Foster Care & Medicaid: What Caregivers Should Know

Taking care of children in the foster care system can be incredibly rewarding, but managing their medical needs can sometimes get complicated. Medicaid gives foster kids access to doctors, mental healthcare, prescriptions, and other services.

This health insurance can be especially helpful for children with disabilities such as autism, post-traumatic stress disorder (PTSD), or medical concerns like enuresis (bedwetting) that may require incontinence supplies. Keep reading to learn how Medicaid supports children in foster care and the most common conditions many of them face.

Most children in foster care get their health coverage through Medicaid. In fact, all children in foster care who qualify for Title IV-E — a federal funding program that helps states cover foster care expenses — are automatically eligible for Medicaid in their state. The goal of Title IV-E is to improve child welfare.

For many foster children, their state Medicaid program is the first time they’ve had consistent access to healthcare. With that coverage in place, social workers make sure foster children can receive the full range of care they need.

Their Medicaid program also includes Early and Periodic Screening, Diagnostic, and Treatment (EPSDT), a Medicaid benefit that covers regular checkups, screenings, and follow-up care for anyone under the age of 21. This is especially important because foster children often move between homes and schools. Medicaid goes with them, so they can keep getting care even when other parts of their life change.

In nearly every case, yes. Children who enter foster care are automatically eligible for Medicaid in most states because of Title IV-E with a few exceptions:

• Change in legal status: The foster child is adopted or reunified with their biological family. Any change in legal guardianship or custody can affect their Medicaid eligibility.
• Aging out of foster care: When a child turns 18 or 21 (depending on the state), they may “age out” of foster care. They may lose access to Medicaid services unless the state offers extended foster care.
• Moving across state lines: Medicaid works differently in each state, and coverage doesn’t transfer automatically. When a foster child moves to another state, their caseworker must start the process of getting them approved and enrolled in the new state’s Medicaid program. This is done through the Interstate Compact on the Placement of Children (ICPC).
• Administrative delays: Mistakes in paperwork, missed renewals, or delays in case management can cause a child to lose Medicaid coverage.

If you care for a foster child, always write down any changes in where they live, who takes care of them, their health, or their insurance. This helps make sure they continue getting the care they need.

They can, depending on how the adoption happened. 

If the adoption includes an adoption assistance agreement, the child will typically keep their Medicaid. Without this agreement, coverage may end after the adoption, depending on your state’s rules for beneficiaries.

Children adopted from the state foster care system often keep their Medicaid because they may qualify through Title IV-E or a state adoption assistance program. Private adoptions usually don’t offer that kind of automatic eligibility, so the child would need to qualify for Medicaid in another way, such as through low income or a disability.

Many families choose to keep Medicaid even if they also have private insurance. In these cases, Medicaid can act as secondary insurance, which is especially helpful if your child needs products or services that private insurance won’t cover. For example, if your child was adopted from foster care and has incontinence as a result of a health condition, Medicaid may cover necessary supplies, even when private healthcare plans won’t.

Nearly one in two adolescents who enter foster care have long-term physical problems, such as asthma or hearing loss.  Some physical problems are present from birth (congenital) or develop over time, while others result from abuse or neglect, including:

• Developmental delays: Foster children may be behind in speech, learning, and motor skills.
• Poor hygiene-related conditions: Without stable caregivers or routines, children may not get the care they need to stay clean and healthy. This can lead to issues like tooth decay, rashes, or urinary tract infections (UTIs).
• Behavioral concerns: Up to 80% of children in foster care have at least one mental health concern when they first enter the system. Anxiety, depression, and PTSD are some of the most common. For some children, the stress from their past home life can also contribute to urinary incontinence (UI), or trouble controlling their bladder.

Research shows that children in foster care experience bedwetting at a higher rate than children who aren’t in foster care. However, urinary incontinence can have many causes, so if you’re a foster care social worker or a foster care parent, it’s important to be patient and understanding. With consistent support and proper care, your foster child can feel more confident about their bladder control.

Some children in foster care have bladder control problems because of conditions they were born with, like Down syndrome, autism, or spina bifida. 

For others, long-term stress or past abuse can lead to common bladder issues, such as nocturnal enuresis (bedwetting while asleep). Incontinence can also be caused by medical conditions — like UTIs or chronic constipation — that may start before a child enters foster care or develops while they’re in foster care.

Social workers are the link between foster children, caregivers, and the resources they need to manage incontinence. While they may not order incontinence supplies themselves, they can guide caregivers through the process of getting their foster child covered by Medicaid to cover the cost of these supplies. This might involve:

• Helping foster parents fill out forms
• Gathering medical documentation
• Coordinating with doctors or Medicaid offices to confirm a foster child’s eligibility 

They can also flag unmet needs, such as untreated medical issues or a lack of incontinence supplies, and connect families to helpful services. This may include occupational therapy or behavioral health services for children who need assistance with the emotional effects of incontinence.

By staying involved and advocating for the child, social workers help ensure that important medical and daily care needs aren’t overlooked.

If you’re a foster parent caring for a child with incontinence, the first step is to make sure they’re enrolled in Medicaid and that their coverage is active.

Next, you’ll need to schedule a visit with a healthcare provider. The healthcare provider will need to confirm the condition and write a prescription for incontinence supplies, such as diapers, pull-ups, or underpads. This is because Medicaid only covers the cost of incontinence supplies when it’s linked to a documented medical condition that causes incontinence. Most states cover the cost of these products, but the rules and products allowed can vary, so it’s a good idea to stay in touch with your child’s social worker.

Need help with receiving incontinence supplies? 

Whether it’s checking Medicaid coverage or setting up monthly deliveries straight to your home, Aeroflow Urology is here to help guide you through the process. See if your foster child qualifies for free incontinence supplies today:

No, Medicaid plans often have specific provider networks, which means Medicaid will typically only cover in-network doctors. Before scheduling appointments, check with your state’s Medicaid office to find a doctor who accepts their coverage.

Yes, if there’s a documented medical reason, Medicaid can cover incontinence products for older kids. Former foster care youth, including both teens and young adults, may still qualify depending on their state’s Medicaid rules. Check eligibility requirements at https://www.medicaid.gov/.

Your foster child will need a diagnosis and prescription from a healthcare provider for Medicaid to cover incontinence supplies. Requirements vary by state, but if your child qualifies, Aeroflow Urology can ship the supplies straight to your home for free.

Yes, if a young person was in foster care and had Medicaid on or after their 18th birthday, they can keep getting Medicaid coverage until they turn 26.

Medicaid doesn’t automatically move with your foster child. You will have to re-enroll your foster child in Medicaid in the new state, as each state has its own Medicaid rules. A social worker or case manager can help with the transfer.

References:

American Academy of Pediatrics. (n.d.). Physical health needs of children in foster care. https://aap.org/en/patient-care/foster-care/physical-health-needs-of-children-in-foster-care

Association of Administrators of the Interstate Compact on the Placement of Children (AAICPC). (n.d.). About. American Public Human Services Association (APHSA). https://aphsa.org/aaicpc/

Castillo, J., & Pham, S. (2024). Enuresis and psychological concerns in a foster care population. Psychological Trauma: Theory, Research, Practice, and Policy, 16(Suppl. 1), S39–S44. https://doi.org/10.1037/tra0001192

Council on Foster Care, Adoption, and Kinship Care; Committee on Adolescence; Council on Early Childhood. (2015). Health care issues for children and adolescents in foster care and kinship care. Pediatrics, 136(4), e1131–e1140. https://doi.org/10.1542/peds.2015-2655

Juvenile Law Center. (n.d.). Foster care. https://jlc.org/foster-care

Thompson, V. (2022, June 3). How state Medicaid programs serve children and youth in foster care. National Academy for State Health Policy. https://nashp.org/how-state-medicaid-programs-serve-children-and-youth-in-foster-care/

U.S. Centers for Medicare & Medicaid Services. (n.d.). Medicaid. Medicaid.gov. https://medicaid.gov/

U.S. Department of Health & Human Services, Administration for Children and Families. (2025, January 17). Title IV-E prevention program. https://acf.gov/cb/title-iv-e-prevention-program

Disclaimer

Information provided on the Aeroflow Urology blog is not intended as a substitute for medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.