Determining 40 Qualifying Quarters

Lawful permanent residents who can be credited with 40 qualifying quarters of employment meet the citizenship/immigration requirement. No five (5) year waiting period is required.

To establish 40 qualifying quarters, complete the following process:

Step 1 Obtain the name, SSN, date of birth and gender of each wage earner whose quarters are being used to establish eligibility. The wage earner may be: the immigrant (self) Not an undocumented immigrant. a current spouse (consider only quarters worked during the marriage) a deceased spouse whose credited quarters were worked during the marriage A parent (deceased or divorced) whose children (biological or adopted) are/were under age 18 at the time the credited quarters are/were worked. Quarters earned prior to birth of the child may be used. A stepparent, if at the time the credited quarters were worked the child was under age 18, unmarried and there was a marital relationship with the child’s parent. If the marital relationship ends for reasons other than death, credited quarters of a stepparent may not be used A child’s quarters of employment cannot be used by a parent to meet this requirement. Step 2 Accept the applicant/member’s or wage earner’s statement of quarters worked if: Alone or in combination with parents and/or spouse the immigrant has sufficient time in the U.S. to have acquired 40 quarters. DHS documents verify that the dates of entry are consistent with 40 credited quarters or more. The immigrant, spouse, parent, or a combination of both have sufficient quarters to meet the requirement. The same quarters may be used to meet the requirement for more than one immigrant. Step 3 Use the WEB-1 system interface with SSA to obtain verification needed to establish credit quarters. Have each wage earner whose quarters are being used to establish eligibility complete and sign Form SSA-3288 , SSA Consent for Release Information, and to provide a statement if his/her work history as outlined in Step 2. The wage earner may be an immigrant or U.S. citizen by birth or naturalization. The wage earner does not have to have paid Social Security taxes or have earned quarters under the SSA. Step 4 Exclude as a credit quarter any quarter in which the wage earner received federal public assistance on or after January 1, 1997. The result is the total qualifying quarters and must equal or exceed 40 for the lawful permanent resident to be eligible for Medicaid. Public assistance is defined as Food Stamp benefits, housing, TANF, employment services, support services, childcare subsidy, federal energy assistance, subsidized utilities, SSI or Medicaid (other than EMA). This list is not inclusive. Public assistance does not include EMA, public health assistance, foster care, adoption assistance, soup kitchen meals, crisis counseling, short term shelter, educational assistance, WIA, disaster relief, or Head Start. This list is not inclusive. Step 5 Determine the number of credited quarters, as follows and document calculations in the case record. Prior to 1978: If earnings totaled at least $50 per quarter (January through March, April through June, July through September, or October through December), a quarter was credited to the wage earner. On or after January 1, 1978: Credited quarters are based on the total yearly earnings. To determine the number of credited quarters, divide the total yearly earnings by the figures listed below for that year. The result (up to 4), minus the number of quarters public assistance was received, is the number of credit quarters. 1978 $250 1987 $460 1996 $640 2005 $920 2014 $1200 2023 $1640 1979 $260 1988 $470 1997 $670 2006 $970 2015 $1220 1980 $290 1989 $500 1998 $700 2007 $1000 2016 $1260 1981 $310 1990 $520 1999 $740 2008 $1050 2017 $1300 1982 $340 1991 $540 2000 $780 2009 $1090 2018 $1320 1983 $370 1992 $570 2001 $830 2010 $1120 2019 $1360 1984 $390 1993 $590 2002 $870 2011 $1120 2020 $1410 1985 $410 1994 $620 2003 $890 2012 $1130 2021 $1470 1986 $440 1995 $630 2004 $900 2013 $1160 2022 $1510 Step 6 Document calculations in the case record. The chart below provides each DHS status, which is routinely applicable to eligibility determinations. This chart is not all-inclusive. DHS has the discretion to change documents or codes to allow any immigrant or group of immigrants to stay in the U.S. for an indefinite period. Service agencies may not be aware of these changes prior to implementation. Additionally, documents issued by the DHS vary by local DHS office. For example, two immigrants with the same immigration status may not have the same document to verify the same status. Letters of decision from immigration judges may identify DHS status, also. Direct questions regarding documents to the appropriate policy help desk.

Chart 2215.1 – Determination of Immigrant Status IF the applicant/recipient’s Immigration DHS status is: THEN the applicant / recipient meets the Citizenship / Immigration eligibility criteria for the following COAs: Verify with one of the following DHS documents: Lawful Permanent Resident with 40 qualifying quarters of coverage who enters the U.S. prior to 8/22/96 SSI, Any Family or ABD COA. Resident Alien Card Passport, Visa, I-94, I-181, DHS AR-3a or other DHS documentation stating the “Processed for I-551, Temporary Evidence of Lawful Residence” on or after 8/22/96 Any Family or ABD COA, beginning from the date of entry. No waiting period applies. Lawful Permanent Resident without 40 qualifying quarters of coverage who entered the U.S. Prior to 8/22/96 SSI, Any Family or ABD COA. On or after 8/22/96 Any Family or ABD COA, beginning 5 years after the date of entry. Effective 1/1/2024, Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA, beginning from the date of entry. Lawful Permanent Resident who was lawfully residing in U.S. on or prior to 8/22/96 and who is, or becomes disabled or blind SSI, any Family or ABD COA. Resident Alien Card Passport, Visa, I-94, I-181, DHS AR-3a or other DHS documentation bearing the endorsement “Processed for I- 551, Temporary Evidence of Lawful Residence” Lawful Permanent Resident who was lawfully residing in U.S. on or prior to 8/22/96 and was 65 years or older at that time Ineligible for SSI, unless disabled or having 40 qualifying quarters. Refer to SSA to make application for SSI if appropriate. Eligible for any Family COA or ABD COA based on age. Any SSI recipient who applied for SSI before 1979 SSI, Any ABD COA Any DHS status or any documentation establishing that the immigrant applied for SSI prior to 1979 An immigrant granted asylum status under Section 208 of INA who entered the U.S. Prior to 8/22/96 Any Family or ABD COA OR SSI for 7 years from date asylee status is granted, regardless of current DHS status I-94 annotated with Section 208 asylum codes of AS1, AS2, AS3, AS6, AS7, AS8 On or after 8/22/96 Any Family or ABD COA OR SSI for 7 years from date asylee status is granted, regardless of current DHS status Other DHS documents with asylum codes of AS1, AS2, AS3, AS6, AS7, AS8 An American Indian born outside the US, but recognized as a Lawful Permanent Resident if living along the Canadian border SSI OR Any Family or ABD COA Same as above or 50% blood is that of an American Indian or is a member of a federally recognized tribe. An immigrant paroled for at least one year under Section 212(d)(5) who entered the U.S. prior to 8/22/96 Any Family or ABD COA I-688B annotated 274a.12(a)(4) or c(11), I-94 annotated with 212(d)(5an), I-512 annotated with Section 212(d)(5) on or after 8/22/96 Any Family or ABD COA, beginning 5 years from the entry date Effective 1/1/2024, Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA for 5 years beginning from the date granted parolee status. A Cuban and Haitian entrant admitted under Section 501(3) of Refugee Education Assistance Act of 1980 (as of 11/98) SSI for 7 years from date of entering into U.S. OR Any Family or ABD COA I-94 annotated with paroled as refugee, Section 207 or married Cuban, I-551 or I-151 with CH6, CNP, CU6 or 7 An immigrant with Amerasian DHS status who entered the U.S. either prior or on or after 8/22/96. SSI for 7 years from date of entry into the U.S. regardless of current status OR Any Family or ABD COA I-95 annotated with AM1, AM2, AM3 I-551 annotated with AM6, AM7, AM8, Vietnamese Exit Visa, Vietnamese Passport, or U.S. Passport stamped AM1, AM2, AM3 Any above listed immigrant and considered a battered spouse or child and who is no longer living with the batterer. Any Family or ABD COA, beginning 5 years after the date of entry. Effective 1/1/2024, Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA, beginning from the date of entry. Any DHS document that established a spouse or child(ren) as lawfully residing in the U.S. and considers them as a battered spouse or child(ren). A qualified immigrant with any documented status if the immigrant is: a veteran who has been honorably discharged for reasons other than immigration, OR on active military duty (other than active duty for training) AND a qualified immigrant spouse and unmarried children (natural, adoptive or step) under 18 of the veteran or military personnel on active duty SSI OR Any Family or ABD COA Any DHS document that establishes that the immigrant is lawfully residing in the U.S. (Spouse and any unmarried children [natural, adoptive, or step] under 18, must also be documented as lawfully residing in the U.S. A refugee admitted under Section 207 of Immigration & Naturalization Act (INA) SSI for 7 years from date of entry into U.S., regardless of current status, Any Family or ABD COA Immigrant whose deportation is being withheld under Section 243(h) or 241(b) of the INA SSI for 7 years from date of withholding deportation OR Any Family or ABD COA I-94 annotated with Section 243(h) Other DHS documentation from an immigration judge showing that deportation has been withheld Conditional entrants under Section 203(a)(7) of the INA in effect prior to 4/1/80 who entered the U.S. Prior to 8/22/96 Any Family or ABD COA I-94 annotated with Section 203(a)(7) Conditional entrants under Section 203(a)(7) of the INA in effect prior to 4/1/80 who entered the U.S. On or After 8/22/96 EMA for 5 years beginning from the date of entry THEN Any Family or ABD COA Effective 1/1/2024, Pregnant women through the end of their postpartum period or children under the age of 19, no waiting period applies. For all other individuals EMA, beginning from the date of entry. I-94 annotated with Section 203(a)(7) Iraqi and Afghani Special Immigrants (Public Law 110-161) Any Family or ABD COA beginning the date the A/R is granted the Special Immigrant status. The date the status is granted must be 12/26/07 or later. For dates prior to 12/26/07, these groups would only be eligible for EMA. Iraqi or Afghani passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) category SI1, SI2, or SI3, and DHS stamp or notation on passport or I-94 showing date of entry. Iraqi passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) category SQ1, SQ2, or SQ3, and DHS stamp or notation on passport or I-94 showing date of entry. DHS Form I-551 showing Iraqi or Afghan nationality (or Iraqi or Afghan passport) with an IV (Immigrant Visa) code of SI6, SI7, or SI9. DHS Form I-551 showing Iraqi nationality (or Iraqi passport) with an IV (Immigrant Visa) code of SQ6, SQ7, or SQ9. Persons from the Compact of Free Association States, which include the Federated States of Micronesia, Republic of the Marshall Islands, and the Republic of Palau. Citizens of the Compact of Free Association States have a special status with the U.S. that allows them to enter the country, work here and acquire a Social Security number without obtaining an immigration status from the Department of Homeland Security. They are known as Compact of Free Association (COFA) migrants (compact citizens) and are to be considered “qualified non-citizens”. Effective 12/27/2020, they are eligible for Medical Assistance (does not extend to PCK) and are not required to meet the 5-year waiting period required of other non-citizen immigrants. Any documentation stating, they are a citizen of one of the Compact of Free Association States. Immigration status for COFA migrants may be verified by Federal Data Services Hub (FDSH) or other established pathways. Ukrainian national who enters between 2/24/2022 and 9/30/2023 as parolee Medicaid or PCK to the same extent as refugees, without a 5-year waiting period and are considered “qualified non-citizens” for purposes of Medicaid and PCK. Form I-94 with Ukrainian Humanitarian Parole (UHP) Class of Admission (COA); Foreign passport with parole stamp that includes a UHP COA; or Form I-766 with C11 category Ukrainian national who are paroled after 9/30/2023 and are the spouse of child or parolee, or the parent, legal guardian, or primary caregiver of parolee described above who is determined to be an unaccompanied minor Medicaid or PCK to the same extent as refugees Ukrainian granted Temporary Protected Status (TPS) or has a pending application for TPS and who has been granted employment authorization Not eligible for Medicaid or PCK and are not considered as “qualified non-citizens” Ukrainian non-citizens Eligible for EMA if they do not qualify for full Medicaid based on their immigration status Deferred Action for Childhood Arrivals (DACA) Any Medical Assistance COA using EMA procedures except PCK, P4HB, Pathways N/A All other immigrants Any Medical Assistance COA using EMA procedures except PCK, P4HB and Pathways N/A