Medicaid Work Requirements for Former Foster Youth
If you aged out of foster care, you are exempt from the 80-hour rule until you turn 26, even if you were in foster care in a different state.
Short answer: You are exempt until age 26 if you were in foster care when you turned 18 (or at an older age if your state extends foster care) and you had Medicaid while in foster care. CMS applies this to youth from any state, no matter what year you turned 18. Most former foster youth are in their own Medicaid group, which the rule does not cover at all.
The rule in the law
Federal law excludes anyone "described in" the former foster care youth Medicaid group, sec. 1902(a)(10)(A)(i)(IX) of the Social Security Act (sec. 1902(xx)(9)(A)(ii)(I)). The CMS rule (42 CFR 435.554(c)(1)) says you qualify if you:
- Are under 26
- Were in foster care under the responsibility of any state when you turned 18 (or the higher age your state uses for extended foster care)
- Were enrolled in Medicaid in any state while in that foster care
- Are not enrolled in another required Medicaid group, such as the group for parents
The 2018 SUPPORT Act opened this group to youth from other states only for people who turned 18 on or after January 1, 2023. CMS chose to apply the newer, broader test to everyone for the work requirement, no matter when you turned 18. Its example: someone who aged out in one state in 2024, moved to another state, and was enrolled in the adult group there is still exempt in 2027.
When the exemption ends
It ends when you turn 26. If you are still in the adult expansion group then, the rule can apply to you, unless another exemption fits. Plan ahead in the months before your 26th birthday.
What proof is usually needed
Medicaid applications already ask about foster care history. States should use their own child welfare and eligibility records, and CMS says they do not need to recheck your status until you turn 26. If your state asks, a letter from the child welfare agency or court records showing you were in foster care at 18 can help.
What to do next
- Answer "yes" to the foster care question on your Medicaid application or renewal.
- If you moved from another state, tell your Medicaid office where you were in foster care.
- Use the free checker to see if the rule applies to you and which exemptions may fit.
- Find your state guide for start dates, how to report, and who to call.
- Got a notice? You have at least 30 days to answer, and you can ask for a fair hearing. See what to do about a notice.
Frequently asked questions
Do former foster youth have to meet Medicaid work requirements?
No, not until age 26, if you were in foster care at 18 and had Medicaid while in foster care.
I aged out in another state. Am I still exempt?
Yes. CMS applies the exemption to youth who were in foster care in any state, no matter what year they turned 18.
I was adopted at 16. Am I exempt?
Not under this exemption, because you were not in foster care when you turned 18. Another exemption may fit.
What happens when I turn 26?
The exemption ends. If you are in the adult expansion group, you will need to meet the 80-hour rule or qualify for another exemption.
Are former foster youth exempt from SNAP work rules too?
No. The SNAP exemption for former foster youth ended in 2025. See SNAP rules for former foster youth.
Sources
- Public Law 119-21 (H.R. 1), sec. 71119: community engagement requirement (GovInfo)
- CMS interim final rule, Medicaid community engagement requirement, 91 FR 33348 (June 3, 2026)
- CMS-2454-IFC, official PDF (GovInfo)
- CMS State Health Official letter #22-003: coverage of youth formerly in foster care (Dec. 16, 2022)