The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 changed eligibility for individuals who are not citizens of the United States. MO HealthNet eligibility for aliens is based on whether the alien is qualified or non- qualified, and the alien's date of entry into the United States.
Section 6036 of the Deficit Reduction Act of 2005 amended section 1903 of the Social Security Act requiring states to obtain satisfactory documentation of citizenship and identity prior to approving Medicaid benefits, effective July 1, 2006.
Individuals currently receiving Medicaid benefits were required to provide verification of citizenship and identity at the next reinvestigation.
Certain individuals are exempt from having to provide documentation of citizenship and identity. Refer to Section 0110.020.00 for more information.
Refer to Section 0110.020.01 for a complete list of acceptable documents to use as verification.
Section 211 of the Children’s Health Insurance Program Reauthorization Act (CHIPRA) signed February 4, 2009, amended section 1903(x) of the Social Security Act. The law allows an individual declaring to be a citizen or national of the United States who is required to present documentary evidence of citizenship or nationality a reasonable opportunity to present the documentation. A reasonable opportunity is defined as 90 days from the date of approval.
Refer to Section 0110.020.02 for more information on reasonable opportunity.
A qualified alien is one who is:
All qualified aliens who were in the U.S. PRIOR to August 22, 1996, and who otherwise meet MC+ eligibility criteria, are eligible. The alien need not have been receiving Medicaid August 22, 1996.
For qualified aliens entering the U.S. ON OR AFTER August 22, 1996, some may be eligible for MC+ or Medicaid immediately, while others are subject to a five-year period of ineligibility.
1. Qualified Aliens Eligible Immediately (MAF)
Qualified aliens entering the U.S. on or after August 22, 1996 who are members of the groups listed below and who otherwise meet Medicaid eligibility criteria have no waiting period to obtain eligibility.
2. Qualified Aliens Five-Year Period of Ineligibility (MAF)
Qualified aliens entering the U.S. on or after August 22, 1996 who are not eligible for MC+ or Medicaid for five years following their date of entry are listed below. Once the five-year period of ineligibility has expired, these qualified aliens will be eligible for Medicaid in the same manner as other qualified aliens.
EXCEPTION: The five-year ineligibility period DOES NOT APPLY to the aliens listed above if they are:
Public Laws 110-161, 110-181, 110-329, and 111-08 grant certain Iraqi and Afghan immigrants special immigrant status under section 101(a)(27) of the Immigration and Nationality Act (INA) effective December 26, 2007. Under the special immigrant status, the immigrant is eligible for refugee resettlement assistance, entitlement programs, and other benefits as a refugee. Prior to December 19, 2009, eligibility could not exceed eight months.
The Defense Appropriations Act of FY 2010 (Section 8120, P.L. 111-118) provides that effective December 19, 2009, Iraqi and Afghan Special Immigrants are eligible for benefits to the same extent and for the same period as refugees pursuant to Section 207 of the Immigrations and Nationality Act. Provided that other eligibility requirements are met, Iraqi and Afghan Special Immigrants are eligible for benefits indefinitely.
The effective date of eligibility for both Iraqi and Afghan Special Immigrants can be no earlier than December 26, 2007, and begins the date the special immigrant status is granted. Iraqi and Afghan special immigrants enter the United States with another immigrant status, for example LPR (Lawful Permanent Resident). Once granted special immigrant status, these immigrants do not have to meet other immigrant qualifications such as residing in the U.S. for five years, during their period of special immigrant status.
Verify the date of entry into the U.S. and current immigrant status of the Iraqi and Afghan Special Immigrants. Verification of the status is provided in the Documentation for Special Immigrants chart, which is available on the FSD Intranet. To access the chart:
To enter the special immigrant information in FAMIS, take the actions listed below.
Non-qualified aliens are ineligible for the MC+ healthcare coverage.
NOTE: Qualified aliens subject to the five-year period of ineligibility and non-qualified aliens may be eligible for emergency medical care for ineligible aliens, refer to 1997 memorandum IM-137.
Section 6036 of the Deficit Reduction Act of 2005 amended section 1903 of the Social Security Act requiring states to obtain satisfactory documentation of citizenship and identity in order to receive Medicaid benefits. Effective July 1, 2006, states must obtain documents establishing citizenship and identity for new applicants and recipients for all categories of Medicaid. Documentation of citizenship and identity for recipients must be verified at the next reinvestigation completed effective July 1, 2006.
The following individuals are exempt from having to provide documentation of citizenship/identity:
Refer to Section 0110.020.00 for a complete list of acceptable documents to use as verification.
All non-citizen applicants for MO HealthNet who declare they are qualified aliens must provide INS documents to establish immigration status. You must give the alien a reasonable opportunity to provide the required documentation. If the alien does not provide the requested documentation within a reasonable time frame, you may deny eligibility. If the alien does provide the requested documentation within the time frame, verify the documentation with the INS using the SAVE System.
Exception: At this time, the INS SAVE system does not contain information about victims of severe forms of trafficking. Until further notice, do not contact SAVE concerning these individuals. See Trafficking Victims.
If an applicant presents an expired INS document or is unable to present any documentation of his or her immigration status, refer the person to the local INS District Office to obtain evidence of status unless he or she can provide you with an alien registration number. If the applicant provides an alien registration number, use the SAVE System to verify status. If the applicant presents a receipt indicating he or she has applied to INS for a replacement document, contact the INS to verify status by using the SAVE System. Contact the INS at any time if there is any reason to question the authenticity of a document presented or the information on the document is insufficient to determine whether the alien status requirement is met.
Acceptable documentation of qualified alien status is as follows:
NOTE: Refugees usually adjust to Lawful Permanent Resident status after 12 months in the U.S., but for purposes of establishing eligibility are still considered refugees. Therefore, check the coding on Form I-551 for codes RE-6, RE-7, RE-8, or RE-9.
NOTE: Persons admitted on B2 visas are not qualified aliens, or lawfully residing in the U.S. under section 214 of CHIPRA and are not eligible for benefits as a Cuban/Haitian Entrant.
NOTE: IF AN ALIEN CLAIMS THIS STATUS, CONTACT IM PROGRAM AND POLICY FOR FURTHER INSTRUCTIONS.
EXCEPTION: The battered alien will not be a qualified alien during any period in which the individual responsible for such battery or cruelty resides in the same household or family eligibility unit as the individual subjected to such battery or cruelty.
NOTE: This does not include a spouse or child of such Indian nor a non-citizen whose membership in an Indian tribe or family is created by adoption unless such person is of at least fifty percent (50%) or more Indian blood.
Department of Health and Human Services (HHS) Office of Refugee Resettlement (ORR) has been delegated the authority to conduct certifications. At this time, ORR will issue certification letters to victims of trafficking who meet the certification requirements. ORR also will issue similar letters for children who have been subjected to trafficking.
To receive a certification, a victim of trafficking must be willing to assist with the investigation and prosecution of trafficking cases AND either (1) have made a bona fide application for a T visa OR (2) be an individual whose continued presence the Attorney General is ensuring to effectuate a trafficking prosecution.
FSD will not need to conduct any certification activities.
When a victim of trafficking applies for benefits,
Note: At this time, INS Systematic Alien Verification for Entitlements (SAVE) does not contain information about victims of severe forms of trafficking. Until further notice, do not contact SAVE concerning victims of severe forms of trafficking.)
Acceptable documentation of active full-time active duty in the Armed Forces (U.S. Army, Air Force, Marine Corp, or Coast Guard) is:
A current military ID card (DD Form 2 (Active)) that lists an expiration date of more than one year from the date of issue. This does not include full-time National Guard duty. If the card will expire within one year, use a copy of his/her military order to document active duty status.
A member of a reserve component shall establish status by showing a current DD Form 2 (Reserve){red} and military active duty orders showing such persons is on active duty, but NOT on active duty for training. No other method of verifying this status is currently available.
NOTE: If the individual is unable to furnish either of the above, active duty may be verified through the nearest RAPD (Real Time Automated Personnel Identification System) located at many military installations or by notifying the following office in writing (which can be transmitted by not eligible for this status. A character of discharge �Under Honorable Conditions� is not an �Honorable� discharge for these purposes.
NOTE: If the applicant cannot provide the DD-214, the Military Personnel Record Center, 9700 Page, St. Louis, MO 63132 will send a copy of the DD-214 if a signed authorization is provided.
Acceptable Documentation for Establishing Status as a Spouse, Child, or Unmarried Surviving Spouse of an Active Duty Armed Forces Member or Veteran is possession of a current military ID Card showing:
NOTE: If the Military ID Card is unavailable or further documentation is needed, refer the individual to the VA regional office.
If U.S. Citizenship is questionable the following are examples of acceptable documentation: