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It is only for children adopted out of a state foster or foster/adopt system. The state they come from keeps the tab and pays the state they move to if needed also. Our two adopted kids have it and have vastly different needs. my son was very medically fragile and needed several therapies,numerous meds and specialists just to get him to age 10. he still has the meds and specialists and we count our blessing that he had help with insuarance. The co-pays alone could have been a real hardship. Our daughter age 10seemed healthy and we considered not signing for the state medicaid but as mental illness was in her family we thought better safe. In the four years we've had her we did get a bipolar and reactive detachment diagnosis on her and have accessed psychiatrists and therapists and mood stablizing meds. Her needs will probably be life long and so at 18 she may need to apply for medicaid for herself. So hope that helps. We didn't birth and abuse neglect these kids but we are willing to raise and love them. We are happy not to go bankcrupt doing it if possible.