. Child in ICF or ICF- ID A child in an ICF or an ICF-ID is an institutionalized individual in a medical facility when he meets the definition of “institutionalized individual” in section M1410.010 B.2. When he meets the institutionalized individual definition, he is an assistance unit of one person. E. Resources There is no resource test for the Individuals Under Age 21 covered group. F. Income 1. Income Limits For the Individuals Under Age 21 covered group, the income limit is the income limit found in M04, Appendix 5. The foster care or adoption subsidy payment is excluded when determining the unit’s income eligibility. Foster care and Adoption Assistance children in residential facilities do not have a different income limit. For a foster care/adoption assistance child living outside the State of Virginia, the income limit for the assistance unit is the income limit for the Virginia locality which holds custody, pays the adoption subsidy, or signed the adoption assistance agreement. 2. Income Exceeds F&C 100% Income Limit For foster care (including DJJ) and adoption assistance children whose income exceeds the Individuals Under Age 21 income limit, determine the child’s Medicaid eligibility in the Child Under 19 covered group and for FAMIS if the child under 19 or as an MN Individual Under Age 21 if the child is over 19 but under 21 (see M0330.804). Ineligible individuals must be referred to the Health Insurance Marketplace for evaluation for the Advance Premium Tax Credit (APTC). G. Entitlement & Enrollment Children under 19 receive 12 months of continuous eligibility unless they reach age 19; are no longer Virginia residents; the child or child’s representative requests eligibility be closed; the agency determines that eligibility was incorrectly approved because of agency error or fraud, abuse, or perjury attributed to the child or the child's representative; or the child is deceased. 1. Entitlement Entitlement to Medicaid begins the first day of the month in which the Medicaid application is filed, if all eligibility factors are met in that month. Retroactive entitlement, up to three months prior to application, is applicable if all Medicaid eligibility criteria were met during the retroactive period.