Page 193

UPDATED: JANUARY 2011

630

OTHER ELIGIBILITY REQUIREMENTS CITZENSHIP AND IMMIGRATION STATUS QUALIFIED ALIENS

REFUGEE MEDICAL ASSISTANCE (RMA)

Eligibility for RMA is based on the applicant’s income on the date of application. The LDSS must NOT average income prospectively for the application-processing period to determine income eligibility for RMA. A sponsor’s income (solely because the person is serving as a sponsor), in-kind services and shelter provided to an applicant by a sponsor or resettlement agency and any cash grant received by the applicant from the United States Department of State or Department of Justice during the initial 30-day Reception and Placement Program period are exempt in determining the applicant’s eligibility. All other Medicaid rules and regulations apply in determining eligibility under RMA.

NOTE: Match grants provided to an applicant by a voluntary agency under direct agreement with the Office of Refugee Resettlement (ORR) must be counted in determining eligibility. However, a Match grant should not cause the individual to be ineligible for Medicaid.

Eligibility is first determined for S/CC. If the individual is not eligible as an S/CC, then eligibility under FHPlus is determined. If the applicant is not eligible as an S/CC or under FHPlus, an ADC budget is performed and the S/CC is allowed to spend-down to the Medically Needy Income Level.

If a refugee who is receiving RMA receives new or increased earnings from employment after eligibility for RMA has been determined, the increased earning will not affect his/her continued RMA eligibility.

If during the initial eligibility period an individual who is receiving “regular” Medicaid becomes ineligible for “regular” Medicaid due to increased earnings, the individual must be transferred to RMA without an RMA eligibility re-determination. This includes refugees receiving Medicaid through Family Assistance (FA) Program or under Low Income Family (LIF) category of assistance. However, before transferring the individual to RMA, the case must first be evaluated for eligibility under Transitional Medical Assistance (TMA).

Should earnings/income decrease during the initial eligibility period, eligibility must be redetermined. If the individual is now eligible under regular Medicaid or FHPlus, authorize coverage as appropriate. If the individual continues to be ineligible under regular Medicaid or FHPlus, as an S/CC, but the decrease in earnings/income results in a decrease

(MRG)