Most children can be covered through Medi-Cal after their adoption. The program which is most applicable is the Title IV-E Adoption Assistance Program.
Title IV-E provides both assistance for adoption fees and medical coverage through Medi-Cal for the child being adopted. This alleviates the financial burden on the new parents to obtain healthcare coverage. If the child being adopted is eligible for this assistance, the adoptive parents can take advantage of it at the time of the adoption, or they can sign a form to have their benefits held. This will allow the parents to get Medi-Cal coverage for the child at a later date if it is needed.
In order to be eligible for Title IV-E, the child will need to be considered a special needs child. Certain characteristics have been identified that make it hard to get a child placed in a permanent home. When children demonstrate one or more of these characteristics, they are considered special needs. In California, special needs children are classified by one of the following categories.
- The child is over three years of age
- The child’s race, ethnicity, color, or language create barriers to the child being easily adopted
- If the child is a member of a sibling group, that is being adopted as a group
- If the child has a mental, physical, emotional, or medical disability
- If the child’s family/parental history presents medical or behavioral issues that may have had an adverse impact on the child’s development
Aside from adoption assistance, adopted children many have coverage with Medi-Cal under one of their other programs. For example:
- Section 1931(b) – Medi-Cal for Families. This program is based on financial need and will cover adopted children based on the income and resources of their adoptive parents.
- Minor Consent Program. This program provides specific services to minors under the age of 21. Eligibility is based on the income and resources of the child, and parental notification and consent are not required.
- Disability Programs. If the child has a disability that is already documented or can be documented, they may be eligible for one of the many disabilities Medi-Cal programs.
- Children’s Program. Medi-Cal has several healthcare programs for children that are based on the income of the household but at different levels. A household can make up to 200% of the FPL and still be eligible under a children’s program.
While there isn’t a specific program that covers every child that were in foster care and then adopted, Medi-Cal is comprised of a wide assortment of programs that contain a lot of overlaps. With all these programs available, adopted children are most likely to be covered by Medi-Cal.