Eligibility Charts   7.4.2

 

ALL

The following charts describe the immigration-related eligibility requirements for MA, TANF/GC, and FS. In addition, a chart showing SSI/IDA eligibility has been included  to assist SSRs who get questions from customers about SSI eligibility rules.   When using these charts, it is important to note that many immigrants will fall into more than one immigrant category. In such cases, the immigrant is eligible for the program benefit if s/he falls into at least one eligible category.

MA

Immigration Category Circumstances Under Which Immigrant Is Eligible for MEDICAID OR D.C. MEDICAL CHARITIES (other than Emergency Medicaid) Immigrants Receiving SSI Eligible   See the SSI table for information on immigrant eligibility for SSI. Qualified Immigrant  Eligible if: entered the country before August 22, 1996;  meets veteran exemption; meets Native American exception; or  entered the country on or after August 22, 1996 and has been in the U.S. in a 'qualified status' for more than 5 years (no one  qualified under this category until August 23, 2001). Immigrant Category     Entered the country as a Refugee (or was granted refugee status)   Granted Asylee Status   Granted Withholding of Removal   Cuban/Haitian Entrant   Amerasian Immigrant   Victim of Severe Form of Trafficking in Persons    All immigrants in these categories are eligible for Medicaid Non-Qualified Immigrant  Eligible if meets Native American exception

 

Individuals who would be eligible for Medicaid but for their immigrant status are eligible for Emergency Medicaid services. Medical services covered are for medical conditions  (including emergency labor and delivery) manifesting themselves by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in:

 

In addition to Emergency Medicaid Services, non-qualified immigrant children may qualify for locally-funded Medical assistance through  “DC Healthy Families Expansion Coverage,” a funding-capped  program that can serve approximately 800 children. Children eligible for “Expansion Coverage” must be ineligible for standard Medicaid because of their immigration status. They must meet all other non-financial requirements in the AX Medicaid program, except provision of a Social Security Number.  heir income must be below 200 per cent of Federal Poverty Level.

 

Children eligible for “Expansion Coverage” must enroll in managed care and are eligible for standard Medicaid services. However, they cannot receive Medicaid services on a fee-for service basis prior to enrolling in managed care. Children eligible for “Expansion Coverage” are not eligible for retroactive eligibility and cannot qualify for benefits by spending down their income with medical bills.

 

IMA currently runs a waiting list when requests for the program exceed the program’s capacity.

 

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