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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 102 – Non-Financial Requirements Page |49 Effective Month: September 2018 Examples of Ineligible Aliens Who are Lawfully Admitted Foreign Students Visa, Passports or Form I-766 OR Visitors Tourists Form I-94, Arrival/Departure Record annotated with A to M OR Foreign government representatives on official business and their families and servants Form I-688, Temporary Resident Card annotated with Section 210 or 245A OR Crewmen on shore leave International organization representatives and their families and servants Temporary workers (individuals allowed entry temporarily for employment purposes) Form I-688 A and B, Employment Authorization Card OR Form I-185, Canadian Border Crossing Card OR Members of the foreign press, radio, film, etc., and their families Form I-186, Mexican Border Crossing Card OR Short-term parolees Form SW 434, Mexican Border Visitor’s Permit OR Form I-95-A, Crewman’s Landing Permit Note: Form I-94, Arrival-Departure Record, is also issued for refugees and other related statuses.