Adoption Assistance and Medicaid Coverage

When adoption assistance includes medical assistance, the medical assistance is provided through the Medicaid program. Medicaid assists with the following for the child:

• Medical and dental care.
• Eye care.
• Durable medical equipment and supplies.
• Psychiatric and behavioral health care.
• Medical transportation.

Medicaid coverage is provided as an adoption assistance benefit when the child is eligible for either Title IV-E or state-paid adoption assistance. Coverage is not provided when the child is only eligible for reimbursement of nonrecurring adoption expenses.

The coverage for children receiving adoption assistance benefits transitions to the STAR (State of Texas Access Reform) Medicaid program.

Medicaid Coverage for Children Placed or Moved Out of State

Under federal law, children receiving Title IV-E adoption assistance are entitled to receive Medicaid coverage from their state or territory of residence, no matter which state negotiated the adoption assistance agreement. Many states, including Texas, also provide medical assistance to children from other states and U.S. territories who receive state-paid adoption assistance.

DFPS uses procedures developed under the Interstate Compact on Adoption and Medical Assistance (ICAMA) to notify another state or territory that a Texas child is moving or living there and to request activation of Medicaid coverage. See 1731 The Interstate Compact on Adoption and Medical Assistance and its Effect on Adoption Assistance.

If the other state or territory does not provide coverage to recipients of state-paid adoption assistance, Texas continues to provide Medicaid coverage. However, this coverage can be used only with providers enrolled in the Texas Medicaid program.

See Texas Administrative Code §700.861: Will my child receive benefits if I move to, or live in, another state?