Medicaid/CHIP U.S. Residency

1. For Medicaid, applicants in the following residency categories meet the eligibility criteria:
   • U.S. Citizen
   • ALL LPR children
   • Legal Permanent Resident (LPR) on or before 8/22/96 ( applies to adults only)
   • Individuals with one of the following “Qualified Immigrant” status: ( applies to adults only)
     • Abused/Battered,
     • Amerasian,
     • Asylee,
     • Conditional Entrant,
     • Cuban/Haitian,
     • Parolee,
     • Refugee
     • Victim of Crime/ Trafficking
     • Withheld Deportation
   • LPR continuously in the U.S. since 8/21/96 ( applies to adults only)
   • LPR for at least 5 years with 40 quarters of SSA wage credits including applicable credits from spouses or parents if child is < age 18 (Applies to adult Medicaid Only effective July 1, 2011.) ( applies to adults only)
   • LPRs who are U.S. military veterans or active duty and their spouses and children (a military connection) who meet the following requirements:
     • An LPR U.S. military veteran who is:
       • “honorably discharged” from the armed service, and
       • meets the minimum active date requirement of:An active duty LPR, U.S. military member currently on full-time duty in the U.S. Army, Navy, Air Force, Marine Corps, or Coast Guard. It does not include full-time National Guard duty.
         • 24 months of continuous active duty, or
         • the full period the person was called or ordered to active duty.
       • An LPR’s spouse if he/she is currently married to a veteran or active duty military member.
       • An LPR’s minor child if he/she is an unmarried dependent child under the age of 18.
       • A surviving spouse of a deceased LPR veteran or LPR active-duty U.S. military member if the spouse has not remarried, and the marriage fulfills one of the following requirements:
         • lasted at least one year; occured within 15 years after the period of service in which the injury or disease that resulted in the dealth of the veteran or active duty member ended; or
         • resulted in the birth of a child, either during or before the marriage.
2. For CHIP, applicants NOT Medicaid eligible in the following residency categories meet the eligibility criteria:
   • U.S. Citizen; or
   • LPR
3. For CHIP Perinatal, applicants NOT Medicaid eligible in the following residency categories meet the eligibility criteria:
   • U.S. citizen; or
   • Undocumented; or
   • LPR after 8/21/96
4. Refer to Immigration Codes Quick Forms Reference, and Benefits Screening Chart

Refugees:

1. In Texas, there are different State medical programs that cover refugees:
   • TANF with Medicaid,
   • Medicaid only,
   • CHIP, and
   • Refugee Medical Assistance (RMA) Program (a sub-category of Medicaid)
2. The date of legal entry for purposes of determining RMA, Medicaid and CHIP eligibility is the date the refugee/entrant entered the U.S. as shown on any USCIS document.
3. The following two categories are considered “qualified immigrants” for purposes of determining state program eligibility IF the individual has and is able to present one of the following VALID USCIS documents:

4. The following rules apply to the above categories of “qualified immigrants”:

• If any Category 1 “qualified immigrants” were admitted before 8/22/96, they may qualify for Medicaid or CHIP.
• If any Category 1 “qualified immigrants” were admitted after 8/22/96 and if they screen eligible for Medicaid or CHIP, schedule an application assistance appointment. Once an application is sent to the State, if the applicant receives a denial letter for a reason other than non-compliance, they may once again apply for MAP.
• All Category 2 “qualified immigrants” are eligible for RMA, Medicaid or CHIP for ONLY 8 months from the legal date of entry.
• Once an immigrant in Categories 1 or 2 becomes a U.S. Citizen, an LPR, or has a military connection, or for Adult Medicaid only, an LPR for 5 years and has 40 quarters, they may qualify for Medicaid or CHIP.
• There is no time limit on refugee status and no requirements to apply for legal permanent residence or citizenship, however, these factors may affect the individual’s continued eligibility for Medicaid and CHIP.

5. The RMA Program is administered by Voluntary Agencies (VolAgs) who receive Refugee Settlement Grants from the federal government. The RMA Program is further administered locally by the following 2 VolAgs:

• • Caritas of Austin
    611 Neches
    Austin, TX 78701
    Phone: 512-479-4610
    Contact: Nadine Pedusseau, Ext. 162, or Harry Crawford, Ext. 145
  • Refugee Services of Texas (RST)
    3710 Cedar Street, Box 8
    Austin, TX 78705
    Phone: 512-472-9472
    Contact: Sofia Casini, Ext. 105, or Melissa Helber, Ext. 106

• The RMA Program has the following limitations:

• • • Individual must be ineligible for Medicaid and CHIP, and
    • RMA is issued for ONLY 8 months from the legal date of entry
    • The RMA Program does not require the applicant have a social security number.

• Individuals in Category 1, except for Section 208 Asylees, who are sponsored by a VolAg agency, are required to contact their local VolAg agency upon arrival. This would be Caritas of Austin or RST for refugees locating in Travis County. These agencies should handle the individuals RMA and/or Medicaid or CHIP application assistance.
• Individuals who are past the 8 months from legal date of entry and whose RMA benefits have been terminated should be screened for potential eligibility for MAP, Medicaid and/or CHIP and scheduled an appropriate appointment.
• Section 208 asylees or refugees with an individual sponsor may contact 2-1-1 or 512-978-8130 for application assistance. In the event the individual appears to qualify for Medicaid or CHIP, they should be scheduled for application assistance. The State will determine the applicant’s state program eligibility or issue a denial letter. If the applicant receives a denial letter for a reason other than non-compliance, they may once again apply for MAP.
• Refer to Household Size/Budget Group Quick Reference, when determining budget groups for RMA/Medicaid.