D. Transitioning Foster Care Youth

The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA), requires states to provide Medicaid coverage to youth and young adults under age 26 who were in foster care and were receiving Medicaid when they aged out of foster care.

The Former Foster Care Children (FFCC) program provides healthcare coverage to youth who aged out of foster care at age 18, were receiving Medicaid coverage at the time they aged out, who are a U.S. citizen, and meet all other Medicaid eligibility criteria. This coverage is available through age 25 under two separate programs, based on age:

•   Young adults ages 18 through 20 are automatically enrolled in the STAR Health program, but can switch to the STAR program, if they prefer; and

•   Young adults ages 21 through 25 must choose a STAR or STAR+PLUS program health plan.

For foster youth who are under the age of 21 but who are not eligible for the FFCC program because the youth did not receive Medicaid at the time they aged out of care, coverage is provided by the Medicaid for Transitioning Youth (MTFCY) program in STAR Health for youth who:

•   Were in DFPS conservatorship on their 18th birthday or older;

•   Do not have other health coverage and meet program rules for income;

•   Meet program rules for income; and

•   Are a US citizen or have a qualified alien status, such as a green card.

It is not necessary for a court to extend jurisdiction beyond age 18 for this coverage to apply. For more information, see the Extending Foster Care for Transitioning Youth chapter of this Bench Book.

Special Issue: All Medicaid recipients, including youth formerly in foster care, must renew their Medicaid eligibility once every 12 months. To ensure continuous coverage, youth must provide their current mailing address to HHSC. If a youth changes their address without notifying HHSC, and HHSC receives returned mail and cannot locate the youth, the youth's Medicaid benefits will be denied. A youth can report an address change online through www.YourTexasBenefits.com, the Your Texas Benefits mobile app, by calling 2-1-1 (Option 2 after selecting a language), in person at a local Medicaid eligibility office, or by reporting the change in writing by mail or by fax. Youth must also respond to requests for information from HHSC and may need to verify that they are a Texas resident or their immigration status. As of December 10, 2022, youth formerly in foster care can self-attest to their Texas residency at application and redetermination rather than provide documentation (such as a driver's license or a utility bill).