Citizenship and Alien Status Requirements for the Medicaid Program

Date:  October 26, 2004 

 

12 

Trans. No.  04 OMM/ADM-7 

 

Page No. 

 

 

1. QUALIFIED IMMIGRANTS WHO ENTERED THE U.S. PRIOR TO AUGUST 22, 1996: 

 

A qualified immigrant who entered the United States prior to August 

22, 1996, may receive all care and services available under the 

Medicaid program, provided he or she is determined to be otherwise 

eligible.  This provision includes individuals who attained 

qualified immigrant status subsequent to August 22, 1996, and who 

can demonstrate to the district’s satisfaction that they 

continuously resided in the United States until attaining qualified 

immigrant status.  Federal Financial Participation (FFP) should be 

claimed for Medicaid provided to these qualified immigrants. 

 

2. QUALIFIED IMMIGRANTS WHO ENTERED THE U.S. ON OR AFTER AUGUST 22, 

1996 AND ARE IN CERTAIN CATEGORIES EXEMPT FROM THE FEDERAL FIVE YEAR 

BAN ON MEDICAID:

 

 

The following qualified immigrants

 

who entered the United States on 

or after August 22, 1996, may receive all care and services 

available under the Medicaid program, provided they are determined 

to be otherwise eligible. 

•

 

Persons who have been granted asylum under Section 208 of the 

INA; 

•

 

Persons for whom deportation has been withheld under Section 

243(h) or 241 (b) (3) of the INA; 

•

 

Persons who are Cuban and Haitian entrants (as defined in 

Section 501(e) of the Refugee Education Assistance Act of 

1980); 

•

 

Qualified immigrants lawfully residing in the State who are on 

active duty in the armed forces, or who have received an 

honorable discharge from the armed forces and their spouses 

and unmarried dependent children, who are also qualified 

immigrants. 

NOTE: Non-citizen veterans and Active Duty Military 

personnel and their spouses and children are exempt from 

most of the immigration status related restrictions under 

the Personal Responsibility and Work Opportunity 

Reconciliation Act (PRWORA).  For example they are eligible 

for Supplemental Security Income (SSI) and Food Stamps and 

are exempt from the five year ban. 

•

 

Refugees under Section 207 of the INA (including Amerasian 

immigrants admitted under the provisions of Public Law 100-

202). 

•

 

Victims of a severe form of trafficking are qualified 

immigrants who receive Medicaid to the same extent as 

refugees. A comprehensive discussion of this group is set 

forth at Section “D.4.” of this directive.  

 

Federal Financial Participation (FFP) should be claimed for Medicaid 

provided to these qualified immigrants. 

 

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Date:  October 26, 2004 

 

13 

Trans. No.  04 OMM/ADM-7 

 

Page No. 

 

 

3.

 

ALL OTHER QUALIFIED IMMIGRANTS WHO ARE NOT IN THE ABOVE TWO GROUPS:  

 

This group of qualified immigrants may receive all care and services 

available under the Medicaid program, provided s/he is determined to 

be otherwise eligible.  However, for these individuals their Date of 

Entry (DOE) will determine whether or not Federal Financial 

Participation (FFP) is available.  During their first five years in 

the U.S. with a status as qualified immigrant, FFP is not available.  

The cost of their Medicaid coverage will be born solely by  

State 

and local shares (50% State/50% local).  Once a qualified immigrant 

in this group has resided in the United States as a qualified 

immigrant for a period of five years, FFP will become available. 

This means the federal government will pay a share of their Medicaid 

costs.  The shares are generally split 50%Federal/25%State/25%local. 

 

Therefore, for these individuals it is critical that the Medicaid 

eligibility worker make the appropriate WMS system changes to assure 

the change from FNP to FFP claiming as the five year ban period 

comes to an end. 

 

Qualified immigrants in this group include the following: 

•

 

Persons lawfully admitted for permanent residence (i.e. LPRs-

“green card holders”) under the Immigration and  

 

Nationality Act (INA);  

•

 

Persons paroled into the United States under Section 212(d)(5) 

of the INA for a period of at least one year; 

•

 

Persons granted conditional entry pursuant to Section 

203(a)(7)Immigration and Nationality ACT (INA); and 

•

 

Persons who have been determined by the social services 

district to be in need of Medicaid as a result of being 

battered or subject to extreme cruelty in the United States by 

a spouse, parent, or by a member of the spouse’s or parent’s 

family residing in the same household as the alien family 

member at the time of the battering or extreme cruelty. A 

comprehensive discussion of this group is set forth at Section 

“D.5.” of this directive.  

 

4.

 

VICTIMS OF A SEVERE FORM OF TRAFFICKING: 

 

There have been several new visa categories issued by the United 

States Citizenship and Immigration Services (USCIS) over the past 

several years. The T Visa Status is one of them, and is issued by 

USCIS to immigrants who are “victims of a severe form of 

trafficking”.  

 

For purposes of Medicaid/Family Health Plus/Child Health Plus A 

eligibility victims of a severe form of trafficking, holders of a T 

visa/T-1, and holders of T-2, T-3, T-4 and T-5 (“Derivative T-

visas”) who are the minor children, spouses and in some cases the 

parents and siblings of victims of severe forms of trafficking in 

persons, may receive Medicaid benefits to the same extent as 

refugees (Trafficking Victims Protection Reauthorization Act of 2003 

[TVPRA-P.L. 108-193]). 

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