Medical Assistance

2.1.2.2.2 Immigration Status

To receive Medical Assistance (MA), applicants must be U.S. citizens, U.S. nationals or certain lawfully present noncitizens. See the MA Citizenship policy for more information.

Refer to the Immigration Status and Minnesota Health Care Programs Eligibility chart for a quick reference guide to Medical Assistance eligibility for applicants and enrollees who are noncitizens.

MA Eligibility for Noncitizen Children Under Age 21 and Pregnant People

The following people are eligible for MA, regardless of their specific immigration status:

• All lawfully present noncitizen children younger than age 21

• All lawfully present pregnant noncitizens

Pregnant people and children who are undocumented or are noncitizens not otherwise eligible for MA, including Deferred Action for Child Arrival (DACA) grantees, may be eligible for MA under another basis. See MA for Noncitizens Not Otherwise Eligible for Medical Assistance.

See Appendix H Lawfully Present Noncitizens for more information about lawfully present noncitizens.

MA Eligibility for Noncitizens Age 21 or Older and Not Pregnant

To be eligible for MA, lawfully present noncitizens who are age 21 or older and not pregnant must have a qualified immigration status. People with certain qualified immigration statuses must wait five years after receiving the qualified immigration status before they are eligible for MA.

The date a person enters the United States (also called the date of entry) is not always the same date they acquire a qualified immigration status. The date of entry is used to determine eligibility for Refugee Medical Assistance for refugees who are ineligible for MA. The date a person obtains a qualified immigration status is used to determine the start of the five-year waiting period, when applicable.

Qualified Immigration Statuses Without a Five-Year Waiting Period

Lawfully present noncitizens with the following immigration statuses are eligible for MA without a five-year waiting period:

• Afghan or Iraqi Special Immigrants

• Afghan citizens or nationals granted humanitarian parole between July 31, 2021, and December 23, 2022 September 30, 2023, are eligible for MA until March 31, 2023, or the end of their parole term, whichever is later. Spouses, children, parents and/or guardians of Afghan humanitarian parolees who are paroled after September 30, 2023, are also eligible for MA until the end of their parole term.

• Amerasians

• American Indian noncitizens

• Asylees, including asylees who later adjust to lawful permanent resident status

• Citizens of the Freely Associated States - the Federated States of Micronesia, the Republic of Marshall Islands, and the Republic of Palau

• Conditional Entrants

• Cuban/Haitian Entrants

• Lawful permanent residents (LPRs) who entered the United States before August 22, 1996 and have continuously resided in the United States, regardless of when they adjusted to LPR status. 

• LPRs who adjusted from asylee or refugee status.

• Qualified noncitizens who are U.S. veterans or on active military duty and their spouses and children

• Refugees, including refugees who later adjust to lawful permanent resident status

• T-Visa

• Trafficking victims

• Ukrainian citizens or nationals, or those who last habitually resided in Ukraine,s granted humanitarian parole between February 24, 2022, and September 30, 2024, are eligible for MA until the end of their parole term. Spouses, children, parents, and/or legal guardians of Ukrainian humanitarian parolees who are paroled after September 30, 2023, are also eligible for MA until the end of their parole term.

• Withholding of Removal

Qualified Immigration Statuses With a Five-year Waiting Period

Lawfully present noncitizens with the following qualified immigration statuses who entered the United States after August 22, 1996, are eligible for MA after a five-year waiting period:

• Battered noncitizens

• Immigrants paroled for one year or more

• Lawful permanent residents (LPRs), except:

  • LPRs who adjusted from asylee or refugee status or who entered the United States before August 22,1996 and have continuously resided in the United States, regardless of when they adjusted to LPR status.

MA for Noncitizens Not Otherwise Eligible for Medical Assistance

Four programs are available to certain noncitizens who are not eligible for MA because of their immigration status.

• Children’s Health Insurance Program (CHIP) funded MA may be available for pregnant people who are undocumented or noncitizens not otherwise eligible for MA. Eligibility may continue through the 12 month postpartum period. CHIP-funded MA is not available to people enrolled in other health care coverage. See Pregnant Person Basis of Eligibility. 

• People who are receiving services from the Center for Victims of Torture (CVT) may be eligible for state funded MA-CVT See 2.5.2 MA for People Receiving Services at the Center for Victims of Torture

• People with a medical emergency may be eligible for Emergency Medical Assistance (EMA) See 2.5.3 Emergency Medical Assistance

• People who meet specific criteria may be eligible for federally funded Refugee Medical Assistance (RMA) See 2.5.7 Refugee Medical Assistance

Verification

Immigration status must be verified electronically:

• At Application

• When a change in immigration status is reported by the enrollee after application

• When a new non-citizen household member is added and requests coverage

• When corrections are made about a person's immigration status after application

See 1.3.2.1 MHCP Change in Circumstances for more information.

Paper Documentation

The county, tribal or state agency must attempt and exhaust all trusted electronic sources, including SAVE, prior to requiring paper documentation from the enrollee.

Applicants and enrollees whose immigration status cannot be verified electronically must be provided an opportunity to submit documents or resolve discrepancies to verify immigration status. Paper documentation submitted to verify immigration status must be validated using electronic sources, such as SAVE.

See Immigration documentation types at HealthCare.gov for information about immigration documentation.

Reasonable Opportunity Period

Eligibility is approved for applicants who meet all other eligibility criteria and attest to meeting the noncitizen eligibility requirements.

A person approved for MA without electronic verification of their immigration status has a reasonable opportunity to work with the agency to resolve clerical discrepancies preventing electronic verification or to provide proof of status for SAVE validation. A notice is sent to the enrollee to indicate they have 90 days, plus five days for mailing, from the date of the notice to satisfy the request.

The 95-day reasonable opportunity period can be extended for MA enrollees who demonstrate a good faith effort to get and provide proof of their immigration status. Enrollees who need more time to obtain the needed documents must receive a notice that tells them the new due date. There is no limit to the number of times the reasonable opportunity period can be extended for a MA enrollee to obtain proof of immigration status. Eligibility and coverage for a person whose immigration staatus cannot be verified must end with a 10-day advance notice if the person fails to provide proof or assist in the verification process by the end of the reasonable opportunity period or any extension.

During the reasonable opportunity period, the county, tribal or state servicing agency must continue efforts to complete verification of an applicant’s immigration status. This includes correcting errant demographic data, re-running electronic sources and checking case records and files for prior instances of successful electronic verification or immigration status documentation received previously. The agency must document efforts to verify an applicant’s immigration status during the reasonable opportunity period in the case record. The agency must also help applicants and enrollees obtain required paper proofs.

A person who reapplies for health care coverage, whose immigration status was not previously verified, must be given a new reasonable opportunity period to provide proof of immigration status.

State Residency

Verification of immigration status cannot be used to determine the individual is not a state resident. See 1.4 MHCP State Residency

Legal Citations

Additional Ukraine Supplemental Appropriations Act, 2022, Public Law Number 117-128

Afghanistan Supplemental Appropriations Act, 2022, Public Law 117-103

Centers for Medicare and Medicaid Services State Health Officials letter re: Individuals with Deferred Action for Childhood Arrivals (August 28, 2012), at www.medicaid.gov/Federal-Policy-Guidance/downloads/SHO-12-002.pdf

Centers for Medicare & Medicaid Services (CMS) State Health Officials letter re: Medicaid and CHIP Coverage of “Lawfully Residing” Children and Pregnant People (July 1, 2010), at www.cms.gov/smdl/downloads/SHO10006.pdf

Children’s Health Insurance Program Reauthorization Action of 2009 (CHIPRA), Public Law 111-3, Section 214

Code of Federal Regulations, title 42, section 435.406

Code of Federal Regulations, title 42, section 435.945

Code of Federal Regulations, title 42, section 435.949

Code of Federal Regulations, title 42, section 435.952

Code of Federal Regulations, title 42, section 435.956

Consolidated Appropriations Act, 2021, Public Law 116-260

Minnesota Statutes, section 256B.06, subdivision 4 & 10

Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), Public Law 104-193

United States Code, title 8, section 1641

Published: September 10, 2024

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