Refugee Medical Assistance Program 510-05-95-20

(Revised 7/1/09 (ML #3183)

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  1. The Refugee Medical Assistance Program is a program designed to cover Medical expenses for unaccompanied minors and other legally admitted refugees who are not eligible for Medicaid or Healthy Steps. Medicaid receives 100% federal funding for Refugee Medical Assistance (RMA).
  2. Refugees and unaccompanied minors who meet all Medicaid eligibility criteria, including need, must be enrolled in Medicaid instead of the Refugee Medical Assistance Program. Similarly, refugee children and unaccompanied minors who are eligible for Healthy Steps are processed under that program prior to considering Refugee Medical Assistance.

When a refugee or unaccompanied minor does not meet the technical requirements to be eligible for Medicaid and has no medical "need" which equals or exceeds recipient liability, and is not eligible for Healthy Steps the individual can be enrolled in Refugee Medical Assistance.

  1. Refugee Medical Assistance is available during the first eight months a refugee is in this country , the first eight months after an asylee has been granted asylum, or longer if an unaccompanied minor.  
  1. Unaccompanied minors are not limited to the eight-month refugee time limit, but can remain eligible under the unaccompanied minor coverage until age 21. Children age 18-21 must be attending school full time.
  2. The date an asylee is granted asylum (regardless of the actual date of entry) is considered the date the asylee entered the country and is the first month of the eight-month period.
  3. When any other refugee has been in this country for eight months, Refugee Medical Assistance ends. Refugees who want continued medical coverage must have their eligibility determined under the Medicaid or Healthy Steps programs.
  1. Eligibility for Refugee Medical Assistance is determined using medically needy income and asset methodologies and limits, except:
  1. Refugees who receive a refugee cash assistance payment (currently administered through Lutheran Social Services) and are not eligible for traditional Medicaid or Healthy Steps are eligible for Refugee Medical Assistance without regard to any other eligibility tests;
  2. Refugees who become eligible for Refugee Medical Assistance continue eligible without regard to increases in earned income until the end of the eight-month period; and
  3. Refugees who lose Medicaid during the first eight months in the country due to increased earnings are transferred to Refugee Medical Assistance without an eligibility test. Their earned income will not affect their Refugee Medical Assistance for the remainder of the 8-month period.
  1. A refugee who has income above the medically needy income level will have a recipient liability.  Because increases in income do not affect eligibility, the recipient liability will remain the same for the duration of the Refugee Medical Assistance coverage, except that the recipient liability can decrease if income decreases or expenses increase.  
  2. There are several groups of individuals who enter the US and are included under the 'Refugee' Category. These individuals may be eligible for Refugee Medical Assistance (RMA) for the first 8 months upon entry to the US. The month of US Entry is considered month 1 of the 8 month period. The following table identifies who these individuals are and provides information that may be obtained to identify them:

 

   

Type of Individual

How to Identify

Alien Granted status as a refugee under Section 207 of the Act

Use of SAVE, or obtain Form I-94 annotated with stamp showing admission under section 207 of the INA. Derive the date of admission from the date of inspection on the Form I-94 refugee stamp.  

Note: If the date is missing, must obtain further verification.

(These are the individuals we usually see and deal with in North Dakota.)

Alien Paroled as a Refugee or Asylee* under section 212(d)(5) of the Act

Use of SAVE, or obtain a valid I-94 card which will indicate they have been paroled pursuant to section 212(d)(5) of the INA, with an expiration date of at least 1 year from the date issued, or indefinite.  

Alien Granted status as an Asylee* under Section 208 of the Act

Use of SAVE, or obtain either a Form I-94 annotated with stamp showing grant of asylum under section 208 of the INA, or a grant letter from the Asylum office, or an order of an immigration judge. Derive the date status granted from the date on Form I-94, the grant letter, or the date of the court order.

Note:  If the date is missing from Form I-94, request the grant letter from the alien. If it is not available, must obtain further verification.

Alien Granted parole status as a Cuban/Haitian Entrant

Use of SAVE, or if the individual cannot provide documentation of status, refer him/her to the Department of Homeland Security for evidence of current immigration status.

Certain Amerasians from Vietnam Admitted to the US as immigrants

Use of SAVE, or obtain the immigrant's Form I-551 with the code AM1, AM2, or AM3 or passport stamped with an unexpired temporary I-551 showing a code AM6, AM7, or AM8.  Derive the date of admission as an Amerasian immigrant from the I-551, or the date of inspection on the stamp on Form I-94.  

Note:  If the date is missing on the I-94, verify status with the Department of Homeland Security.

Individuals Admitted for permanent residence, provided the individual previously held one of the statuses above.

If the individual held one of the previous statuses above, they will more than likely have been in the US more than 8 months and thus cannot be eligible for Refugee Medical Assistance.  

*  For Asylee's, individuals that enter the US and have not been granted Asylum by INS are considered an 'Applicant or Asylum'. Federal Law prohibits 'Applicants for Asylum' from being eligible for Medicaid or Refugee Medical Assistance. Therefore, they must be granted Asylum in order to be eligible for Medicaid or Refugee Medical Assistance under the 'Refugee Category'.