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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M03 April 2022 Subchapter Subject Page ending with Page M0330.000 FAMILIES & CHILDREN GROUPS M0330.108 7

2. Enrollment The aid category (AC) for individuals in the covered group of Individuals Under Age 21 is: • 076 for a non-IV-E Foster Care child; • 075 for a Department of Juvenile Justice child; • 072 for a Non-IV-E Adoption Assistance child; • 082 for a child under age 21 in an ICF or ICF-ID.

M0330.108 ADOPTION ASSISTANCE CHILDREN WITH SPECIAL NEEDS FOR MEDICAL OR REHABILITATIVE CARE

A. Policy 42 CFR 435.227 - The federal Medicaid law allows the State Plan to cover an individual under age 21 years: • for whom a non-IV-E adoption assistance agreement between the state and the adoptive parent(s) is in effect; • who cannot be placed with adoptive parents without Medicaid because the child has special needs for medical or rehabilitative care; and • who was enrolled in Medicaid under any covered group before the adoption assistance agreement was entered into OR who would have been eligible for Medicaid before the adoption assistance agreement was entered into if the eligibility requirements and standards of the IV-E foster care program were used, without employing the threshold title IV-A eligibility determination. If the child was not enrolled in Medicaid or would not have been eligible for Medicaid prior to the adoption assistance agreement being entered into, the child is not eligible for Medicaid in the Adoption Assistance Children With Special Needs for Medical or Rehabilitative Care covered group. The child’s eligibility in another covered group must be evaluated. If the child is under age 19, evaluate his eligibility in the FAMIS Plus covered group of Child Under Age 19 (see M0330.300). If the child is over age 19 but under age 21, the child may be eligible as a Non-IV-E Adoption Assistance child in the MN Individuals Under Age 21 covered group. See section M0330.804. B. Nonfinancial Eligibility Requirements The child must: • be under age 21,

• meet the definition of a child with special needs for medical or rehabilitative care adopted under a Non IV-E Adoption Assistance agreement in M0310.102, and

• meet the nonfinancial requirements in chapter M02. C. Financial Eligibility Requirements 1. Assistance Unit The assistance unit consists of only the child if the child was eligible for Medicaid prior to the adoption assistance agreement being entered into. The adoptive parent(s)’ income and resources are not counted or deemed; only the child’s own income and resources are counted.