Division of Medicaid

A. The recipient is responsible for reporting a temporary absence from Mississippi and for giving information on his purpose, plans and dates of departure and return. The recipients eligibility must be reviewed every three (3) months to determine the recipients continued intent t…

A. An individual receiving a state supplementary payment (optional or mandatory), such as state adoption assistance or state foster care payment, is a resident of the state making the supplementary payment. Notes 23 Miss. Code. R. 102-1.9 42 CFR §435.403 (Rev. 2006).

A. An eligible individual must either be a citizen of the United States or a qualified alien. 1. Most United States citizens are natural-born citizens, meaning they were born in the United States or were born to United States citizens overseas. Individuals born in the United Stat…

A. The Child Citizenship Act of 2000, enacted February 21, 2001, amended the Immigration and Naturalization Act to provide automatic acquisition of U. S. citizenship by operation of law to certain foreign born children, including orphans with a full and final adoption by U. S. ci…

A. The citizenship and identity of applicants and recipients declaring to be U. S. citizens will be established in accordance with provisions of the Deficit Reduction Act (DRA) of 2005, which was effective with applications and reviews on and after July 1, 2006. Documentary verif…

A. Individuals declaring to be U. S. citizens are exempt from citizenship and identity documentation requirements if they are in one of the following categories:1. Medicare recipients entitled to, or enrolled in, Medicare Part A or B under any claim number are exempt from the ver…

A. Primary Evidence has the highest reliability. If provided, no further verification is needed. If any other level of evidence is used to verify U. S. citizenship, a second document verifying identity must be obtained. 1. The following documents may be accepted as primary proof …

A. Proof of identity is required when primary evidence of citizenship cannot be obtained and a secondary, third or fourth level evidence is used. 1. The identity of all applicants and recipients must be verified. 2. When a child younger than age sixteen (16) or a disabled individ…

A. The identity of the responsible person who is a non-applicant filing an application for others must be verified.1. The responsible person is defined as a non-applicant parent, relative, non-relative or an authorized representative filing the application on behalf of others. 2.…

A. In general, eligibility and level of coverage is based on the aliens date of entry into the U. S., the date qualified alien status was obtained and/or the aliens immigration status. Notes 23 Miss. Code. R. 102-3.1 42 CFR §435.406(a)(2) (Rev. 2007).

A. A qualifying quarter means a quarter of coverage as defined under Title II of the Social Security Act, which is worked by the alien, and/or: 1. All the qualifying quarters worked by the spouse of the alien during their marriage, provided the alien remains married to the spouse…

A. Subject to the limitations above, the aliens own QQs can possibly be combined with those of his parent(s) and/or spouse to attain the required forty (40) quarters. Notes 23 Miss. Code. R. 102-3.11 8 USC § 1645.

A. After December 31, 1996, any quarter in which any of these individuals, i.e., the alien, his parent(s) and/or spouse, received Federal means-tested benefits, such as TANF, SSI and Medicaid, cannot be credited to meet the forty (40) quarter requirement. Notes 23 Miss. Code. R. …

A. Non-exempt aliens in the following classifications, admitted to the U. S. on or after 8/22/96, are subject to the five (5) year disqualification. 1. Lawful Permanent Resident Aliens; 2. Aliens Granted Parole for at Least One Year; and 3. Battered Aliens. 4. Aliens granted cond…

A. The following alien classifications are exempt from the five (5) year ban: 1. Refugees, 2. Asylees, 3. Amerasian immigrants, 4. Cuban/Haitian entrants, 5. Aliens who have been granted withholding of deportation, 6. Victims of trafficking, and 7. Qualified aliens who are honora…

A. Some aliens in the above classifications have a seven (7) year time limit imposed on eligibility. B. When the seven (7) year period ends, eligibility terminates the following month unless the aliens status has changed or he meets an exemption. Notes 23 Miss. Code. R. 102-3.15 …

A. When the time-limited aliens status adjusts to LPR during the seven (7) year period, the alien can continue to be eligible for the remainder of his seven (7) year period. B. However, to continue to be eligible beyond the seven (7) year period, the alien must be credited with f…

A. These qualified aliens are subject to the seven (7) year eligibility limit:1. Refugees. Qualify until seven (7) years after date of entry into the U. S.; 2. Asylees.- Qualify until seven (7) years after the grant of asylum; 3. Cuban and Haitian entrants. Qualify until seven (7…

A. The following groups of qualified aliens are exempt from both the five (5) year disqualification and the seven (7) year eligibility time limit and if otherwise eligible, qualify for full Medicaid: 1. Non-citizen members of a Federally-recognized Indian tribe, as defined in 25 …

A. As previously indicated, a qualified alien who entered the U. S. prior to 8/22/96 and obtained qualified status on or after that date, must have remained continuously present in the U. S. from their last entry date into the country prior to 8/22/96 until becoming a qualified a…

A. Individuals living in the United States, who are not citizens, by birth or acquisition, and are not U. S. Nationals, are aliens. B. For Medicaid purposes, certain aliens are referred to as qualified, meaning they are potentially eligible for full Medicaid services just like U.…

A. Aliens who were not continuously present are considered to have entered the U. S. on or after 8/22/96 and unless an exemption is met, are subject to the five (5) year disqualification period from the date qualified status was obtained and the forty (40) QQ requirement. Notes 2…

A. Trafficking victims are not included in the statutory definition of qualified alien. Under Section 107(b) (1) (A) of the Trafficking Victims Protection Act, however, they are eligible for means-tested benefits to the same extent as refugees, i.e., victims of trafficking and th…

A. The qualified status of a trafficking victim is not based on immigration status. The Office of Refugee Resettlement (ORR) issues a certification letter for an adult who has been subjected to a severe form of trafficking and meets statutory certification requirements. The ORR a…

A. Battered aliens were not initially included in PRWORAs definition of qualified aliens. In passing Section 501 IIRIRA, Congress added a new Section 4319(c), which provides that the term qualified alien shall include such immigrants. 1. The alien must be either the person batter…

A. To be eligible as a veteran, the qualified alien must have been honorably discharged, not based on alienage, and must have fulfilled minimum active duty service requirements. A qualified alien who is an active duty member of the Armed Forces, but not on active duty for trainin…

A. Surviving spouses who remarry lose the benefit of this exemption the month after the month of the remarriage. Spouses whose marriage ended in divorce lose the benefit of this exemption the month after the month of divorce. Notes 23 Miss. Code. R. 102-3.25 8 USC § 1612.

A. To qualify as a child of a veteran or active duty service person, the biological, adopted or stepchild must be:1. Unmarried and claimable as a dependent on the military person's tax return; and 2. Under eighteen (18) years of age or under twenty-two (22) and a student regularl…

A. An alien who does not meet the specific requirements of a qualified alien is a non-qualified alien for Medicaid purposes. A non-qualified alien who meets MS residency requirements and other applicable eligibility factors can receive Medicaid Emergency Services only. An applica…

A. Illegal aliens are non-qualified aliens. This group of individuals includes: 1. Undocumented aliens who entered illegally without knowledge of USCIS; or 2. Aliens who were admitted for a limited period of time and did not leave the U.S. when the period of time expired. B. Thes…

A. Ineligible aliens may be lawfully admitted to the U. S., but only for a temporary or specified period of time. These aliens are never qualified aliens, because of the temporary nature of their admission status, most ineligible aliens are not entitled to any Medicaid benefits, …

A. "Non-qualified aliens" are non-citizens are potentially eligible only for Emergency Medicaid services; however, there may be exceptions. B. Non-citizens applying for Emergency Medicaid services are not required to disclose information regarding citizenship, alien status or enu…

A. Aliens who are admitted legally to the U. S., but do not fall into one of the specific categories of qualified aliens are non-qualified aliens. These individuals may include Legal Temporary Residents (LTRs), as well as individuals who are given temporary administrative statuse…

A. Applicants who are found to be in the U. S. illegally through the application process are not subject to immigration reporting requirements. Persons who apply for benefits on behalf of others, i.e., a mother applying for her children, are not subject to immigration reporting r…

A. Aliens who are not entitled to full Medicaid benefits may be eligible for emergency services only, if the following conditions exist: 1. All other eligibility requirements are met except satisfactory immigration status; 2. Care and services needed are not related to an organ t…

A. At the point of application, the applicant, who is a non-qualified alien or a qualified alien subject to five (5) year disqualification, must be informed that if all applicable program eligibility requirements are met, Medicaid may reimburse for emergency services only (includ…

A. When determining eligibility for Medicaid coverage for treatment of an emergency medical condition only, information obtained must: 1. Establish eligibility based on emergency services criteria, such as copy of the hospital bill or other documentation from the hospital includi…

A. The alien must be financially eligible. If not, the application will be denied. Notes 23 Miss. Code. R. 102-3.35 42 CFR §435.406(b) (Rev. 2007).

A. Children born in the United States to parent(s), who is a non-qualified alien as discussed in may be eligible for full Medicaid. The parent(s) and any sibling(s) who are non-qualified aliens cannnot be eligible for full Medicaid benefits; however, they may be assessed for Emer…

A. Aliens who seek admission to the U.S. must establish that they will not become public charges.' B. A "public charge" is an alien who has become (for deportation purposes), or who is likely become (for admission/adjustment purposes), solely dependent on government assistance as…

A. Effective 8/22/96, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) limited alien eligibility for Medicaid and other federal programs. However, Mississippi elected to grandfather in aliens who were receiving and eligible for Medicaid on that…

A. There are nine (9) classifications of qualified aliens. Seven (7) are based on INS alien status, one (1) is based on battery or extreme cruelty and INS alien status, and one (1) is based on severe forms of trafficking and certification by U. S. Health and Human Services. B. Th…

A. The Systematic Alien Verification for Entitlements (SAVE) process is used to verify: 1. The authenticity of the aliens USCIS documents, 2. The date of the aliens admission to the U.S. and 3. The current immigration status of the alien. Notes 23 Miss. Code. R. 102-3.6 42 CFR §4…

A. Victims of a severe form of trafficking and aliens applying for Emergency Medicaid services only are not subject to the SAVE verification process. Notes 23 Miss. Code. R. 102-3.7 42 CFR §435.406 (Rev. 2007).

A. Unless an exemption is met, qualified aliens admitted to the U. S. on or after August 22, 1996, are disqualified from receiving public benefits for: 1. The first five (5) years from the date they entered the country or 2. The first five (5) years from the day they obtained qua…

A. At the end of the five (5) year disqualification period, an alien classified as lawfully admitted for permanent residence (LPR) is potentially eligible for full Medicaid benefits only if he has forty (40) qualifying quarters (QQs) of earnings covered by Social Security or can …

A. Enumeration is the process of assigning Social Security Numbers. In general, applicants for Medicaid must be enumerated as a condition of eligibility by either; 1. Furnishing the Social Security Number. a) The applicant can verbally provide the SSN when they do not have a card…