The CAO will determine the refugee's eligibility for TANF and SSI related MA before determining eligibility for Refugee Medical Assistance (RMA). See the Medical Assistance Eligibility Handbook for program requirements and procedures. 45 CFR 400.94
Reminder: The CAO will contact the VOLAG to determine if it is providing assistance to the refugee. Consent of the client for the contact is not required.
NOTE: If the refugee meets all requirements, the CAO will authorize MA retroactively for medical care if they were eligible when the medical services were received. 45 CFR 400.93
If the refugee does not meet the age, specified relative, and deprivation requirements for TANF-related MA and is not aged, blind, or disabled, the CAO will determine eligibility for RMA. 45 CFR 400.94
Reminder: A refugee who is pregnant is eligible for TANF-related MA. The pregnancy must be verified.
The CAO will apply the requirements and procedures contained in the Medical Assistance Eligibility Handbook with the following modifications: 45 CFR 400.100
The CAO will apply the TANF related requirements and exclusions of the Medical Assistance Eligibility Handbook, Chapter 340, Resources, to determine the refugee's resource eligibility. The CAO will consider resources as follows: 45 CFR 400.102
Those actually available at the time assistance is needed. The CAO will not consider resources owned by the refugee or the refugee's legally responsible relative if the resource remains in the country of origin.
Those actually made available from the VOLAG, sponsor, or other community group.
Reminder: The CAO will not deem the resources of the VOLAG or sponsor to determine the refugee's eligibility for RMA. The CAO will consider only those resources actually made available to the refugee.
The CAO will apply the TANF related requirements and exclusions of the Medical Assistance Eligibility Handbook, Chapter 350, Income, to determine the refugee's income eligibility.
Exception: The CAO will not apply the TANF earned income incentive deduction when determining the refugee's net income. Total net monthly income, without the earned income incentive deduction must be less than or equal to the appropriate MA income limit for the refugee to receive RMA benefits.
The CAO will not deem the income of the VOLAG or sponsor to determine the refugee's eligibility for RMA. The CAO will consider only the income actually made available to the refugee.
A refugee who is a full-time undergraduate or post-graduate college student is not eligible for RMA unless the refugee or the college program meet the following criteria: 45 CFR 400.100(a)(5)
The refugee is eligible as an Unaccompanied Refugee Minor. See Section 730.22.
The refugee is a professional in need of professional refresher training and other recertification services to qualify to practice his profession in the US. The education must meet all of the following: 45 CFR 400.81(b)
Is approved as part of the employment plan developed for the refugee by the designated employment service provider.
Does not exceed one year's duration, including time enrolled before the refugee's application for benefits.
Is specifically intended to assist the refugee in becoming relicensed in his/her profession and, if completed, can realistically be expected to result in relicensing.
NOTE: A full-time student who does not meet the above criteria may qualify for PC, if under age 21, or PD or TD under regular requirements. The CAO will not assign a refugee program status code to the budget.
A refugee is considered to be Chronically Needy during the time they are receiving Nonmoney Payment RMA. The CAO will determine the Chronically/Medically Needy status at the end of RMA time eligibility. 45 CFR 400.94
The refugee who loses their eligibility for RMA or RCA due to increased earnings from employment, new employment, or increased hours of employment is eligible for continued MA for eight months or until the end of their refugee assistance time eligibility, whichever comes first. 45 CFR 400.104
The CAO will extend MA benefits for both RMA and RCA recipients as follows:
1. Explore possible third party medical resources available through employment
2. Continue the category of MA received by the time of closure. If the refugee is receiving RCA at the time of ineligibility, close RCA and authorize category PD.
3. Continue the program status code 02, as appropriate. 45 CFR 400.104
4. Enter a future close date for the end of the eight months or the end of the RCA or RMA period, whichever comes first.
Reminder: A future close may be entered for any day of the month. Central Office will remove the program status code.
5. Provide the refugee with an Advance Notice advising of the closure and the need to report changes during the extended period.
6. Before the end of the extended period (or the date time eligibility ends), determine if the refugee is eligible for MA using regular NMP or MNO requirements. If eligible, continue MA in the appropriate category. Do not assign a refugee program status code to the budget.
Reissued February 14, 2013, replacing March 16, 2012