Section 144-332-3.5-3 - OTHER NON-MAGI ELIGIBILITY GROUPSOther special coverage groups refers to various special groupings created by federal and/or state legislation. Specifically:
Refugee/Asylees IV-E Eligibles and State Adoption assistance Section 3.1: Refugees/AsyleesPersons who are eligible for services under the Refugee Resettlement Program (RRP) are eligible for Medicaid provided that financial and basic eligibility requirements are met. Eligibility is determined on the basis of need without regard to family composition or the presence of children. Age is not considered. Financial eligibility follows MAGI-Based budgeting in Part 17.5.
A. Special Eligibility Factors(1) Each applicant must have a Form I-94, I-151, or I-551 indicating that the individual has been admitted under Section 212(d)(5) of the Immigration and Naturalization Act (INA) or granted asylum under Section 208 of the INA.(2) Any funds received through the RRP are counted as unearned income and used in determining eligibility.(3) The following guideline should be used for documentation: (a) Form I-94 may be accepted as proof of age.(b) Any documents that the refugees brought with them when they emigrated showing the relationship among family members is acceptable evidence of relationship.(c) School records and medical records established since arrival in the United States may be used as methods of verification.(d) Information recorded in the refugee assistance case folder may be used as supporting evidence.(e) If there are no written records of any kind, the refugee's statement is acceptable unless the statement appears unreasonable.(4) The income of sponsors and any income-in-kind they provide is not used in determining eligibility.(5) Children born to refugees in this country are considered United States citizens. They are issued alien registration numbers which are the same as their mother's with the suffix 01, 02, 03, etc. These children are considered a part of the refugee family for eligibility purposes.(6) Individuals who are dependents of repatriated United States citizens may be eligible during the first ninety days after their arrival in the United States if the individuals qualify as refugees under the RRP.B. Limitation(1) An individual can receive Medicaid as a refugee for only the eight month period including the month that the refugee enters the United States. Example
The individual enters the United States as a refugee on July1st. She is potentially eligible to receive Medicaid as a refugee from July 1st through February of the following year.
(2) An individual can receive Medicaid as an asylee for only eight months beginning in the month they are granted asylum. Example
An individual enters the United States in January, but is not granted asylum until November. November is the first month of the eight month period.
This limitation applies on an individual basis.
At the end of the 8th month period, eligibility is reviewed for other program categories. If none exists, Medicaid ends with timely and adequate notice.
This limitation does not apply to individuals who meet age factors for MAGI - Based or SSI - Related coverage. If eligible under other programs, the individual should first be covered under those programs. The refugee program is one of last resort.
Section 3.2: IV-E Eligibles and State Adoption AssistanceA. Move-In from Out of StateAn individual under the age of 21, who is receiving Title IV-E funds from another state or is covered by a State Adoption Agreement from another state and moves to Maine, is eligible for Medicaid. The income and assets of the child and parents are not considered to determine eligibility for this child.
There must be an assignment of rights to medical support and the Department must be provided with a Social Security number for the child.
There are three groups of children who fall into this category:
(1) Children whose medical and financial circumstances qualify them for federal IV-E adoption assistance;(2) Children whose medical and financial circumstances qualify them for federal IV-E foster care assistance; and(3) Children whose medical and financial circumstances quality them for state adoption assistance. The foster or adoptive parents in Maine are provided with a written explanation of their status by the state of origin which usually serves as verification of their status.
B. Maine ResidentsThe following children are eligible for Medicaid:
(2) children named in a Federal (IV-E) or Maine State Adoption Assistance Agreement; (3) children who are placed in Permanency Guardianship by the State of Maine, as defined in 22 MRSA Sec. 4038-C. C. Former Foster Care ChildrenAn individual is eligible to enroll in Medicaid if he/she:
(2) is not eligible for and enrolled in another mandatory Medicaid coverage under 42 CFR §§435.110 through 435.118 or 42 CFR §§435.120 through 435.145; (3) was in foster care in the State of Maine and was enrolled in Medicaid through the State of Maine at age 18. The income and assets of the individual (or anyone else in his/her household) is not considered to determine eligibility for the individual.
10-144 C.M.R. ch. 332, § 3.5-3