Citizen and immigration status definitions
Revised February 10, 2015
Purpose: To explain basic definitions of various citizen and immigrant statuses relevant for determining eligibility for Apple Health programs.
A person's citizenship or immigration status must be determined as part of the eligibility determination for health care coverage under Apple Health (which includes both Classic Medicaid program and the new MAGI-based Medicaid programs). Everyone falls into one of the following four citizenship/immigration status groups for purposes of coverage eligibility:
Eligibility for all programs must determine an individual's citizenship or alien status. An individual will fall into one of the following four groups for purposes of benefits eligibility:
- Lawfully Present "Qualified Alien";
- Lawfully Present "Non-Qualified Alien";
- Not Lawfully Present (Undocumented) Immigrant; or
- Citizen or U.S. National.
A lawfully present immigrant refers to any non-citizen presently permitted to remain in the United States. Lawfully present means that USCIS has actively granted these immigrants permission to remain in the U.S. and has issued documentation of their lawfully present status that is currently valid. A lawfully present immigrant must still meet state residency requirements in WAC 182-503-0520 in order to qualify for health care coverage.
"Qualified Alien" and "Non-Qualified Alien" are terms used in federal immigration law and do not by themselves indicate whether an immigrant is eligible for benefits. Both "Qualified Aliens" and "Non-Qualified Aliens" may be eligible for health care coverage.
- For an overview of citizenship and immigration status eligibility rules, see the Citizenship and Alien Status Guide.
Note: If there is uncertainty about whether a particular individual has met the conditions for citizenship or immigration status, legal assistance is available at the Northwest Immigrant Rights Project in Western Washington at 206-587-4009 or in Eastern Washington at 509-854-2100.
In general, Qualified Aliens who are exempt from, or who have met, the 5-year bar are eligible for federally-funded Apple Health (Medicaid) programs. Qualified Aliens who are not exempt from and have not yet met the 5-year bar are eligible for state-funded Apple Health programs if they are a pregnant woman or child or if they have a qualifying emergency under the Alien Emergency Medical (AEM) program as described under WAC 182-507-0110.
Hmong or Highland Laotian Tribe Members
Hmong (or Highland Laotian) tribe members born before May 8, 1975, whose tribe assisted the U.S. military during Vietnam era (August 5, 1964 to May 7, 1975) are “Qualified Aliens” and eligible for Apple Health (Medicaid) without having to meet the 5-year bar. The tribe member's spouse and unmarried dependent children under age 19 automatically qualify as a result of the spouse’s special immigration status.
If the applicant does not have USCIS documentation of this status, he or she may submit the following statement under penalty of perjury: I was a Hmong (or Highland Laotian) tribe member when the tribe assisted the U.S. military during Vietnam era (August 5,1964 to May 7, 1975).
Individuals approved for the Haitian Family Reunification Parole (HFRP) program will enter the U.S. as Cuban/Haitian entrants under 501(e) of the Refugee Education Assistance Act of 1980 and are "Qualified Aliens" who are exempt from the 5-year bar.
Iraqi or Afghan Special Immigrants
Immigrants from Iraq or Afghanistan who were granted Special Immigrant Status under section 101(a)(27) of the INA are qualified aliens and are eligible for federally-funded Washington Apple Health. Their eligibility period starts from their date of entry into the United States or, if occurred after the U.S. entry, the date Special Immigrant Status was granted. For more information on documentation, immigration status codes, benefit eligibility and a step-by-step process for these immigrants, see Desk Aid Iraqi and Afghan Special Immigrants Benefits.
Non-Qualified Aliens (and Qualified Aliens who are not exempt from and have not yet met the 5-year bar) are not eligible for federally-funded Apple Health programs unless they are a child, pregnant woman or they have a qualifying emergency under the Alien Emergency Medical (AEM) program as described under WAC 182-507-0110. Some lawfully present non-qualified aliens have temporary status or pending applications and consequently their status may expire when their document is expired or when a final denial of their application is issued, with the following exceptions:
- Citizens of Marshall Islands, Micronesia or Palau - They may have a birth certificate, current or expired I-94 Arrival/Departure Record, current/expired passport, or other document verifying they are citizens of one of these countries. These individuals have special rights under compacts of Free Association and are lawfully allowed to enter, reside and work in the U.S., but are not U.S. Nationals. They are considered lawfully present Non-Qualified Aliens unless they have some other immigration status.
- Persons granted cancellation of removal or suspension of deportation.
Some common Non-Qualified Alien statuses that are not specifically described in the WAC above are:
- Pending applicants for Asylum, Withholding of Deportation/Removal under the Convention Against Torture (CAT) if over age 14 with an approved work authorization or if under 14 and their application has been pending for 180 days or more;
- Immigrants who have been granted withholding of removal under the Convention Against Torture (CAT);
- Individuals with approved relative visa petitions who have applied and are pending adjustment to LPR status;
- Immigrants with a current nonimmigrant status who have not violated the terms of their status, such as:
- "U" visa holders;
- Religious workers under section 101(a)(15)(R) of the INA;
- An individual with a petition pending for 3 years or more, as permitted under section 101(a)(15)(V) of the INA;
- A fiancé of a citizen, as permitted under section 101(a)(15)(K) of the INA;
- Tourist/Visitor visa holders; and
- Visitors on business.
Undocumented individuals are individuals who are not lawfully present. This includes both individuals who entered the U.S. without document inspection and individuals whose lawful presence status has expired.
An individual whose lawful presence has expired may be in the process of pursuing an extension or change of status. Without evidence of actively pursuing an extension or change of status, an individual whose lawful presence status has expired will be considered an undocumented individual.
Note: Deferred Action Childhood Arrival (DACA or “Dream Act”) persons are not eligible for federally-funded Washington Apple Health. DACA persons are undocumented individuals who have been granted deferred action. DACA persons may be eligible for state-funded health care coverage, including Apple Health for Kids, Apple Health for Pregnant Women, and Medical Care Services.
Citizens and U.S. Nationals
Citizenship for Foreign-Born Natural or Adopted Children of U.S. Citizens. For children born outside the U.S. to acquire citizenship under the Child Citizenship Act of 2000, they must meet all the conditions in WAC 182-503-0530 on or after February 27, 2001. The Act applies to children related to the citizen parent by birth or adoption only - stepchildren are not included unless also adopted. Citizenship for these children can depend on which parent is a U.S. citizen, how long the citizen parent resided in the U.S., and whether the parents were married at the time.
Once a child becomes a citizen under the Act, subsequent changes in the parents' marital status, such as separation or divorce, have no bearing on the child's citizenship. Nor does it matter whether the parent in question became a U.S. citizen after entering the U.S.
If the child is 18 years or older when the parent becomes a citizen, child citizenship laws do not apply and he/she must independently apply for naturalization.
For individuals who automatically become citizens under terms of the Child Citizenship Act of 2000 or previous legislation, USCIS issues no documentation unless requested. Individuals themselves may not be aware that they or their children are already citizens.
Note: For information on the Department's naturalization assistance program, see the Social Services Manual, SSI Facilitation Chapter, Section E, subsection on SSI facilitation.
American Indians/Alaska Natives
The term “American Indian” refers to members of federally recognized (and in some cases, state-recognized) tribes in the U.S. The term “Alaska Native” refers to members of Alaska Native Villages and of Alaska Native Corporations under the Alaska Native Corporation Settlement Act.
American Indians and Alaska Natives born outside the United States are eligible for federal benefits to the same extent as American Indians and Alaska Natives born in the U.S. if they are: a member of a federally-recognized American Indian tribe (see Governor's Office of Indian Affairs website) or Alaska Native Village or Corporations (see Federal Register Notice).
Note: Noncitizen American Indians have the same eligibility for health care coverage as U.S. Citizens, but citizen documentation requirements do not apply. Instead they will need to provide tribal verification.
Example: A member of a federally recognized tribe (e.g., Pueblo) who is a Mexican citizen gives birth to a child outside of the U.S. The child qualifies as a member of the tribe but is not a citizen. That child is potentially eligible for Washington Apple Health as long as the child can establish that he or she is a member of the federal tribe.
Canadian American Indians
Canadian citizens who have at least 50 percent First Nations (Native American) ancestry (by blood) and who become residents of the U.S. automatically gain lawful permanent resident immigration status under the Jay Treaty of 1794. They may ask for a lawful permanent resident card from USCIS, but they are not required to get immigration documentation. This category does not include the spouse or child of such a person unless he or she also possesses 50 percent First Nations ancestry (by blood) and Canadian citizenship. If a Jay Treaty applicant does not have USCIS documentation, he or she can establish Jay Treaty status by providing both:
- A First Nation (tribal) letter that verifies 50% First Nations ancestry (by blood); and
- A Canadian birth certificate.
Expired Documents versus Expired Immigration Status.
Many immigration documents have expiration dates; however, an expired immigration document does not necessarily mean the immigration status has expired. For instance, Qualified Alien status does not expire even if the immigration documents expire, with the following exceptions:
- Lawful Permanent Residents with Conditions (2 year Conditional Residents): Conditional residents receive a 2 year LPR card, often based on a recent marriage to a U.S. citizen. At the end of the 2 years, they must either file a joint petition to remove the condition or a request for a waiver of the joint filing requirement (for instance, on grounds of divorce and /or domestic violence). Clients with this expired status must provide proof of a pending petition to remove the condition or of an application to waive the joint filing requirement.
- Parolees: Their status expires after the expiration date. Parolees usually have an I-94 arrival/departure record stamped with an entry and expiration date. Some may have their expiration date stamped "waived" or "indefinite".
On the other hand, Non-Qualified Alien status (including those in the U.S. on non-immigrant visas) typically expires when their immigration documents expire.
Additional Information Regarding Specific Document Types and Status
Notice of Action may or may not have an expiration date. It is used to notify the individual that a fee was paid, an application was accepted, the case is pending, a step in the process is completed, or status is approved. Individuals with I-797s are undocumented unless it verifies that status has been approved.
Example: An example that a step in the process has been completed but status has not been approved is the Notice of Approval for Immigrant Petition for Relative. This is the initial step in the family-related immigrant application process. It solely establishes relationship. It does not establish status. If this is the only document provided, the individual is considered undocumented for purposes of benefits eligibility.
Example: An example that status is approved is the Approval Notice of an I-360 Self-Petition under the Violence Against Women Act (VAWA). In most cases a VAWA self-petitioner will first receive a Prima Facie notice, indicating that the petitioner has submitted evidence sufficient to establish a case. Both notices verify that the individual is a Qualified Alien and their status does not expire.
Order from Immigration Judge
An order is issued because the immigrant is or has been in removal proceedings. The Judge provides a decision notifying the individual whether the individual can remain in the country. The order does not have an expiration date.
Example: An example of a status granted by an "Order from Immigration Judge" are Granted Withholding of Deportation which is a qualified alien category and Order of Supervision which is a non-qualified alien category.
Application for Asylum (non-qualified alien) does not have an expiration date; however, USCIS is required to provide a decision within 180 days. Despite this requirement, some asylum applicants may not receive a decision within the 180 day deadline. If the document is more than 180 days old, staff will need to check USCIS website (see below) to determine if it is still pending a decision. If still pending a decision, the asylum applicant retains their non-qualified status.
Note: If an applicant for Asylum is a national of Cuba or Haiti they are Cuban/Haitian Entrants eligible for benefits to the same extent as refugees while their application is pending.
In cases with expired immigration documents, individuals should apply with USCIS for renewal and submit the Form I-912 (Request for Fee Waiver) at the same time. Individuals seeking or receiving public assistance, including Apple Health, are eligible for Fee Waivers with their application. Fee Waiver Guidance can be found at USCIS - Fee Waiver Guidance.
- If USCIS denies the fee waiver request, they will notify the individual with a notice of rejection and an explanation why the fee waiver request was denied. In these cases, copy the notice of rejection into the individual’s file and offer help paying for the documents. If USCIS approves the fee waiver request, the individual will also be notified.
- Staff can check the current case status of pending USCIS documents by entering the receipt number on the document at the USCIS website.
Note: If you are uncertain about someone’s eligibility for benefits after reviewing this clarifying page, please contact your area representative.
|Classic Medicaid (in Washington Connection)||Modified Adjusted Gross Income (MAGI) - Based Medicaid (in Healthplanfinder)|
|Applicants who have been granted DACA status should be coded CL in the INS Stat field on the ALAS screen||Applicants who have been granted DACA status should be described as "Not Lawfully Present" in Healthplanfinder.|
- For all Apple Health applications, make sure you match names, dates of birth, and immigration document expiration dates with what is on the application.
- If unable to verify that claim is still pending using the USCIS website, the individual will need to provide updated documentation from USCIS as to their current status.