Emergency Services for Non-Citizens 510-03-35-70

(Revised 11/1/2025 Release 25.14 )

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(N.D.A.C. Section 75-02-02.1-18)

Ineligible non-citizens (identified in of 510-03-35-55 ), and qualified non-citizens, who are not eligible for Medicaid because of the time limitations or forty qualifying quarters of social security coverage requirement, may be eligible to receive emergency services that are not related to an organ transplant procedure, if all of the following conditions are met:

The non-citizen has a medical condition (including labor and delivery) manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in: Placing health in serious jeopardy; Serious impairment to bodily functions; or Serious dysfunction of any bodily organ or part.

The non-citizen meets all other eligibility requirements for Medicaid except illegal non-citizens do not have to meet the requirements concerning furnishing social security numbers and verification of alien status; and

The non-citizen's need for the emergency service continues. Eligibility for Medicaid ends when the emergency service has been provided, and does not include coverage of follow-up care if the follow-up care is not an emergency service. A pregnant woman, who is not lawfully present in the United States, may be covered from the date she entered the hospital for labor and delivery through the date she was discharged. A pregnant woman who delivers a child and is covered under this provision is not eligible for the twelve month period of eligibility after pregnancy. Her child, however, is a citizen and may be eligible for twelve months of continuous coverage.

When an ineligible non-citizen is requesting coverage for 'Emergency Services' for reasons other than childbirth, a completed SFN 451, Eligibility Report on Disability/Incapacity and medical reports must be submitted to the State Review Team for a determination of whether the medical condition meets ALL the criteria listed in #1 above. Note: Remember to check the box in the upper right hand corner titled 'Emergency Services'.

Pregnant women who are lawfully present in the United States and are otherwise eligible for medical assistance are not subject to the five-year waiting period/ forty quarter requirement through the twelve month postpartum period.

When an ineligible non-citizen is requesting coverage for ‘Emergency Services’ for reasons other than childbirth, a completed SFN 451, Eligibility Report on Disability/Incapacity and medical reports must be submitted to the State Review Team for a determination of whether the medical condition meets ALL the criteria listed in #1 above.

Note: Remember to check the box in the upper right hand corner titled ‘Emergency Services’.