Medicaid Policy                                                                 

394-1 When to Use the RMA Program

Effective Date: May 5, 2025

Previous Policy

 

    

1.    Determine eligibility for RMA if:

·       The adult refugee does not qualify for Medicaid without cost or

·       The child does not qualify for Medicaid without cost, CHIP, or UPP, and

·       The date of application is within 4 months of the date of entry if they were determined eligible on or after May 5, 2025 or within 12 months of the date of entry if they were determined eligible between October 1, 2021 and May 4, 2025.  

(For Iraqi and Afghan Special Immigrants, use either the date of entry, or the date they were granted Special Immigrant status, whichever one is later.)  

 

2.    Re-determine RMA eligibility using the income and assets held on the date of the original medical assistance application if a refugee listed in 394-2 loses Medicaid eligibility within the available RMA eligibility timeframe for one of the following reasons:

·       Increased earnings or assets

·       Categorical ineligibility (e.g. a member receiving Adult Expansion who loses coverage for failing to comply with ESI requirements).  

3.    For all members including Iraqi and Afghan Special Immigrants, close RMA at the end of the 4^th month if the member was determined eligible on or after May 5, 2025, or at the end of the 12^th month of coverage if they were determined eligible after October 1, 2021 but before May 5, 2025.  Once the case is closed, determine eligibility for Medicaid, CHIP or UPP.  Treat Iraqi and Afghan Special Immigrants as qualified non-citizens; the 5-year bar does not apply.