Medicaid Policy                                                                 

205-2 Qualified Non-Citizens

Effective Date: October 1, 2026

Previous Policy

 

If an individual does not meet the citizenship requirements found in 205-1, they are “non-citizens”. 

 

A lawful non-citizen will receive a class of admission when entering the United States indicating their immigration status (i.e. B-2 tourist, F-1 student, IR1 spouse of U.S. citizen, RE1 refugee).  This class of admission defines the immigrants exact legal footing, duration of stay and if they are authorized to work in the U.S. and appears on all immigration documents (Visas, I-94, green card, etc.).

 

To become eligible for Medicaid, the non-citizen must meet certain immigration criteria to become a “qualified non-citizen.” A qualified non-citizen is a non-citizen who is lawfully admitted for permanent residence under various sections of the Immigration and Nationality Act (INA).

 

Some qualified non-citizens cannot receive full-service Medicaid, but may receive coverage only for emergency services for five years from the date they obtained qualified non-citizen status.

 

A.    Eligibility for Non-Citizens 

 

1.   To determine if a non-citizen may be a qualified non-citizen the individual must have a current immigration status that is allowable for Medicaid (205-3).

• The statuses for qualified non-citizens are found in Section B., 
• The status must be verified through SAVE or other immigration documents (see Table VIII)

2.    After determining that the individual is a qualified non-citizen it is necessary to determine if the individual is subject to the five-year bar. (Section C)

3.    If the non-citizen does not meet the requirements to be a qualified non-citizen or is still within the five-year bar, they may be eligible for emergency services only (205-6).

It is important to remember that:

• An individual’s immigration status may change. 

• Examples include COFA migrants requesting LPR status, Refugees requesting other status, etc.

• Verification of immigration status may be completed by electronic means or through other acceptable verification methods (731).
• The status must be verified at each application, renewal, or when a change in immigration status is reported.
• If a qualified non-citizen loses their immigration status, it is possible that they qualify under a different status.  Check for an updated status before making changes to eligibility.

B.  Status of Qualified Non-Citizens   

A qualified non-citizen is an individual admitted to the U.S. under one of the immigration statuses listed below:

1. Lawful Permanent Resident (LPR) 
   1. Any non-citizen who is lawfully admitted for permanent residence as an immigrant in accordance with the immigration laws. Also known as “permanent resident alien,” “resident alien permit holder,” and “Green Card holder.”  Note - for the full list go to the U.S. Department of Homeland Securities web page for Immigrant Classes of Admission.  
         
      • Classes of admission in this category include:
        • Immediate Relatives of U.S. Citizens. 
          • The largest category of new LPRs consists of immediate relatives of U.S. citizens (spouses, children, and parents of U.S. citizens age 21 and older). 
      • Sponsored by Family  
        • Family members beyond immediate relatives may be eligible for immigration. A citizen or lawful permanent resident can sponsor immigrants within four categories. 
        • Unmarried children of U.S. citizens and their children 
        • Spouses and unmarried children of residents 
        • Married children of U.S. citizens and their spouses and children
        • Siblings of U.S. citizens (at least 21 years of age) and their spouses and children

• • • • Immigration for Employment
        • People with skills needed in the U.S. workforce or who want to invest in new U.S. jobs may be eligible to immigrate. 
• • • • Refugees and Asylees
    • The United States provides refuge to persons who have been persecuted or have a well-founded fear of persecution through two groups: a refugee group for persons outside the United States and their immediate relatives, and an asylum group for persons in the United States and their immediate relatives.
      • Diversity
        • The United States has a Diversity Immigrant Visa Program. People from countries with relatively low levels of immigration may apply for diversity visas, which are distributed by lottery. 
• • • • Other 
        • There are other admission categories based on special legislation.  Some examples are:
        • Parolees
        • Special Immigrant Visa
        • Nicaraguan and Central American Relief Act
        • Haitian Refugee Immigration Fairness Act
        • Immigration Reform and Control Act of 1986 (IRCA)  

2.  Cuban and Haitian entrant

1. An individual granted parole as a Cuban-Haitian Entrant (Status Pending) or any other special status or a national of Cuba or Haiti who is not subject to a final, non-appealable and legally enforceable removal order, and:
   • Was paroled into the United States and has not acquired any other status under the Immigration and Nationality Act; or
   • Is in removal proceedings under the Immigration and Nationality Act; or
   • Has an application for asylum pending with USCIS.

3. American Indian born in Canada who is at least one-half American Indian. They are considered lawful permanent residents, but will not have INS documents.  A statement from the tribe is acceptable verification. They are not subject to the five-year bar for eligibility.
4. Citizens of the Freely Associated States (COFA)
   1. A citizen of the Freely Associated States of: The Federated States of Micronesia (FSM), the Republic of the Marshall Islands (RMI), and the Republic of Palau (Palau).

C.  Application of the Five-year Bar

 

Some qualified non-citizens are barred from receiving Medicaid, QMB, SLMB or QI for five years from the date they obtain qualified non-citizen status. The five-year bar applies only to immigrants who enter the country on or after August 22, 1996. Qualified non-citizens who do not meet one of the following exemptions can receive Medicaid only for emergency services until after the five-year bar has expired (205-6). At the end of the five-year bar, lawful permanent residents can receive full Medicaid. If a child is a qualified non-citizen but has not met the five-year bar, see if the child meets the criteria in section 205-2.1.

1.    Exceptions to the five -Year Bar

Resident non-citizens who have been granted certain non-citizen statuses or meet certain conditions can be eligible for Medicaid, QMB, SLMB or QI and are not subject to the five-year bar regardless of their entry date. They must meet the eligibility requirement for Medicaid or the Medicare Cost-Sharing programs. Resident qualified non-citizens not subject to the five-year bar include an individual who:

a.    Is admitted as a refugee under section 207 of the Immigration and Nationality Act (INA).

b.    Is granted asylum under section 208 of the INA.

c.    Has had deportation has withheld under section 243(h) of the INA (prior to September 30, 1996) or under section 241(b)(3) of the INA (after September 30, 1996).

d.    Is a Cuban and Haitian entrant as defined in section 501(e) of the Refugee Education Assistance Act of 1980.

e.    Was admitted as an Amerasian immigrant.

f.     Is an American Indian born in Canada who is at least one-half American Indian or who is a member of an Indian tribe (as defined in section 450b(e) of title 25).

g.    Is a veteran with an honorable discharge from the Armed Forces of the United States. The spouse and unemancipated dependent children of the veteran may also qualify if they too are qualified non-citizens and are considered to be household members. The spouse of a deceased veteran who has not remarried may also qualify if he or she is a qualified non-citizen.

h.    Is on active duty in the Armed Forces of the United States. A person on active duty for training does not qualify under this category. The spouse and unemancipated dependent children of the person on active duty may also qualify if they are qualified non-citizens and are considered to be household members.

i.     Is a Hmong and other Highland Lao tribal peoples who have been lawfully admitted to the United States for permanent residence, and who fought on behalf of the United States during the Vietnam conflict are considered Veterans and therefore are not subject to the five-year bar on eligibility.

j.     Is a victim of a severe form of trafficking, in accordance with §107(b)(1) of the Trafficking Victims Protection Act of 2000, P.L. 106-386.

k.    Beginning December 19, 2009, an Iraqi and Afghan Special Immigrants admitted to the United States for permanent residence, regardless if they received the status before December 19, 2009.   

l.     Is a legal permanent resident who first entered the country under one of the exempt categories above and who later converted to LPR status.

m.   Is a citizen of the Freely Associated (COFA) States of: The Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau, as long as they have not applied for LPR status.

• If they have been granted LPR status, the five-year bar applies. 

2.    Entry Prior to August 22, 1996

a.    All qualified non-citizens can be eligible for Medicaid, QMB, SLMB, or QI without meeting the five-year bar, when they meet all other eligibility criteria and entered the United States before August 22, 1996 as a qualified non-citizen. The U.S. residency does not have to be continuous.

b.    If they entered before August 22, 1996 without a qualified non-citizen status and later received a qualified non-citizen status, and have continuously resided in the U.S., they are exempt from the five-year bar.

c.    If they entered before August 22, 1996 without a qualified non-citizen status and have not continuously resided in the U.S., the five-year bar begins with the month they receive their qualified non-citizen status, unless they meet one of the exceptions.

d.    To decide if the five-year bar applies, the date of entry may be a date other than the date on the individual's INS non-citizen registration card.

e.    To decide if a person entered the United States before August 22, 1996, it does not matter if the immigrant entered the U.S. legally or illegally, or whether a legal entrant maintained a legal status with INS for the whole time they have resided in the U.S.

f.     To decide if a person has resided in the U.S. continuously, any single absence of more than 30 days or multiple absences totaling more than 90 days is considered to interrupt the continuous residence.

g.    The applicant's qualified non-citizen status must be valid at the time of application.

3.    Entry after August 22, 1996

Immigrants who entered the country on or after August 22, 1996 and who do not meet one of the exceptions listed above, are subject to the 5-year bar.

a.     Use the actual date of entry only to determine if the five-year bar applies. This may or may not be the date on the person's INS Alien registration card.

b.    Once you have determined that the five-year bar applies, the non-citizen is not eligible for full Medicaid services for five years from the date that he or she obtained qualified non-citizen status.  This will be the date on the immigrant's INS Alien registration card, which may be different from the actual date of entry.

c.    Qualified non-citizens who are subject to the five-year bar can only qualify for emergency Medicaid services for five years from the date they obtained qualified non-citizen status.  (See section 205-6.)