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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 M0330.805 39
M0330.805 ADOPTION ASSISTANCE CHILDREN WITH SPECIAL NEEDS FOR MEDICAL OR REHABILITATIVE CARE
A. Policy 42 CFR 435.308(b) - A state may choose to provide medically needy coverage to a child 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 and 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 MN covered group. The child may be eligible in the MN Non-IV-E Adoption Assistance classification of Individuals Under Age 21 in section M0330.804. B. Nonfinancial Eligibility 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 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.
A child in an ICF or an ICF-MR 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. The child’s eligibility is determined in the F&C 300% SSI covered group in M0330.501.