All states offer some form of emergency Medicaid for non-citizens. While federal guidelines provide a small degree of consistency, the actual range and availability of coverage varies widely by state.
Eligibility criteria and certain rules differ between states. For example, some states allow non-citizens to apply for coverage in advance. Others include the specific medical condition to be treated as part of the emergency Medicaid application process, which prevents advance applications entirely.
States that permit qualifying applicants to pre-apply for coverage strongly encourage the practice.Most states offer some form of temporary or emergency Medicaid for pregnancy and delivery. Coverage for pregnant non-citizens is not guaranteed to continue post-delivery but can be extended in certain circumstances. In addition to reviewing the federal guidelines that apply in all states, non-citizens can benefit from contacting authorities in the states in which they live for details on state-level policies.
Emergency Medicaid exists specifically to provide a safety net for individuals in crisis who lack access to any other resources. As a result, emergency Medicaid eligibility is directly determined by applicants’:
The program exclusively serves individuals who are not citizens of the United States but who meet all other requirements for Medicaid coverage. Generally, this includes:
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It is important to note that some individuals in the above categories, such as battered spouses, may also qualify for standard Medicaid, depending on their residency and citizenship statuses. All emergency Medicaid applicants must meet standard Medicaid income limits and demonstrate evidence of residency or the intent to establish residency. As a result, the program effectively allows Medicaid for undocumented immigrants but not for tourists or others considered to be simply “passing through” an area.
The emergency program was designed intentionally to extend Medicaid to undocumented immigrants, mixed immigration status households and other vulnerable populations. In recognition of the common barriers to care among these populations, federal guidelines prevent program personnel from reporting applicants’ immigration or documentation status to the United States Immigration and Naturalization Services (INS). All qualifying applicants can receive assistance without fear for their families, jobs or safety.
Furthermore, receiving emergency non-citizen Medicaid assistance does not impact immigrants’ eligibility or likelihood of achieving legal United States residency or citizenship. The only exception to this rule is non-citizens who apply for long-term Medicaid care under the program. Individuals who represent an extended, indefinite drain on program resources in such a manner may be less likely to be issued green cards.
Legal non-citizens who do not yet qualify for standard Medicaid benefits because they have not yet been in the country for the full five-year mandated waiting period can still qualify for emergency Medicaid assistance.
A key component of emergency Medicaid eligibility is the nature of the illness, injury or condition for which applicants seek care. Federal program guidelines define medical emergencies as situations in which patients:
However, beyond these criteria, each state sets its own policies and limits for what constitutes a qualifying emergency under the Medicaid for non-citizens program. States also differ in their judgements of when patients’ conditions cease to be considered emergencies and they become ineligible for further care.
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For example, in some states, patients’ emergency status is presumed to end when they are transferred out of medical facilities’ emergency or acute services wards and to rehabilitative departments. In other states, emergency Medicaid applicants may be eligible to continue receiving services after they have been stabilized. For example, patients’ attending physicians may determine that their acute conditions will immediately become life-threatening emergencies again if they do not continue receiving treatment. In most cases, that determination will allow patients to remain covered until the situation is resolved.
Emergency health care is not a form of health care or a substitute for health insurance. It cannot be used for routine or preventative care. Rather, like federal disaster assistance programs, it exists to mitigate the impact of severe and extraordinary incidents in the moment. In nearly all cases, emergency Medicaid applicants must assume fiscal responsibility for their care as soon as their conditions no longer qualify as emergencies.
There is no single, finite list of services covered in all states under the Medicaid for non-citizens program. Emergency surgery and stabilization after severe injury are almost universally covered, but states differ on their assessments of:
Organ transplants are not eligible for coverage under the program. Authorities encourage potential applicants to familiarize themselves with their states’ rules and policies before applying for assistance.
Medicaid for pregnant non-citizens can help recipients deliver their babies safely in any American hospital. Some states also make provision for emergency Medicaid funding for pregnancy related services including:
Babies born in American hospitals are automatically United States citizens. If their families meet income eligibility guidelines, those babies will then immediately qualify for standard Medicaid coverage or CHIP coverage. Post pregnancy, the mothers of those babies may be eligible for ongoing pregnancy services under standard or emergency Medicaid depending on the rules in their states of residence.
When and how to submit emergency Medicaid applications varies by state. In California, for instance, qualifying residents can apply for coverage in advance so that arrangements are in place in the event that they need emergency care. In Arkansas, by contrast, residents can apply for emergency Medicaid only after experiencing a medical emergency that might make them eligible for assistance.
Most states maintain online portals or applications that residents can use to seek assistance. Some states also provide hard copy applications and/or toll-free phone numbers residents can call to seek assistance. A few states, such as California, also offer in-person emergency Medicaid application options.
Prospective applicants can contact local Social Services authorities for information on state policies and procedures. Residents who have received emergency care can also request assistance in applying from the hospital or other facility that provided the care.
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