Health and Recovery Services Administration, Department of Social and Health Services
 

Medical Eligibility Overview
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REFUGEES AND ALIENS

REFUGEES: Under the 100% federally-funded Refugee Program, a person who has been granted asylum in the U.S. as a refugee or asylee may receive cash benefits for a maximum of eight months. These persons automatically receive Categorically Needy (CN) medical services.  Immediately after entering the U.S., families and single refugees are eligible for this program.

Refugees/asylees who have been in the U.S. for more than eight months are determined eligible for medical benefits the same as U.S. citizens.

Refugees/asylees who have income above cash grant limits may be eligible for the Medically Needy program for a maximum of eight months as described above, when they spend down excess income.

EMERGENCY PROGRAM FOR ALIENS

ALIEN EMERGENCY MEDICAL (AEM) is a federally-funded program for non-citizen aliens with emergent medical condition (s).  A qualifying emergency medical condition is described in WAC 388-500-0005. 
An applicant must be categorically related to a Medicaid program (e.g., a parent with a dependent child, a person who is aged, blind or disabled, or a child under age 19), but are ineligible for Medicaid due to citizenship or alien status.  

  • The CSO may need to refer a case to the Health and Recovery Services Administration's (HRSA) Division of Disability Determination Services to determine the client's disability status.  
  • The CSO may need to refer a case to an HRSA Medical Consultant to decide if the client has an emergent medical condition.
  • Persons eligible for AEM can receive medical benefits for the emergent condition only.  
  • Income and resource limits are the same as for the program to which they are related, i.e., CN or MN.

AEM cases have a three month certification period.  Prenatal services and
transplants are not covered under this program.  

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