Citizenship and immigration status general requirements
Revised December 15, 2014
Purpose: To provide information on how an applicant's immigration status affects their eligibility for health care coverage, including nonemergency Medicaid and the state children’s health insurance program (CHIP).
All applicants for Apple Health programs must provide their citizenship/immigration status. Immigration status determines what program an applicant is eligible for, including whether the program is state-funded or federally-funded. See Definitions for more information on citizenship and the different immigration statuses. For some immigration statuses, the date of entry is an important factor in determining eligibility for Apple Health programs. See Date of Entry for more information.
All individuals fall into one of the following groups:
- U.S. Citizens and U.S. Nationals
- Lawfully Present Qualified Aliens
- Must meet 5-year bar; or
- Exempt from 5-year bar
- Lawfully Present Nonqualified Aliens
- Undocumented Individuals
See the Citizenship and Alien Status Guide for detailed information on each of the groups.
Some noncitizens who served in the military may be considered a veteran when they meet the following conditions:
- Served in any branch of the U.S. armed services,
- Fulfilled the minimum active duty service requirements or 24 months of continuous active service, whichever is less, and
- Was honorably discharged or released.
Veterans also include individuals who died while on active duty or after being released from active duty. Surviving spouses who have not remarried and dependent children of veterans are treated as veterans for purposes of this rule.
Note: The 5-year bar does not apply to individuals that have obtained a “qualified alien” status within the last 5 years, if they entered the U.S. prior to 8/22/96 and have continuously lived in the U.S. since 8/22/96. See WAC 182-503-0535.
Note: The code on the green card indicates how an LPR entered the U.S. If an individual entered the U.S. under a status that is exempt from the 5-year bar and they have had LPR status for less than 5 years, they are still exempt from the 5-year bar.
Note: An Employment Authorization Document (EAD) does not in itself confer immigration status. EADs contain coded information that indicates an individual's immigration status. Immigrants with a variety of statuses may be issued an EAD. An expired EAD does not mean that a person's immigration status has expired and should not in itself be a reason to deny benefits.
Note: Examples of violation of status are persons who overstay their visa or work without permission from USCIS. If in violation of status and still in the U.S. without proof of pending status change or extension of status, these nonimmigrants are considered undocumented.
Example: An individual applying for benefits has an I-94 (Arrival/Departure Record) with a "B2" code that is not expired. According to the NILC Guide, "B2" signifies tourist status. A person with a tourist status is considered a lawfully present nonimmigrant and if otherwise eligible (including residency requirements) may qualify for Apple Health for Kids or Pregnant Women.
Example: A five-person family applies for benefits. The father has a Lawful Permanent Resident card (I-551) but the mother and three children only have Employment Authorization Documents (EADs). All four EADs are coded "A15". According to the NILC Guide, the "A-15" code indicates "V" status. These are spouses and children of lawful permanent residents whose visa petitions have been pending for at least three years. Immigrants with "V" status are lawfully present nonqualified aliens. These aliens may qualify for state benefits or federal Apple Health for Kids or Pregnant Women. The father may be eligible for federal benefits depending on other factors such as date of entry into the U.S.
- When working or reviewing an individual’s case, it is important to enter an applicant’s immigration status correctly. If you enter the immigration status incorrectly, it can improperly increase the agency’s costs.
- For example, if an applicant is a “Nonqualified Alien”, the applicant’s immigration status should never be entered as “Not Lawfully Present” (in Healthplanfinder) or “Undocumented” (in ACES).
- If working a Classic Medicaid case in ACES, gather all the information necessary to determine eligibility as described in WAC 182-503-0535. Document immigration status, date of entry, armed service/veteran status, work quarters (if applicable), and SSN information in the system. Inform any individual who is subject to the five-year bar of the expiration date of their five-year bar and of the need to inform the agency if family members become citizens (including parents who have children under 18). See ACES Manual for more information.
- For immigrants who have applied for Classic Medicaid and who have an Affidavit of Support form (I-864) filled out on their behalf, be sure to determine work quarters and immigration status. If the affidavit is still in effect:
Alien Emergency Medical
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