Apple Health for Refugees
Purpose: To describe the program rules for the refugee medical program.
WAC 182-507-0130 Refugee medical assistance (RMA).
Effective October 6, 2012
- An individual is eligible for refugee medical assistance (RMA) if the following conditions are met. The individual:
- Meets immigration status requirements of WAC 182-507-0135;
- Has countable resources below one thousand dollars on the date of application;
- Has countable income equal to or below two hundred percent of the federal poverty level (FPL) on the date of application. The following income is not considered when determining eligibility for RMA:
- Resettlement cash payments made by the voluntary agency (VOLAG);
- Income of a sponsor is not counted unless the sponsor is also part of the individual's assistance unit; and
- Income received after the date of application.
- Provides the name of the VOLAG which helped bring the individual to the United States so that the department of social and health services (DSHS) can promptly notify the VOLAG (or sponsor) about the medical application.
- An individual who receives refugee cash assistance (RCA) is eligible for RMA as long as the individual is not otherwise eligible for medicaid or a children's health care program as described in WAC 182-505-0210. An individual does not have to apply for or receive RCA in order to qualify for RMA.
- An individual is not eligible to receive RMA if the individual is:
- Already eligible for medicaid or a children's health care program as described in WAC 182-505-0210;
- A full-time student in an institution of higher education unless the educational activity is part of a DSHS-approved individual responsibility plan (IRP); or
- A nonrefugee spouse of a refugee.
- If approved for RMA, the agency or its designee issues an approval letter in both English and the individual's primary language. The agency or its designee also sends a notice every time there are any changes or actions taken which affect the individual's eligibility for RMA.
- An individual may be eligible for RMA coverage of medical expenses incurred during the three months prior to the first day of the month of the application. Eligibility determination will be made according to medicaid rules.
- A victim of human trafficking must provide the following documentation and meet the eligibility requirements in subsections (1) and (2) of this section to be eligible for RMA:
- Adults, eighteen years of age or older, must provide the original certification letter from the United States Department of Health and Human Services (DHHS). No other documentation is needed. The eight-month eligibility period will be determined based on the entry date on the individual's certification letter;
- A child victim under the age of eighteen does not need to be certified. DHHS issues a special letter for children. Children also have to meet the income eligibility requirements;
- A family member of a certified victim of human trafficking must have a T-2, T-3, T-4 , or T-5 visa (derivative T-visas), and the family member must meet eligibility requirements in subsections (1) and (2) of this section.
- The entry date for an asylee is the date that the individual's asylum status is granted. For example, an individual entered the United States on December 1, 1999, as a tourist, then applied for asylum on April 1, 2000, interviewed with the asylum office on July 1, 2000, and was granted asylum on September 1, 2000. The date of entry is September 1, 2000, and that is the date used to establish eligibility for RMA.
- RMA ends on the last day of the eighth month from the month the individual entered the United States. For example, an individual who entered the United States on May 28, 2011, is eligible through the end of December 2011.
- An individual approved for RMA is continuously eligible through the end of the eighth month after the individual's entry to the United States, regardless of an increase in income.
- The agency, or its designee, determines eligibility for medicaid and other medical programs for an individual's spouse when the spouse arrives in the United States. If the spouse is not eligible for medicaid due to the countable income of the individual, the spouse is still eligible for RMA for eight months following the spouse's entry into the United States.
- An individual who disagrees with a decision or action taken on the case by the agency, or its designee, has the right to request a review of the case action(s) or request an administrative hearing (see chapter 182-526 WAC). The request must be received by the agency, or its designee, within ninety days of the date of the decision or action.
WAC 182-507-0135 Immigration status requirement for refugee medical assistance (RMA).
Effective October 6, 2012
- An individual is eligible for refugee medical assistance (RMA) if the individual provides documentation issued by the United States Citizenship and Immigration Services (USCIS) to show that the individual is:
- Admitted as a refugee under section 207 of the Immigration and Nationalities Act (INA);
- Paroled into the United States as a refugee or asylee under section 212 (d)(5) of the INA;
- Granted conditional entry under section 203 (a)(7) of the INA;
- Granted asylum under section 208 of the INA;
- Admitted as an Amerasian immigrant from Vietnam through the orderly departure program, under section 584 of the Foreign Operations Appropriations Act, incorporated in the FY88 continuing resolution P.L. 100-212;
- A Cuban-Haitian entrant who was admitted as a public interest parolee under section 212 (d)(5) of the INA;
- Certified as a victim of human trafficking by the federal Office of Refugee Resettlement (ORR);
- An eligible family member of a victim of human trafficking certified by ORR who has a T-2, T-3, T-4, or T-5 visa; or
- Admitted as special immigrant from Iraq or Afghanistan under section 101 (a)(27) of the INA.
- A permanent resident alien meets the immigration status requirements for RCA and RMA if the individual was previously in one of the statuses described in subsection (1)(a) through (g) of this section.
- Recipients of Refugee Cash Assistance (RCA) are automatically eligible for RMA. A person who is eligible for RCA may choose not to receive cash assistance and still receive RMA.
- RMA eligibility is established as follows on the basis of an applicant's income (and resources for those ages 65 and over) on the date of the application, rather than averaging income over the application processing period.
- A student enrolled in an institution of higher education and carrying a full-time academic workload is considered a full-time student. A full time student is eligible for RMA only if educational activity is a part of his or her personal employment plan.
- An applicant who is not eligible for RCA because of income may be eligible for RMA. Applicants must meet monthly income standards up to 200% of FPL in the month of application.
Note: Individuals from Iraq or Afghanistan who were granted Special Immigrant status under section 101 (a)(27) of the INA, their spouses and unmarried children under 21 are qualified aliens and eligible for federally funded benefits to the same extent and for the same time period as refugees. Their eligibility period starts from the date of entry into the United States or, if it occurred after the US entry, the date the Special Immigrant status was granted as indicated on the I-551 (green card).
For more information on documentation, Immigration Status codes, benefit eligibility and step-by-step process, please see Desk Aid Iraqi and Afghan Special Immigrants Benefits.
- All completed applications for medical assistance for refugees should be faxed to HCA at 360-664-2186, to the attention of Jessica Cottom.
- HCA screens all medical assistance applications from refugees (described in WAC 182-507-0135) for modified adjusted gross income (MAGI)-based Apple Health programs first. Refugee applicants who are denied MAGI-based Apple Health -- typically refugees ages 65 and over -- are referred to DSHS for screening for the Refugee Medical Assistance (RMA) program in Washington Connection, 182-526.