503.01 Refugee Assistance Program 2

503.01.01 Eligibility Criteria 2

503.01.01A Categorical Criteria 2

503.01.01B Non-Financial Criteria 3

503.01.01C Financial Criteria 4

503.02 Case Processing Procedures 4

503.03 Budgeting 5

503.03.01 Retroactive Coverage 6

503.03.02 Changes in Income 6

503.04 RAP Eligibility Determination Flow Chart 6

503.05 RAP Budgeting Examples 7

503.01 Refugee Assistance Program

(Rev. 02/01/23)

The Refugee Assistance Program (RAP) is a MAGI eligibility category that offers Medicaid coverage to refugees.

A refugee is an individual who is outside his/her native country and is unable or unwilling to return to that country because of persecution or a well-founded fear of persecution on account of race, religion, nationality, membership in a particular social group, or political opinion. Refugees include, but are not limited to, Iraqis, Afghans, Cuban-Haitian Entrants, Ukrainian, and Amerasian immigrants.

Asylees meet the definition of “refugee” for eligibility purposes. Asylees are individuals who travel to the United States and then apply for and receive a grant of asylum. These individuals do not enter the United States as refugees. They may enter as students, tourists, business people, or without papers. Once they are in the United States, or at a land border or port of entry, asylees are eligible for services once the United States Citizenship and Immigration Services (USCIS) has granted asylum.

503.01.01 Eligibility Criteria

(Eff. 12/01/14)

Before eligibility for the Refugee Assistance Program (RAP) can be established the applicant must be considered for full coverage Medicaid eligibility. If the refugee does not qualify for any other Medicaid program, they may be eligible under RAP.

503.01.01A Categorical Criteria

(Rev. 03/01/24)

To be eligible for RAP a person must prove, by providing documentation issued by the United States Citizenship and Immigration Services (USCIS) that he or she was:

Admitted as a refugee under Section 207 of the Immigration and Nationalities Act (INA);

Paroled into the U.S. as a refugee or asylee under Section 212 (d)(5) of the INA;

Granted conditional entry under Section 203 (a)(7) of the INA;

Admitted as an Amerasian Immigrant from Vietnam through the orderly departure program, under Section 584 of the Foreign Operations Appropriations Act, incorporated in the FY88 Continuing Resolution P.L. 100-212;

A Cuban-Haitian entrant who was admitted as a public interest parolee under Section 212 (d)(5) of the INA; or

An Iraq or Afghanistan entrant who has been granted Special Immigrant status under Section 101 (a)(27) of the INA.

Ukrainian nationals who enter the United States as parolees on or between February 24, 2022, and September 30, 2023

Afghan Nationals described in section 2502(a) of Public Law 117-43 (Extending Government Funding and Delivering Emergency Assistance Act), under section 2502(b)(1) would continue if the individual is re-paroled as long as their original parole date to enter the United States was between July 31, 2021, and September 30, 2023.

There is no requirement for an applicant applying for RAP to have a qualifying child in order to meet categorical eligibility and receive RAP coverage.

503.01.01B Non-Financial Criteria

(Eff. 05/01/26)

To be eligible for RAP an individual must:

Be a refugee as outlined in MPPM 503.01.01A;

Be a South Carolina resident;

Provide a Social Security Number, proof that one was applied for; or indicate they have applied for a Social Security Number on the application form;

Not be incarcerated as an inmate; and

Not be eligible for any other full coverage Medicaid program; and

Not be a full-time student enrolled in a college or university (institution of higher education).

A refugee with a date of entry on or after May 5, 2025, may be eligible for RAP benefits through the fourth month from the date of entry into the United States. The Eligibility Specialist will start the four-month count with the date of entry month as the first month. Once the refugee has been in the United States for four months, based on the date of entry on the I-94, I-151, or I-551 card, RAP benefits must be terminated on the last day of the fourth month.

Note

A refugee whose date of entry is prior to May 5, 2025, may be eligible for RAP benefits for 12 months from the date of entry into the United States.

After four months, the refugee must qualify under another coverage group to be eligible for full benefits. If the refugee qualifies, the individual can receive full Medicaid benefits for up to seven years. After seven years, the individual must meet the 40 work quarters/five-year criteria for full benefits; otherwise, they can only qualify for emergency services.

In contrast to refugees, asylees are eligible for coverage the day asylum is granted. Asylees whose asylum is granted on or after May 5, 2025, are eligible for RAP benefits through the fourth month from the date their asylum is granted.

Note

An asylee whose asylum is granted before May 5, 2025, may be eligible for RAP benefits for 12 months from the date of approval for asylum.

503.01.01C Financial Criteria

(Eff. 12/01/14)

Applicants must meet 62% of the Federal Poverty Limit (FPL) to be eligible for the RAP eligibility category. Financial eligibility is determined by using MAGI methodology. For more information about MAGI methodology, refer to MPPM 203.03.

Compare the net countable income to the PCR Need Standard for the budget group size. To qualify for PCR the budget group must have net countable income less than or equal to the PCR Need Standard.

503.02 Case Processing Procedures

(Eff. 05/01/26)

A completed and signed Medicaid application form is required. The preferred application to use for the Refugee Assistance Program is the Healthy Connection Application, DHHS Form 3400.

If the family is applying for another Medicaid program, such as Aged, Blind and Disabled (ABD), it is possible for the refugee with a date of entry on or after May 5, 2025, to receive benefits under RAP through the fourth month from the date of entry while the ABD application is pending.

Individuals must meet all eligibility criteria outlined in MPPM 503.01.01, including the requirement that the individual is not a student enrolled as full-time student in a college or university.

If the individual indicates being a full-time student on the application, a collateral call is required to verify whether they are enrolled in a college or university. If the collateral call is unsuccessful, the Eligibility Specialist must send a DHHS Form 1233 along with a DHHS Form 1766ME, Declaration Statement, to obtain verification. If the Declaration Statement is not returned, the individual will not be eligible for the Refugee Assistance Program.

REMINDER: If the individual is a student, Student Details must be entered into Cúram evidence.

Note

A refugee whose date of entry is prior to May 5, 2025, may be eligible for RAP benefits for 12 months from the date of entry into the United States.

An asylee whose asylum is granted before May 5, 2025, may be eligible for RAP benefits for 12 months from the date of approval for asylum.

Case Processing examples Example #1 Applicant/beneficiary enters on 5/4/2025 and applies for Medicaid benefits on 6/4/2025. If not categorically eligible for benefits he would be able to receive RAP benefits from 5/1/2025 to 4/30/2026. Example #2 Applicant/beneficiary enters on 5/5/2025 and applies for Medicaid benefits on 6/4/2025. If not categorically eligible for benefits he would be able to receive RAP benefits from 5/1/2025 to 8/31/2025.

Manual Eligibility of RAP Case Manual Eligibility is used to ensure Medicaid coverage is available to RAP beneficiaries. Use the following steps in Cúram to apply Manual Eligibility to RAP cases: First, complete the MAGI Workbook to determine the individual’s household composition and financial eligibility. Second, open Cúram , and click on the Application Case Tab. Click on the Evidence Tab. Click on the Evidence link on the Side Panel. Click on the New Evidence link. The New Evidence list will open. Select All from the Category drop-down menu. Reorganize the list display by clicking on the word Type at the top of the left-hand column. The list now displays in alphabetical order by evidence type. Move the scroll bar to the right of the list until Manual Eligibility is displayed. Click on the List Action Menu button to the right of this evidence type and select Add. The Manual Eligibility evidence dialogue box opens. Fill in the following information: Received Date : Enter the date of application. Name Participant : Select the name from the drop-down menu. (Refer back to the MAGI Workbook for participant names that meet the RAP criteria.) Payment Category : Select REFUGEE MEDICAL ASSISTANCE – 70 from the drop-down menu. Benefits Code : Select F (Full) from the drop-down menu. Start Date : Enter the date of application. End Date : Enter the End Date. Remember that RAP coverage lasts four months from the date of entry. A work task must be set in OnBase for follow-up RAP periods. Additional Information : Do not add or change any information to this section. Click the Save button. Repeat steps for each additional eligible applicant. After the evidence dialogue box closes, click the Refresh button on the Evidence Dashboard. The Manual Eligibility evidence type will now be displayed under the Participant Data category. For more information, refer to the Processing Refugee or Asylee Medicaid Cases.pdf Job Aid.

503.03 Budgeting

(Eff. 12/01/14)

Once the income of all budget group members has been reported and verified, the eligibility worker calculates the countable monthly income by using the MAGI Workbook to determine financial eligibility for the budget group. The budget group's monthly gross income is compared to 62% of the Federal Poverty Level (FPL). If the monthly earned income is less than or equal to the limit, then eligibility for RAP coverage is approved.

Refugee resettlement checks and third-party payments are not counted as income.

503.03.01 Retroactive Coverage

(Eff. 12/01/14)

If the applicant meets all the RAP eligibility requirements in each of the retroactive months, the RAP applicant may be eligible for retroactive benefits in the three months preceding the application month. Eligibility for each retroactive month must be determined separately.

503.03.02 Changes in Income

(Eff. 05/01/25)

Eligibility for RAP is based on the applicant’s income on the date of application. If a refugee is determined eligible and later receives earnings from employment, the refugee will continue to receive benefits through the fourth month from the date of entry into the United States regardless of income earned. The month of entry is considered the first month.

Iraqi or Afghan Special Immigrants will receive benefits through the fourth month from their date of U.S. entry as “special immigrants” or from the date of their conversion to special immigrant status.

503.04 RAP Eligibility Determination Flow Chart

(Eff. 05/01/25)

503.05 RAP Budgeting Examples

(Rev. 10/01/23)

RAP Budgeting Examples Example #1 Nashi Omri Garane came to Columbia, SC from the Kakuma Refugee Camp in Kenya on May 5, 2025, and applied for assistance on May 9, 2025. He has verification that an application has been made for a Social Security Number and SAVE has verified he is a refugee. His sponsor is providing shelter assistance only. He is not married, does not have a dependent child, and is not disabled. He does not plan to file taxes or be claimed as a tax dependent. He has no earned or unearned income. He meets all other RAP criteria. Therefore, Mr. Garane is eligible for RAP. His RAP eligibility will begin in May 2025, and will continue until August 31, 2025. Example #2 The same circumstances from Example #1 apply; however, Mr. Garane started working at Green Pickle Deli on June 12, and has an earned income of $165 per week. He has no unearned income. Because Mr. Garane started work on June 12, which is after the application date, his earned income is excluded. Therefore, Mr. Garane remains eligible for RAP. Example #3 Nashi Omri Garane, his wife Nancy, and their daughter Yasmena came to Columbia, SC from the Kakuma Refugee Camp in Kenya on July 2, 2025, and applied for assistance on July 9, 2025. They attest on the application they have applied for a Social Security Numbers for the household and SAVE has verified they are refugees. Their sponsor is providing shelter assistance only. Mr. Garane started working on July 8 and earns $165 per week. No one in the family plans to file taxes or be claimed as a tax dependent. The family has no unearned income and meets all other criteria. $165 = Applicant’s Income $165 x 52 = $8,580 Annual Income $8,580 ÷ 12 = $715 Monthly Income The family is eligible for PCR.