To be eligible for Alien Emergency Medical a person must:
- Be related to a Medicaid program (e.g., a parent with a dependent child, an adult with a disability, a blind or aged (65 or older) adult, or a child under age 19), but not for Medicaid due to citizenship or Social Security Number requirements.
- Have an emergent qualifying medical condition as described in WACs 182-507-0115, 182-507-0120, or 182-507-0125; and;
- Be approved by the Health Care Authority's medical consultants as having what meets the definition of an emergency medical condition in chapter 182-500-0030 WAC.
The WAC descriptions below summarize the three qualifying emergent medical conditions:
- 182-507-0115 Alien Emergency Medical - The service must be provided in a hospital setting (inpatient, outpatient surgery, emergency room) that includes evaluation and management visits by a physician. Services are limited to those needed to treat the emergency condition. Certification is limited to the month in which the hospitalization occurred.
- 182-507-0120 Alien Medical for Dialysis and Cancer Treatment - Services are limited to treatment for the qualifying condition of cancer, treatment of life-threatening benign tumors, acute renal failure, end stage renal disease, or antirejection medication. These services are not limited to a hospital setting.
- 182-507-0125 Alien Nursing Facility Program - Must meet all other eligibility factors for nursing home placement and have prior approval authorization by Aging and Disability Services Administration. This program is subject to caseload limits.
Income and resource limits are the same as for the program to which they are related, i.e., categorically needy (CN) or medically needy (MN) scope of care programs for the categories listed in the first bullet on this page.