MaineCare and CHIP applicants must declare their United
States citizenship or qualifying noncitizen status and have their status
verified to receive MaineCare benefits. An individual who is not a citizen of
the United States may be eligible for full MaineCare benefits, or they may be
eligible for emergency services only.
Section
3.1
Verification of Citizenship and Identity
I. Unless exempted below in Paragraph II(A)
through (F), all members of a household applying for Medicaid and CHIP must
verify citizenship and identity. The Department will attempt to verify
citizenship or qualifying noncitizen status through electronic services before
requiring verification from the applicant or member.
II. The requirement to verify U.S.
citizenship and identity does not apply to:
A.
Current recipients of Supplemental Security Income (SSI).
B. Current recipients of Social Security
benefits, based on the individual's disability.
C. Individuals entitled to or enrolled in
Medicare.
D. Children who receive
child welfare assistance under IV-B of the Social Security Act or foster care
assistance under IV-E of the Social Security Act. This exemption is for the
child only, not the family providing the care.
E. A newborn whose mother receives Medicaid
at the time of birth.
F.
Individuals while covered under Presumptive Eligibility.
G. Individuals whose citizenship or eligible
noncitizen status has been verified by the Department and for whom no change in
status has been reported to the Department.
III. Applicants and household members who
declare United States citizenship or a qualifying noncitizen status, who are
otherwise eligible and only pending for verification of citizenship or
noncitizen status, will be granted a reasonable opportunity period of 90 days
from the date of request for verification to provide documentation necessary to
prove citizenship or qualifying noncitizen status. MaineCare or CHIP coverage
will be provided during the reasonable opportunity period, starting with the
first day of the month of application.
A reasonable opportunity period is not provided if an
individual does not declare U.S. citizenship or a qualifying noncitizen
status.
The reasonable opportunity period is defined as
follows:
A. It begins the date after
the member receives notice informing them they need to provide documentation of
citizenship or qualifying noncitizen status. The date the notice is received is
5 days after the date on the notice.
B. It ends on the earlier of the date the
Department verified the individual's citizenship or immigration status or at
the end of the 90-day period if verification of citizenship or satisfactory
noncitizen status was not obtained.
The Department may extend the reasonable opportunity period
if the individual is making a good faith effort to obtain any necessary
documentation, or if the Department needs more time to complete the
verification process.
If the applicant does not provide documentation necessary
to verify citizenship or qualifying noncitizen status of the applicant and
household members within 90 days, benefits for unverified household members
will end. A reasonable opportunity period will not be provided on subsequent
applications submitted by or on behalf of the applicant or household
members.
IV.
Failure to declare or prove citizenship or qualifying noncitizen status may
result in ineligibility for Medicaid or CHIP. Emergency Services may be
provided to an applicant who does not declare or is unable to prove declared
qualifying noncitizen status within the reasonable opportunity period.
If an individual within a household is not eligible due to
inability to prove citizenship, identity or noncitizen status, the individual
will still be counted as part of the household and that person's income and
assets will be included in determining eligibility for the rest of the
household.
Section
3.2
Citizenship and Identity Requirements
I. A United States citizen is:
A. An individual born in the United States or
its territories, including Puerto Rico, the Virgin Islands, Guam, and the
Northern Mariana Islands, except those born to a foreign diplomat, and who
otherwise qualifies for U.S. citizenship under §301 et
seq. of the Immigration and Nationality Act; [8 U.S.C. §§
1401-1409] .
B. An individual born of a parent who is a
U.S. citizen or who otherwise qualifies for U.S. citizenship under §301
et seq. of the Immigration and Nationality Act; [ 8 U.S.C.
§§ 14011409 ].
C. A
naturalized citizen.
D. A national
(both citizen and noncitizen national):
1.
Citizen National. A citizen national is an individual who otherwise qualifies
as a U.S. citizen under §301 et seq. of the Immigration
and Nationality Act. [ 8 U.S.C. §§ 14011409 ].
2. Noncitizen National. A noncitizen national
is an individual who was born in one of the outlying possessions of the United
States, including America Samoa and Swain's Island, to a parent who is a
noncitizen national.
II. Primary Verification of Citizenship and
Identity
The following documents may be accepted as proof of both
citizenship and identity because each contains a photograph of the individual
named in the document, and the citizenship and identity of the individual have
been established by either the U.S. or a state government. Primary
verifications satisfy both citizenship and identity requirements:
A. U.S. passport, including U.S. passport
card: a U.S. passport need not be currently valid to be accepted as evidence of
U.S. citizenship, if it was originally issued without limitation. However, a
passport that was issued with limitation and is not currently valid may be used
as proof of identity only. U.S. passports issued after 1980 show only one
person. However, spouses and children were sometimes included on one passport
through 1980. The citizenship and identity of the included person can be
established when one of these passports is presented.
B. Certificate of Naturalization (Department
of Homeland Security form N-550 or N-570);
C. Certificate of U.S. Citizenship
(Department of Homeland Security form N-560 or N-561); or
D. Tribal enrollment documents, evidencing
membership or affiliation with a Federally recognized tribe.
III. Secondary Verifications of
Citizenship
If primary verification from the list in Paragraph II of
this section is unavailable, the person should provide satisfactory documentary
verification from Paragraph VI of this section to establish identity, and
satisfactory verification of citizenship from the list below:
A. A U.S. public birth certificate showing
birth in one of the 50 States, the District of Columbia, Puerto Rico (if born
on or after January 13, 1941), Guam, the Virgin Islands of the U.S., American
Samoa, Swain's Island, or the Northern Mariana Islands (after November 4, 1986
(NMI local time)). The birth record document may be issued by the state,
commonwealth, territory, or local jurisdiction. It must have been recorded
before the person was 5 years of age. (A delayed birth record document that is
amended after 5 years of age is considered fourth level evidence of
citizenship. See section V, paragraph B.
B. If the document shows the individual was
born in Puerto Rico, Guam, the Virgin Islands of the U.S., or the Northern
Mariana Islands before these areas became part of the U.S., the individual may
be a collectively naturalized citizen. Collective naturalization occurred on
the dates listed for each of the Territories. The following will establish U.S.
citizenship for collectively naturalized individuals:
1. Puerto Rico
a. evidence of birth in Puerto Rico and the
person's statement that they were residing in the U.S., a U.S. possession, or
Puerto Rico on January 13, 1941; or
b. evidence that the person was a Puerto
Rican citizen and the person's statement that they were residing in Puerto Rico
on March 1, 2017 and that they did not take an oath of allegiance to
Spain.
2. U.S. Virgin
Islands
a. evidence of birth in the U.S.
Virgin Islands, and the person's statement of residence in the U.S., a U.S.
possession or the U.S. Virgin Islands on February 25, 1927; or
b. the person's statement indicating
residence in the U.S. Virgin Islands as a Danish citizen on January 17, 2017
and residence in the U.S., a U.S. possession, or the U.S. Virgin Islands on
February 25, 1927, and that the person did not make a declaration to maintain
Danish citizenship; or
c. evidence
of birth in the U.S. Virgin Islands and the person's statement indicating
residence in the U.S., a U.S. possession, or Territory or the Canal Zone on
June 28, 1932.
3.
Northern Mariana Islands (NMI) (formerly part of the Trust Territory of the
Pacific Islands {TTPI}):
a. evidence of birth
in the NMI, TTPI citizenship and residence in the NMI, the U.S., or a U.S.
Territory or possession on November 3, 1986 (NMI local time) and the person's
statement that they did not owe allegiance to a foreign state on November 4,
1986 (NMI local time); or
b.
evidence of TTPI citizenship, continuous residence in the NMI since before
November 3, 1981 (NMI local time), voter registration prior to January 1, 1975
and the person's statement that they did not owe allegiance to a foreign state
on November 4, 1986 (NMI local time); or
c. evidence of continuous domicile in the NMI
since before January 1, 1974 and the applicant's statement that they did not
owe allegiance to a foreign state on November 4, 1986 (NMI local
time).
d. If a person entered the
NMI as a nonimmigrant and lived in the NMI since January 1, 1974, this does not
constitute continuous domicile and the person is not a U.S. citizen.
C. A Certification of
Report of Birth (DS-1350)
The Department of State issues a DS-1350 to U.S. citizens
in the U.S. who were born outside the U.S. and acquired U.S. citizenship at
birth, based on the information shown on the FS-240. When the birth was
recorded as a Consular Report of Birth (FS-240), certified copies of the
Certification of Report of Birth Abroad (DS-1350) can be issued by the
Department of State in Washington, D.C. The DS-1350 contains the same
information as that on the current version of Consular Report of Birth FS-240.
The DS-1350 is not issued outside the U.S.
D. A Report of Birth Abroad of a U.S. Citizen
(Form FS-240)
The Department of State consular office prepares and issues
this. A Consular Report of Birth can be prepared only at an American consular
office overseas while the child is under the age of 18. Children born outside
the U.S. to U.S. military personnel usually have one of these.
E. A Certification of Birth Issued
by the Department of State (Form FS-545 or DS-1350)
Before November 1, 1990, Department of State consulates
also issued Form FS-545 along with the prior version of the FS-240. In 1990,
U.S. consulates ceased to issue Form FS-545. Treat an FS-545 the same as the
DS-1350.
F. A U.S. Citizen
I.D. Card
This form was issued as Form I-197 until the 1980s by INS.
INS issued the I-179 from 1960 until 1973. It revised the form and renumbered
it as Form I-197. INS issued the I-197 from 1973 until April 7, 1983. INS
issued Form I-179 and I-197 to naturalized U.S. citizens living near the
Canadian or Mexican border who needed it for frequent border crossings.
Although neither form is currently issued, either form that was previously
issued is still valid.
G. A
Northern Mariana Identification Card (I-873)
The former Immigration and Naturalization Service (INS)
issued the I-873 to a collectively naturalized citizen of the U.S. who was born
in the NMI before November 4, 1986. The card is no longer issued, but those
previously issued are still valid.
H. An American Indian Card (I-872) issued by
the Department of Homeland Security (DHS) with the classification code "KIC"
DHS issues this card to identify a member of the Texas Band
of Kickapoos living near the U.S./Mexican border. A classification code of
"KIC" and a statement on the back denote U.S. citizenship.
I. A final adoption decree showing the
child's name and U.S. place of birth
In situations where an adoption is not finalized and the
state in which the child was born will not release a birth certificate prior to
final adoption, a statement from a state-approved adoption agency that shows
the child's name and U.S. place of birth is acceptable. The adoption agency
must state in the certification that the source of the place of birth
information is an original birth certificate.
J. Evidence of U.S. Civil Service employment
before June 1, 1976
The document must show employment by the U.S. government
before June 1, 1976. Individuals employed by the U.S. Civil Service prior to
June 1, 1976 had to be U.S. citizens.
K. U.S. Military Record showing a U.S. place
of birth
The document must show a U.S. place of birth (for example a
DD-214 or similar official document showing a U.S. place of birth.)
L. A verification with the
Department of Homeland Security's Systematic Alien Verification for
Entitlements (SAVE) database. Inclusion in this database could prove
citizenship through naturalization.
M. Evidence of meeting the automatic criteria
for U.S. Citizenship outlined in the Child Citizenship Act of
2000.
N. Evidence of
meeting the automatic criteria for U.S. citizenship under the provisions of the
INA in effect on the person's birthdate or adoption date, if the person's
birthdate or adoption date was prior to the February 27, 2001 enactment date of
the Child Citizenship Act of 2000 (citizenship laws are not
retroactive, so the law applicable at the time the person was born or adopted
applies, even if that law was subsequently repealed and replaced by a new
section).
IV. Third-Level
Verification of Citizenship
If verification from the lists in Paragraphs II and III of
this section is unavailable and the person claims a U.S. place of birth, the
person should provide satisfactory verification from Paragraph VI of this
section to establish identity, and satisfactory verification of citizenship
from the list below:
A. Extract of a
hospital record on hospital letterhead, indicating a U.S. place of birth. The
hospital record must have been established at the time of the person's birth
and created five years before the initial application date for Medicaid or CHIP
(For children under age 16, the document must have been created near the time
of birth or five years before the date of application). A souvenir "birth
certificate" issued by a hospital does not satisfy this requirement.
B. Life, health, or other insurance record
showing a U.S. place of birth. The record must have been created at least five
years before the initial application date for Medicaid or CHIP.
C. Religious record recorded in the U.S.
within three months of birth showing the birth occurred in the U.S. and showing
either the date of the birth or the individual's age at the time the record was
made. The record must be an official record recorded with the religious
organization. (Entries in a family bible are not considered religious
records.)
D. Early school record
showing a U.S. place of birth. The school record must show the name of the
child, the date of the admission to the school, the date of birth, a U.S. place
of birth, and the name(s) and place(s) of the birth of the applicant's
parents.
V. Fourth-Level
Verification of Citizenship
If verification from the lists in Paragraphs II, III, and
IV of this section is unavailable and the person claims a U.S. place of birth,
the person should provide verification from Paragraph VI of this section to
establish identity, and satisfactory documentary evidence of citizenship from
the list below:
A. Federal or State
census record showing U.S. citizenship or a U.S. place of birth. The census
record must also show the applicant's age.
Census records from 1900 through 1950 contain certain
citizenship information. To secure this information, complete a Form BC-600,
Application for Search of Census Records for Proof of Age. Add in the remarks
portion "U.S. citizenship data requested". Also add that the purpose is for
Medicaid and CHIP eligibility.
B. One of the following documents that show a
U.S. place of birth and was created at least five years before the application
for Medicaid and CHIP:
1. Seneca Indian tribal
census record;
2. Bureau of Indian
Affairs tribal census records of the Navajo Indians;
3. U.S. State Vital Statistics official
notification of birth registration;
4. A delayed U.S. public birth record that is
recorded more than five years after the person's birth;
5. Statement signed by the physician or
midwife who was in attendance at the time of birth; or
6. Bureau of Indian Affairs Roll of Alaska
Natives.
C. Institutional
admission papers from a nursing facility, skilled care facility or other
institution, showing a U.S. place of birth, created at least five years before
the initial application.
D. Medical
(clinic, doctor, or hospital) record showing a U.S. place of birth. The record
must have been created at least five years before the initial application date
for Medicaid or CHIP. (For children under age 16, the document must have been
created near the time of birth or five years before the date of application.)
An immunization record alone is not considered a medical
record for purposes of establishing U.S. citizenship.
E. Written Affidavits of
Citizenship
F. Declarations should
only be used in rare circumstances. If the documentation requirement needs to
be met through affidavits, the following rules apply:
1. There must be at least two affidavits by
two people who have personal knowledge of the event(s) establishing the
individual's claim of citizenship (the two affidavits could be combined in a
joint declaration).
2. At least one
of the people making the affidavit cannot be related to the applicant or
recipient. Neither of the two individuals can be the applicant or
recipient.
3. In order for the
affidavits to be acceptable, the people making them must be able to provide
proof of their own citizenship and identity.
4. If the people making the affidavits have
information that explains why documentary evidence establishing the
individual's claim of citizenship does not exist or cannot be readily obtained,
the declaration should contain this information as well.
5. The applicant or recipient or other
knowledgeable person (guardian or representative) must also provide an
affidavit explaining why the evidence does not exist or cannot be
obtained.
6. The affidavits must be
signed under penalty of perjury.
VI. Evidence of Identity
The following documents, even if expired, may be accepted
as proof of identity and must be submitted when the person uses, as proof of
citizenship, the documents listed in Paragraphs II through V of this section.
(A separate document proving identity need not be submitted when the person
submits primary evidence of citizenship and identity as outlined in Paragraph
II of this section):
A. A driver's
license issued by a U.S. state or territory. The license must either have a
photograph of the individual or other identifying information such as name,
age, sex, race, height, weight, or eye color.
B. School identification card. The card must
have a photograph of the individual.
C. U.S. military card or draft
record.
D. Identification card
issued by the federal, state, or local government. The card must have the same
information that is required for driver's licenses.
E. Military dependent's identification
card.
F. Native American tribal
document.
G. U.S. Coast Guard
Merchant Mariner card.
H.
Certificate of Degree of Indian Blood, or another U.S. American Indian/Alaska
Native Tribal document. The document must have a photograph or other personal
identifying information relating to the individual.
A voter's registration card does not meet this requirement,
as the Centers for Medicare and Medicaid Services (CMS) does not view this as a
reliable form of identification.
I. In the absence of the documents described
in Section 3.2(VI)(A) through (H) of this part, three or more corroborating
documents such as marriage licenses, divorce decrees, high school and college
diplomas from accredited institutions, including general education and high
school equivalency diplomas, property deeds or titles, and employer ID cards
can be used to verify the identity of an individual.
If the individual submitted fourth level verification of
citizenship, Section 3.2(VI)(I) does not apply.
VII. Special Identity Rules for Children and
Certain Individuals with Disabilities
An individual with a disability in a residential care or
institutional facility may have their identity attested to by the facility
director or administrator when the individual does not have or cannot get any
document on the preceding lists. The affidavit is signed under the penalty of
perjury but need not be notarized.
Children under age 16 may have their identity documented
using one of the following if none of the documents in Paragraph VI are
available:
A. School record including
report card, day care or nursery school record, verified by the Department with
the issuing school.
B. Clinic,
doctor or hospital record.
C. An
affidavit of identity. An affidavit of identity is only acceptable if it is
signed under penalty of perjury by a parent, guardian, or caretaker relative
stating the date and place of the birth of the child and cannot be used if
affidavits were used to establish citizenship.
Identity affidavits may be used for children under age 18
in limited circumstances, when the child is from an area where a school ID with
picture is not provided or a driver's license with a picture is not
available.
VIII.
Documentary Evidence
Electronic data matching is the primary method of verifying
citizenship and identity. If citizenship cannot be verified electronically, the
applicant must provide documentary evidence of their citizenship as listed in
Paragraph II through VII of this section.
A. All documents must be either originals or
copies certified by the issuing agency.
B. Copies of citizenship and identification
documents shall be maintained in the case record or electronic data
base.
C. Individuals may submit
documentary evidence without appearing in person at an OFI office. Documents
may be tendered in person, by mail, or by a guardian or authorized
representative. Originals or certified copies presented by the applicant or
recipient will be returned.
D.
Presentation of documentary evidence of citizenship is a one-time activity;
once a person's citizenship is documented and recorded in a state database,
subsequent changes in eligibility should not require repeating the
documentation of citizenship unless later evidence raises a question of the
person's citizenship.
E. The
requirement to provide documentary evidence is the responsibility of the
applicant. If documentation is not presented at application, the individual
will be given a reasonable opportunity to provide the documentation.
Section 3.3
Documentation and Verification for Noncitizens
An individual who is not a citizen or national of the
United States must present alien registration documentation, other proof of
immigration registration from the U.S. Citizenship and Immigration Services
(USCIS), or other documents indicating the individual's qualifying noncitizen
status. If the individual declares a satisfactory noncitizen status and
documentation is not presented at application, the individual will be given a
reasonable opportunity to provide the documentation. See Part 2, Section
3.1(III). Following the reasonable opportunity period, Temporary MaineCare
coverage, as described in Section 12.3 of this part, will not be provided if
the applicant cannot provide satisfactory documentation of noncitizen
status.
The Systematic Alien Verification for Entitlements Program
(SAVE) is the USCIS operative system for verification of noncitizen status for
individuals applying for MaineCare. The noncitizen status of applicants who
declare a qualifying noncitizen status must be verified through SAVE. If
electronic verification indicates that additional documentation is required to
verify attested noncitizen status, the Department will request further
information from the individual. If an applicant disputes the USCIS response,
they may submit additional documentation. The Department will submit additional
documentation received by the Department to SAVE to reattempt electronic
verification of attested status.
Section
3.4
MaineCare Coverage for Noncitizens
The Personal Responsibility and Work Opportunity
and Reconciliation Act of 1996 (PRWORA),
P.L.
104-193, describes noncitizens as either qualified
or non-qualified aliens. PRWORA further defines aliens who are eligible to
receive either full benefit Medicaid or emergency services only, and qualified
aliens who are subject to the five-year bar from Medicaid eligibility.
An individual must provide documentation from the United
States Citizen and Immigration Services (USCIS) to prove their noncitizen
status.
If an individual admits to being an undocumented
noncitizen, this information will not be shared with USCIS. All information is
held confidential in accordance with Part 1, Section
2.
I. Noncitizens Eligible for Full Benefits
Below is a listing of noncitizen groups who may be eligible
for full benefits. See Section 3.4(II) of this part for a listing of noncitizen
statuses that are only eligible for Emergency Services.
A. Veteran or Active Duty Personnel
1. Lawfully residing in U.S.; and
2. A veteran of the U.S. Armed Forces with an
honorable discharge or on active duty (not training) in the U.S. Armed Forces;
or
3. Lawfully residing in the U.S.
and a spouse or unmarried child of the veteran described in Paragraph I(A)(1)
and (2) of this section. "Unmarried child" means a child is or could be claimed
as dependent on veteran's tax return and meets MaineCare requirements for a
dependent child.
B. Legal
Permanent Resident
1. Legal permanent resident
status (LPR) granted under Immigration and Nationality Act (INA).
i. EXCEPTION: Legal permanent residents are
not eligible for full benefits if they have been in the U.S. less than five
years. There is no five-year waiting period if any of the following conditions
applies:
a. The individual's date of entry to
the U.S. is prior to August 22, 1996;
b. The individual is a child under the age of
21;
c. The individual is
pregnant;
d. Prior to adjustment to
legal resident status regardless of the LPR status-granted date, the
noncitizen's status was Refugee (C, below), Asylee (D, below), Person whose
deportation was withheld (E, below), Amerasian immigrant (J, below), or Cuban
or Haitian entrant (K, below). This noncitizen is eligible as a Refugee,
Asylee, Deportee, Amerasian immigrant, or Cuban / Haitian entrant (per Medicaid
State Plan).
C. Refugee
1. Refugee status granted under §207 of
the INA
D. Asylee
1. Asylee status granted under §208 of
the INA
E. Deportation
Withheld
1. Deportee status granted under
§243(h) of the INA as in effect prior to April 1, 1997; or §241(b)(3)
of the INA, as amended
F.
Parolee
1. Parolee status granted for at least
a year under §212(d)(5) of the INA.
i.
EXCEPTION: Parolees are not eligible for full benefits if they have been in the
U.S. less than five years. There is no five-year waiting period if any of the
following conditions applies:
a. The
individual's date of entry to the U.S. is prior to August 22, 1996;
b. The individual is a child under the age of
21;
c. The individual is
pregnant.
G. Conditional Entrant
1. Conditional entrant status granted under
§203(a)(7) of the INA in effect before April 1, 1980
i. EXCEPTION: Conditional entrants are not
eligible for full benefits if they have been in the U.S. less than five years.
There is no five-year waiting period if any of the following conditions
applies:
a. The individual's date of entry to
the U.S. is prior to August 22, 1996;
b. The individual is a child under the age of
21;
c. The individual is
pregnant.
H. Battered Noncitizen or Battered
Noncitizen's Minor Child
1. While lawfully
residing in the U.S. the noncitizen or the minor child was battered or
subjected to extreme cruelty by a spouse, a parent, or a member of the spouse's
or parent's family residing in the same household as the noncitizen;
and
2. batterer(s) no longer lives
in same household, and
3. The
noncitizen or the minor child meets the conditions set forth in §431(c) of
PRWORA as amended (Section 431(c) of PRWORA, as amended, is codified at
8 USC
1641(c)).
i. EXCEPTION: Battered Noncitizens are not
eligible for full benefits if they have been in the U.S. less than five years.
There is no five-year waiting period if one of the following conditions
applies:
a. The individual's date of entry to
the U.S. is prior to August 22, 1996;
b. The individual is a child under the age of
21;
c. The individual is
pregnant.
I. Trafficking Victim
1. Noncitizens certified as a trafficking
victim (TV) under 107(b)(1) of the TV Protection Act of 2000,
P.L.
106-386.
J. Amerasian
1. Admitted to the U.S. pursuant to §584
of the Foreign Operations, Export Financing, and Related Programs
Appropriations Act, 1988
K. Cuban or Haitian Entrant
1. As defined in §501(e) of the
Refugee Education Assistance Act of 1980
L. American Indian Born in Canada
1. The individual is at least one-half
American Indian blood and provisions of §289 of the INA apply
M. Native American who is a Member
of a Federally-Recognized Indian Tribe
1.
Member of an Indian tribe under Section
4(e) of the
Indian Self-Determination and Education Assistance
Act
N. Iraqi
Special Immigrant Eligibility Under
Public Law
110-161 and 110-181, Section 1244
1. Has same status as refugee under 2009
Department of Defense Bill.
O. Afghani Special Immigrant Eligible Under
Public Law
110-161
1. Has
same status as refugee under 2009 Department of Defense
Bill.
P. Compact of Free
Association (COFA) Migrants
1. Effective
December 27, 2020 individual citizens from the Federated States of Micronesia,
the Republic of the Marshall Islands, and the Republic of
Palau.
Q. Lawfully
Residing Pregnant Women, and Children Under the Age of 21
1. Under the
Children's Health
Insurance Program Reauthorization Act of 2009, Section 214, lawfully
residing pregnant women and children under the age of 21 include:
i. A "Qualified alien" otherwise subject to
the five-year waiting period per Section 403 of the Personal
Responsibility and Work Opportunity Reconciliation Act of
1996;
ii. A citizen of a
Compact of Free Association State (i.e., Federated States of Micronesia,
Republic of the Marshall Islands, and the Republic of Palau) who has been
admitted to the U.S. as a non-immigrant and is permitted by the Department of
Homeland Security to reside permanently or indefinitely in the U.S.;
iii. An individual described in 8 C.F.R.
§ 103.12(a)(4) who does not have a permanent residence in the country of
their nationality and is in a status that permits the individual to remain in
the U.S. for an indefinite period of time, pending adjustment of status. These
individuals include:
a. An individual
currently in temporary resident status as an Amnesty beneficiary pursuant to
Section 210 or 245A of the Immigration and Nationality Act
(INA);
b. An individual currently
under protected Status pursuant to Section 244 of the INA;
c. A family Unity beneficiary pursuant to
Section 301 of Public Law
101-649 as amended by, as well as pursuant to,
Section 1504 of Public Law 106-554;
d. An individual currently under Deferred
Enforced Departure pursuant to a decision made by the President; and
e. An individual who is the spouse or child
of a U.S. citizen whose visa petition has been approved and who has a pending
application for adjustment of status; and
iv. An individual in non-immigrant
classifications under the INA who is remaining in the U.S. for an indefinite
period, including the following as specified in Section 101(a)(15) of the INA:
a. A parent or child of an individual with
special immigrant status under Section 101(a)(27) of the INA, as permitted
under Section 101(a)(15)(N) of the INA;
b. A Fiancé of a citizen, as permitted
under Section 101(a)(15)(K) of the INA;
c. A religious worker under Section
101(a)(15)(R);
d. An individual
assisting the Department of Justice in a criminal investigation, as permitted
under Section 101(a)(15)(S) of the INA;
e. A battered alien under Section
101(a)(15)(U) (see also Section 431 as amended by PRWORA); and
f. An individual with a petition pending for
3 years or more, as permitted under Section 101(a)(15)(V) of the INA.
II.
Noncitizens Eligible for Emergency Services
A noncitizen who does not declare a qualified noncitizen
status from Paragraph I of this section, or has no USCIS documents regarding
their noncitizen status, or who is an ineligible noncitizen as defined in
Subparagraph B below, or who is a qualified alien subject to the five-year
waiting period for full Medicaid can get Medicaid or CHIP Emergency Services
only. Individuals must still meet financial requirements and be in a coverable
group. These individuals must meet all basic eligibility requirements
(including Maine residency) except for citizenship or noncitizen status and
providing a Social Security number. If these individuals intend to remain in
Maine at the time of application, they will be considered Maine
residents.
MaineCare Emergency Services coverage is only available for
the noncitizen groups listed below:
A.
Undocumented Noncitizen
1. Non-qualified
noncitizens who do not have USCIS documentation of their citizenship
status.
2. EXCEPTION: Individuals
under the age of 21 described in Part 3, Section 2.1(V) and pregnant
individuals described in Part 3, Section 2.3 (III) may be eligible for full
MaineCare benefits.
B.
Ineligible Noncitizen
1. Non-qualified
noncitizens legally admitted on a temporary basis or for a specific time
period. The following are examples of individuals who are ineligible
noncitizens:
Except for (x) below, these noncitizens should have one of
the following types of INS documents: Form I-94, Arrival-Departure Record; Form
I-185, Canadian Border Crossing Card; Form I-186, Mexican Border Crossing Card;
Form SW-434, Mexican Border Visitor's Permit; Form I-95A, Crewman's Landing
Permit; or Form I-184, Crewman's Landing Permit and Identification Card.
i. Foreign government representatives on
official business and their families and employees;
ii. Visitors for business or pleasure,
including exchange visitors;
iii.
Aliens in travel status while traveling directly through the United
States;
iv. Crewmen on shore
leave;
v. Treaty traders and
investors and their families;
vi.
Foreign students;
vii.
International organization personnel and their families and servants;
viii. Temporary workers, including
agricultural contract workers;
ix.
Members of foreign press, radio, film or other information media and their
families
x. Parolee in the U.S.
under Section 212(d)(5) for less than one year
2. EXCEPTION: Some ineligible noncitizens may
be included for full coverage under CHIPRA 2009, Section 214. Lawfully residing
pregnant individuals and children under age 21 may be eligible for full
benefits-refer to Paragraph I(Q) of this section, "Noncitizens Eligible for
Full Benefits." The term "lawfully residing" includes nonqualified noncitizens
who are in the U.S. lawfully.
C. Qualified Alien Subject to the Five-Year
Waiting Period
1. Qualified aliens who enter
the United States on or after August 22, 1996 are subject to a five-year
waiting period for full Medicaid unless they are specifically exempt from this
waiting period or otherwise included in the State Medicaid Plan.
2. As indicated in Section 3.4 (I), the
following qualified aliens are not subject to the five-year waiting period:
i. Qualified Aliens who came to the United
States before August 22, 1996
ii.
Legal Permanent Residents whose prior qualified alien status was Refugee,
Asylee, Person whose deportation was withheld, Amerasian immigrant, Haitian
entrant, or Cuban entrant.
iii.
Pregnant individuals
iv. Children
under the age of 21
v. The
following Qualified Aliens:
a. Veteran or
Active Duty Personnel
b.
Refugee
c. Asylee
d. Deportation Withheld
e. Trafficking Victims
f. Amerasians
g. Cuban and Haitian Entrants
h. American Indian born in Canada
i. Native Americans who are members of
Federally-recognized Indian Tribes
j. Iraqi Special Immigrants
k. Afghani Special Immigrants
3. Immigrants who
entered the United States prior to August 22, 1996 and did not remain
"continuously present" in the U.S. until becoming a qualified alien on or after
that date are also subject to the five-year waiting period. Any single absence
of more than 30 consecutive days or a combined total absence of 90 days before
obtaining qualified alien status interrupts "continuous presence."
4. The five-year waiting period begins on the
date the immigrant obtains qualified alien status. Once the five-year waiting
period expires, the qualified alien is eligible for full Medicaid
benefits.
