Foster Care Medicaid (FSTMA)

One of the benefits of subsidized guardianship is the child’s extended Foster Care Medicaid coverage. Foster Care Medicaid (FSTMA) is a full benefit, fee-for-service Medicaid plan, which means there are no co-pays, premiums, or deductibles for members. The child remains eligible for FSTMA as long as their Subsidized Guardianship Agreement is in effect (e.g., not terminated).

After guardianship is established, you are not required to add the child to your private health insurance policy but may do so if you wish. If you do, your insurance would become the child’s primary insurance and FSTMA would be their secondary coverage.

If the child has an active Subsidized Guardianship Agreement when they turn 18, they may be eligible for BadgerCare+ (WI Medicaid) coverage until their 26th birthday without income or resource testing. Refer to this memo 2020-37i for more details: https://dcf.wisconsin.gov/files/cwportal/policy/pdf/memos/2020-37i.pdf.

If you have any questions about Foster Care Medicaid, please contact the Department of Children and Families Medicaid Program at 833-543-5265 or dcfmbdspmedicaid@wisconsin.gov.

Out of State Coverage

There are specific exclusions to subsidized guardianship FSTMA coverage if you move outside the state of Wisconsin. This depends on the child’s IV-E eligibility. Consult with the child welfare agency that entered into the Subsidized Guardianship Agreement with you to determine the child’s IV-E status.

• If a child is Title IV-E eligible, they are eligible to receive FSTMA in all 50 states, Washington D.C., and Puerto Rico.
  • For these children, Wisconsin FSTMA will be cancelled, and a referral will be sent to their new state of residence through the Interstate Compact on Adoption and Medical Assistance (ICAMA) system.
  • Families may instead choose to keep the child’s Wisconsin FSTMA open by writing an email request to DCFDSPWIICAMA@wisconsin.gov.
• If a child is not Title IV-E eligible, they will only receive FSTMA in states that have made the choice to provide FSTMA to non-IV-E eligible youth. As of August 2023, this includes California, Connecticut, Georgia, Idaho, Louisiana, Massachusetts, Michigan, Missouri, New Jersey, Oklahoma, Oregon, Texas, Vermont, Wyoming, and Washington D.C.
  • For non-IV-E eligible children moving to one of the states above, Wisconsin FSTMA will be cancelled, and a referral will be sent to their new state of residence through the ICAMA system.
    • Families may instead choose to keep Wisconsin FSTMA open by writing an email request to DCFDSPWIICAMA@wisconsin.gov.
  • For non-IV-E eligible children moving to a state beyond those 14 & Washington D.C., families will have two options:
    • Leave Wisconsin FSTMA open. They may not apply for any sort of Medicaid (including income-based) in the new state if they choose to leave Wisconsin FSTMA open. They may still enroll in private insurance. They may travel back to WI to receive medical care or may try to locate providers in their new state of residence that accept Wisconsin FSTMA. This is a common choice for families living in Illinois and Minnesota.
    • Close Wisconsin FSTMA. The family is then free to apply for another type of Medicaid in the new state of residence instead. They may still enroll in private insurance.

For more information see: https://dcf.wisconsin.gov/files/publications/pdf/5676.pdf.