Revision 09-4; Effective December 1, 2009

§358.203. Citizenship and Qualified Alien Status.

(a) In accordance with 42 CFR §435.406, to be eligible for a Medicaid-funded program for the elderly and people with disabilities (MEPD), a person must be:

(1) a citizen or national of the United States (U.S.);

(2) an alien who entered the U.S. before August 22, 1996, who has lived in the U.S. continuously since entry, and who meets the definition of a qualified alien at 8 U.S.C. §1641; or

(3) an alien who entered the U.S. on or after August 22, 1996, who has lived in the U.S. continuously since entry, and who meets the definition of a qualified alien at 8 U.S.C. §1641 with the eligibility limitations in 8 U.S.C. §1612 and §1613.

(b) A person must provide proof of eligibility under subsection (a) of this section that establishes both identity and citizenship or alien status, unless the person:

(1) receives Supplemental Security Income (SSI) or has ever received SSI and was not denied due to citizenship;

(2) is entitled to or enrolled in any part of Medicare, as determined by the Social Security Administration (SSA); or

(3) is entitled to federal disability benefits based on SSA disability criteria.

§358.205. Alien Status for Treatment of an Emergency Medical Condition.

(a) Title XIX of the Social Security Act (42 U.S.C. §1396 et seq.) and 42 CFR §440.255 require the state to provide Medicaid for the treatment of an emergency medical condition to an alien who is ineligible for regular Medicaid due to immigration status. The Texas Health and Human Services Commission administers the program in Texas.

(b) To qualify for Medicaid for the treatment of an emergency medical condition, an alien must:

(1) be:

(A) a qualified alien as defined in 8 U.S.C. §1641 and not meet the requirements to receive Medicaid as described in 8 U.S.C. §1612 and §1613; or

(B) an undocumented non-qualifying alien as described in 8 U.S.C. §1611;

(2) be otherwise eligible for regular Medicaid services; and

(3) require treatment of an emergency medical condition as described in 42 CFR §440.255.

(c) An undocumented non-qualifying alien applying for Medicaid for the treatment of an emergency medical condition is exempt from providing proof of alien status or providing a Social Security number as described in 42 CFR §435.406(b).

Revision 09-4; Effective December 1, 2009

To lawfully remain in the U.S., a person who is not a U.S. citizen or a U.S. national and is present in the U.S. must have authorization from the Department of Homeland Security (DHS).

 

D-8210 United States Citizenship and Immigration Services (USCIS) Documents

Revision 21-3; Effective September 1, 2021
 
Commuter I-551 — An Alien Registration Receipt Card (Type 2) issued to an alien who has been granted Lawful Permanent Resident (LPR) status but lives in Mexico or Canada and commutes to the U.S. to work. The second digit of the ISS/T field identifies the type of card.

Grommeted I-151 — The Alien Registration Receipt Card with a grommet (a hole surrounded by a metal ring), in the upper right corner. This card was previously issued by INS to an alien who had LPR status but lived in Mexico or Canada and commuted to the U.S. to work.

I-94 — The Arrival/Departure Record issued by DHS to all documented nonimmigrants (students, visitors, parolees, refugees and Cuban/Haitian entrants).

I-151 — The version of the Alien Registration Receipt Card issued by the Immigration and Naturalization Service (INS) to aliens from July 1946 through late 1978.

I-551 — The current version of the Alien Registration Receipt Card (Type 1). INS (now DHS) began issuing this card in 1978 to immigrants who have been granted LPR status and are residing in the U.S. The second digit of the ISS/T field identifies the type of card.

I-688 — A temporary resident card that was laminated and issued by INS to legalized aliens and Special Agricultural Workers (SAWs) whose status had been adjusted to lawful temporary resident (LTR). In certain cases, INS placed a label (I-688EXT) on the back of the card to use until the I-551 was issued. This is not a current immigration form and DHS is no longer issuing this document. Currently, there are no valid I-688 cards (or I-688 cards with extension stickers).

I-688A — An employment authorization card issued by INS to legalize SAW applicants who filed an application to adjust their status to LTR. This is not a current immigration form and DHS no longer issues this document. Currently, there are no valid I-688A cards.

I-688B — The employment authorization document that was a laminated card given by DHS to newly admitted nonimmigrants or those with previous employment authorization who needed an extension. The I-688B replaced the “employment authorization” annotation previously placed on other DHS documents. This is not a current immigration form and DHS is no longer issues this document. Currently, there are no valid I-688B cards.

I-688EXT — Form I-688 with an extended period of validity of the Temporary Resident Card. In certain situations, INS placed a sticker on the back of the card. This served as temporary evidence of permanent residence until the alien received an I-551. This is not a current immigration form and DHS no longer issues this document. Currently, there are no valid I-688 cards or I-688 cards with extension stickers.

I-766 — Employment Authorization Document. Currently, the I-766 is the only valid document verifying employment authorization. This form replaced all other employment authorization documents issued previously.

Passport — A travel document issued by a competent authority showing the bearer's origin, identity and nationality, if any, that is valid for the entry of the bearer into a foreign country.

Temporary I-551 — The card issued to either an immigrant who has just been granted a lawful status or to an immigrant who has lost his Alien Registration Receipt Card and has applied for a replacement I-551.

Visa — A document issued by U.S. embassies and consulates in foreign countries that is a permit for a foreign national to proceed to a U.S. port of entry to apply to DHS for admission to the U.S. The DHS immigration office at the port of entry decides the conditions (that is, category of admission and length of stay in the U.S.) based on the visa category.

 

D-8220 Groups of Aliens

Revision 17-4; Effective December 1, 2017

For Medicaid eligibility purposes, an alien is any person who is not a natural-born or naturalized citizen or national of the U.S.

Effective Aug. 22, 1996, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) limited an alien’s eligibility for Medicaid.

Most aliens must meet two requirements to be eligible for full Medicaid and/or a Medicare Savings Program (MSP):

• the noncitizen must be in a "qualified alien" category (see Section D-8300, Qualified Alien Categories); and
• meet an LAPR condition for qualified aliens (see Section D-8400, LAPR Conditions for Medicaid).

Generally, aliens are now referred to as:

• qualified aliens; or
• non-qualified aliens.

Qualified aliens are potentially eligible for ongoing full Medicaid benefits and/or MSP. Non-qualified aliens are not eligible for ongoing Medicaid coverage however, may qualify for limited Medicaid eligibility for the treatment of an emergency medical condition only.

Except when it involves undocumented aliens, use the Systematic Alien Verification for Entitlements (SAVE) Verification Information System (VIS) to verify the alien status on all noncitizens.

 

D-8221 Date of Qualifying Classification

Revision 19-4; Effective December 1, 2019

Use SAVE VIS to verify the alien status of all documented non-citizens. If a person is undocumented, do not run SAVE.

A qualified alien’s eligibility is based on the:

• date of entry with a qualifying classification;
• alien's qualifying classification; and
• Medicaid application date.

Use the date of entry into the U.S. and, if different, the date of entry with a qualifying alien classification to determine the correct category for the qualified alien.

The date on the alien's Department of Homeland Security (DHS) document or card often represents the alien's first date of entry into the U.S.

In some cases, an alien may be present in the U.S. without a qualifying classification, depart, and then return to the U.S. with a qualifying alien classification. Other aliens may have entered the U.S. without a qualifying alien classification and remained continuously present in the U.S. until obtaining qualified immigrant status. For these aliens, the date on their DHS document or card reflects the date of entry with a qualifying alien classification or the date the qualifying alien classification was granted, not the alien's original date of entry.

Allow aliens with a DHS document or card showing an entry date on or after Aug. 22, 1996, who claim to have entered before that date, an opportunity to submit evidence of their claimed date of entry. This evidence may include pay stubs, a letter from an employer, or a lease or utility bill in the alien's name.

Verifying continuous presence

DHS maintains a record of arrivals to and departures from the country for most legal entrants. This record may be used to establish that an alien has continually resided in the U. S. since before Aug. 22, 1996.

Verify via SAVE with DHS-USCIS to confirm continuous presence in the U.S. Any single absence from the U.S. of more than 30 days, or a combined absence of more than 90 days, is considered to interrupt "continuous presence."

Other entrants, including aliens who entered the U.S. without USCIS documents, must provide documentary evidence proving continuous presence, such as a letter from an employer, a series of pay stubs or utility bills in the alien's name, spanning the time in question.

Note: Once an alien obtains a qualifying alien status, the person does not have to continuously remain present in the U.S.

Related Policy

Documentation and Verification Guide, Appendix XVI
Initial Request at Time of Application, D-5510
Verification of Alien Status, D-8700
Documentary Evidence by Classification, D-8710
Secondary Verification of Alien Immigration Status, D-8840
Reasonable Opportunity to Provide Verification of Alien Immigration Status, D-8841
Entry Before 1996, D-8910
Entry on or After Aug. 22, 1996-Qualifed Alien No Waiting Period, D-8920
LPR Aliens With or Without Five-Year Waiting Period, D-8930

 

D-8222 Reserved for Future Use

Revision 17-4; Effective December 1, 2017

 

Revision 17-4; Effective December 1, 2017

MEPD provides full Medicaid and/or MSP to qualified aliens whose eligibility is mandatory under federal requirements. Mandatory qualified aliens fall into three categories.  Refer to the following sections for information about the three categories of qualified aliens potentially eligible for full Medicaid and/or MSP:

• Section D-8310, Qualified Aliens Subject to a Seven-Year Limited Period
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period
• Section D-8330, Qualified Aliens with a Five-Year Waiting Period

 

D-8310 Qualified Aliens Subject to a Seven-Year Limited Period

Revision 14-4; Effective December 1, 2014

The following qualified aliens are immediately eligible for full Medicaid and/or MSP benefits, provided they meet other program requirements, but are limited to seven years of eligibility:

• Refugees under Section 207 of the Immigration and Nationality Act (INA).
• Asylees under Section 208 of the INA.
• Aliens whose deportation is being withheld under Section 243(h) of the INA or whose removal has been withheld under Section 241(b)(3) of the INA.
• Cuban/Haitian entrants under one of the categories in Section 501(e) of the Refugee Education and Assistance Act of 1980, or aliens in a status that is to be treated as a "Cuban/Haitian entrant" for Medicaid purposes.
• Amerasian immigrants under Section 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act of 1988. "Amerasian immigrants" are by definition lawfully admitted for permanent residence (LAPR), thus they are qualified aliens. If a person is an "Amerasian immigrant" and meets no other condition permitting eligibility, then the person is potentially eligible for Medicaid for seven years beginning with the date "Amerasian immigrant" status was granted.

Note: Amerasians who enter as legal nonimmigrants as defined in Section D-8610, Ineligible Aliens, (for example, foreign students pursuing studies in the U.S.) cannot be qualified aliens unless their classification changes.

• Afghan and Iraqi special immigrants eligible for resettlement assistance, federal benefits and entitlements. When determining eligibility for full Medicaid and/or MSP, treat these aliens as refugees according to provisions of the Department of Defense Appropriations Act for fiscal year 2010, signed by the president on Dec. 19, 2009.

Under federal law, a qualified alien in this category is limited to seven years of potential eligibility for full Medicaid and/or MSP unless the qualified alien fits into another category or becomes a naturalized citizen.

Start the Clock — The clock on the seven years begins to run from the date the person obtains a qualified alien classification, not from the date the person becomes eligible for full Medicaid and/or MSP.

Stop the Clock — The clock on the seven years stops with the beginning of the first month after the seventh anniversary of the date the person obtained qualified alien classification. Once the seven-year period ends, in order to remain eligible for full Medicaid and/or MSP, the alien described in this section must either:

• become a naturalized citizen or meet citizenship status; or
• be eligible for full Medicaid and/or MSP in the same manner as qualified aliens in Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

Consider Medicaid for the treatment of an emergency medical condition when the seven-year period expires and the person does not meet either of the above.

 

D-8320 Qualified Aliens Not Subject to a Waiting Period or Limited Period

Revision 21-3; Effective September 1, 2021
 
Certain aliens are exempt from both the five-year waiting period and the seven-year limited period when they meet certain criteria.

The following aliens are eligible for full Medicaid and or MSP if they meet all other eligibility criteria:

• honorably discharged veterans or active duty members of the U.S. armed forces;
• spouses, unmarried surviving spouses or minor unmarried children of honorably discharged veterans or active duty members;
• Canadian born American Indians;
• members of federally recognized Indian tribes;
• aliens receiving SSI and or Medicaid on Aug. 22, 1996, and lawfully residing in the U.S. on or before Aug. 22, 1996;
• LPRs admitted for permanent residence prior to Aug. 22, 1996, and credited with 40 qualifying quarters of Social Security coverage;
• LPRs lawfully admitted on or after Aug. 22, 1996 and five years have passed since their legal date of entry, and have 40 qualifying quarters of Social Security coverage; and
• Compact of Free Association (COFA) citizens residing in the U.S.

Related Policy

Compact of Free Association (COFA) Citizens, D-5220
Qualified Aliens with a Five-Year Waiting Period, D-8330
Veterans, Armed Forces Active Duty and Dependents, D-8410
American Indians Born Outside the U.S., D-8420
LPR Residing in the U.S. on Aug. 22, 1996, D-8430

 

D-8330 Qualified Aliens with a Five-Year Waiting Period

Revision 14-4; Effective December 1, 2014

Aliens lawfully admitted for permanent residence on or after Aug. 22, 1996, are not eligible for full Medicaid and/or MSP benefits for a period of five years from the date they enter the U.S. or obtain a qualified alien classification, whichever is later, unless they meet:

• certain classifications described in Section D-8310, Qualified Aliens Subject to a Seven-Year Limited Period; or
• one of the LAPR conditions in Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

Start the Clock — The clock on the five-year waiting period begins to run from the date the person:

• enters the U.S. with the qualified alien classification; or
• obtains the qualified alien classification.

Stop the Clock — The clock stops:

• with the beginning of the first month after the fifth anniversary of the date the person obtains the qualified alien classification, or
• earlier than the fifth anniversary if:
  • the alien classification changes and the alien meets criteria in Section D-8310, or
  • the alien meets one of the LAPR conditions in Section D-8320.

Once the five-year period ends, a qualified alien with a five-year waiting period who meets all other eligibility criteria must do one of the following to be eligible for full Medicaid and/or MSP:

• Become a naturalized citizen or meet citizenship status.
• Be credited with 40 qualifying quarters of Social Security coverage.
• Meet an alien classification criterion in Section D-8310 if the clock for the seven years has not ended.
• Meet one of the LAPR conditions in Section D-8320.

Consider Medicaid for the treatment of an emergency medical condition if the person does not meet one of the above or is still within the five-year waiting period.

 

D-8340 Establishing Qualifying Quarters of Social Security Coverage

Revision 14-4; Effective December 1, 2014

The Social Security Administration (SSA) defines a quarter as a period of three calendar months.

• Quarter 1: January, February, March
• Quarter 2: April, May, June
• Quarter 3: July, August, September
• Quarter 4: October, November, December

A quarter of coverage is credit for a requisite (necessary) amount of covered earnings assigned to a calendar quarter on a worker's earnings record.

A qualifying quarter is credit for a requisite (necessary) amount of covered earnings and/or non-covered earnings assigned to a calendar quarter for determining eligibility of an LAPR alien.

Individuals can get up to four qualifying quarters of credit each calendar year based on their own earnings. Individuals also can be credited with additional quarters in a calendar year based on the earnings of a parent or spouse.

To be potentially eligible for full Medicaid and/or MSP, an LAPR alien must be credited with 40 qualifying quarters, either from the alien’s own record, or combined with the quarters earned by a spouse or parent.

Note: The 40-qualifying-quarter requirement does not exempt the individual from the five-year waiting period (bar).

See the policy that follows to determine if the LAPR alien meets the 40-qualifying-quarter requirement.

 

D-8341 Combining Qualifying Quarters of Spouse/Parent

Revision 12-4; Effective December 1, 2012

Quarters from a spouse — Aliens can count their spouse's quarters earned during the marriage in addition to their own quarters to meet the 40 qualifying quarter requirement. For example, if each spouse has 20 quarters, the quarters are added and both spouses are credited with 40 quarters.

Count the spouse's quarters earned during the marriage when the spouse is either a citizen or an alien and any of the following conditions apply:

• The couple is currently married.
• A spouse is deceased and the surviving spouse has not remarried.
• The couple is separated but not divorced.

When determining whether to credit a person's quarters to his spouse, count quarters earned beginning with the quarter from the date of marriage.

Do not count quarters earned by divorced spouses for either ex-spouses.

Note: Aliens who divorce after certification retain their eligible alien status through the end of the current certification period. This also applies to stepchildren.

Quarters from a parent – Aliens also can count the quarters earned by a living or deceased parent in addition to their own quarters to meet the 40 qualifying quarter requirement. In this instance, a parent means the natural or adoptive parent or the stepparent.

Count the parent's quarters when the parent is either a citizen or an alien and the quarters were earned before the child turned 18, including quarters earned before the child was born.

Death of a stepparent does not end the relationship. However, if the parent and stepparent are divorced, the stepparent's quarters are not counted.

Note: Quarters earned by a child are not counted toward the eligibility of a parent.

 

D-8342 Qualifying Quarters Earned on or After Jan. 1, 1997

Revision 12-4; Effective December 1, 2012

Federal law requires that quarters earned on or after Jan. 1, 1997, cannot be credited if the person who earned the quarters received means-tested public benefits.

When determining the total amount of qualifying quarters earned, do not allow any quarters earned on or after Jan. 1, 1997, if the person received TANF, SNAP, Medicaid or SSI benefits in that quarter.

The Wire Third Party Query (WTPY) system response does not reflect receipt of these benefits. Staff should verify if federal means-tested benefits were received by any person contributing quarters so that applicable quarters are deducted before determining the number of qualifying quarters.

Example: An LAPR alien files an application for benefits on Oct. 10, 2012. He has never worked and has no qualifying quarters of his own. He has been married for 30 years and his spouse, who is a U.S. citizen and who has been working since they were married, earned her 40th qualifying quarter in March 2012.

Spouse received SNAP in January 2012 and February 2012; however, she has not been certified to receive SNAP or to be eligible for any other federal means-tested public benefit since February 2012.

Result: As the 40th qualifying quarter was earned while receiving SNAP, it cannot be allowed. Since the spouse continues working, the 40th qualifying quarter is earned in the quarter ending June 2012. Since all 40 qualifying quarters were earned during their marriage, the LAPR alien meets the 40 qualifying quarter determination.

 

D-8343 Non-Covered Wages

Revision 14-4; Effective December 1, 2014

Non-covered wages are those earned by a person whose employer was not required to pay into the Social Security system (such as certain city, federal, school or religious organization employees).

If the alien cannot meet the 40-qualifying-quarter requirement using covered or non-covered earnings verified by the SSA, then obtain sufficient income verification from the employer to determine if the alien earned quarters for the period in question using non-covered earned wages.

If the alien reports self-employment with non-covered earned wages, obtain sufficient information about this employment to verify that the alien:

• was engaged in a trade or business, and
• had net earnings from self-employment.

Acceptable documents include, but are not limited to, pay stubs, employer statements, W-2s, and income tax forms including all applicable schedules. If HHSC already has verification of the income, do not request additional information.

Use the chart below to determine if the person earned sufficient non-covered wages to earn a quarter.

Year	Amount Required for a Quarter	Amount Required for 4 Quarters
2014	$1,200	$4,800
2013	$1,160	$4,640
2012	$1,130	$4,520
2010–2011	$1,120	$4,480
2009	$1,090	$4,360
2008	$1,050	$4,200
2007	$1,000	$4,000
2006	$970	$3,880
2005	$920	$3,680
2004	$900	$3,600
2003	$890	$3,560
2002	$870	$3,480
2001	$830	$3,320
2000	$780	$3,120
1999	$740	$2,960
1998	$700	$2,800
1997	$670	$2,680
1996	$640	$2,560
1995	$630	$2.520
1994	$620	$2,480
1993	$590	$2,360
1992	$570	$2,280
1991	$540	$2,160
1990	$520	$2,080
1989	$500	$2,000
1988	$470	$1,880
1987	$460	$1,840
1986	$440	$1,760
1985	$410	$1,640
1984	$390	$1,560
1983	$370	$1,480
1982	$340	$1,360
1981	$310	$1,240
1980	$290	$1,160
1979	$260	$1,040
1978	$250	$1,000

Example: A person worked for the school district as a custodian from 2001 through 2011. The school district did not pay into the Social Security system. The specialist requested that the person provide verification of earnings for this particular period. (Note: If the State Online Query (SOLQ) shows an F on the 40-quarter record, SSA has verified those non-covered wages, and the specialist does not need to reverify them.)

The person brought a statement from the school district verifying the person’s wages. The person earned $9,000 for 2011. Using the chart above, the income required to earn a quarter for 2011 is $1,120. The person can be credited with four quarters for 2011 because the person earned more than the amount required ($1,120 x 4 = $4,480).

 

D-8344 Procedures for Verifying 40 Quarters

Revision 17-4; Effective December 1, 2017

Determine all persons whose quarters can be included in the quarter coverage count. See D-8341, Combining Qualifying Quarters of Spouse/Parent.

If the alien applicant/recipient and/or person whose quarters will be included did not sign the application form, obtain the person’s signature on Form SSA-3288, Social Security Administration Consent for Release of Information. When a completed and signed Form SSA-3288 cannot be obtained because the person refuses to complete it, SSA cannot release information about that individual.

If a person, other than the LPR applicant, refuses to sign the Form SSA-3288, do not request earnings history for that person. Determine eligibility based on the qualifying quarters of the LPR applicant/recipient. If the LPR applicant/recipient does not meet the qualifying quarter requirement, deny the case.

A signed Form SSA-3288 is not required when requesting information on:

• a deceased individual's Social Security number; or
• a spouse’s Social Security number when the couple is separated but not divorced.

Use the 40 Quarters Verification System in TIERS to request 40 quarters from SSA to determine how many countable quarters are in the LPR's SSA earnings records.

Note:  WTPY may still be used to obtain information on 40 Qualifying Quarters.

Run Inquiry to determine if any person whose quarters are being considered received SSI, SNAP, TANF or Medicaid in any month on or after January 1997. Record the eligibility dates for these benefits so that applicable quarters are deducted from the total before determining if the alien applicant/recipient meets the 40-qualifying-quarter requirement.

Note: Determine if it is possible for the alien to meet the 40-quarter requirement first by obtaining the number of years the alien and each person included in the quarter coverage calculation has lived in the U.S. If the combined number of years totals less than 10 years, the alien will not meet the requirement. (Must earn 4 quarters/year x 10 years = 40 quarters.)

 

D-8345 Response from WTPY

Revision 12-4; Effective December 1, 2012

SSA does not complete the posting of covered earnings quarters for any one year until the following year (around August). For instance, quarters earned in 2011 may not be posted on the WTPY system until August 2012. These quarters are referred to as Lag quarters.

The quarters of covered earnings are based on the calendar year's total earnings. Each year the amount of income needed to earn a quarter changes. State office advises staff of the change each year.

Example: In 2011, an individual must earn $1,120 to earn one quarter. If the individual earned at least $4,480 for 2011 ($1,120 x 4), the individual has four qualifying quarters for the year.

Do not allow credit for an incomplete or future quarter.

Example: The quarter of July-September 2011 cannot be counted until October 2011, even though the individual earned enough income by March 2011 to receive credit for three quarters in 2011.

Note: The WTPY response will not reflect receipt of federal means-tested benefits. Staff should conduct inquiry to verify if SSI, SNAP, TANF or Medicaid benefits were received by any person contributing quarters so that an accurate count of the qualifying quarters is made. See D-8342, Qualifying Quarters Earned on or After Jan. 1, 1997.

Revision 14-4; Effective December 1, 2014

Certain aliens lawfully admitted for permanent residence (LAPR) are immediately eligible for full Medicaid and/or MSP benefits, provided they meet other program requirements and certain LAPR conditions.

A description of the LAPR conditions follows.

 

D-8410 Veterans, Armed Forces Active Duty and Dependents

Revision 14-4; Effective December 1, 2014

This LAPR condition applies to:

• a veteran or active duty member of the U.S. armed forces;
• the spouse of a veteran or active duty member, including a surviving spouse who has not remarried; and
• an unmarried dependent child of a veteran or active duty member.

Verification of honorable discharge or active duty status requires presentation of a copy of the veteran's discharge certificate or current orders showing "Honorable" discharge from, or active duty in, the Army, Navy, Air Force, Marine Corps or Coast Guard.

Neither a general discharge "Under Honorable Conditions" nor service in the National Guard satisfies this LAPR condition.

Contact the local Veterans Affairs (VA) regional office if an applicant presents:

• documentation showing honorable discharge from, or active duty in, any other branch of the military;
• documentation showing any other type of duty (for example, "active duty for training"); or
• if there is any other reason to question whether an applicant satisfies the requirements for this exemption.

Aliens meeting the criteria in this section are immediately eligible for full Medicaid and/or MSP, provided they meet all other eligibility criteria.

 

D-8411 Loss of "Veteran/Active Duty" Status

Revision 14-4; Effective December 1, 2014

Loss of eligibility related to "Veteran/Active Duty" status can occur under the following circumstances:

Change in Active Duty/Veteran Status

A qualified alien who is eligible based on the veteran/active duty policy (including a spouse or dependent child of an active duty member/veteran) loses full Medicaid and/or MSP eligibility the month after the month the active duty member separates from the armed forces with a discharge that is not characterized as honorable or that is based on alien status.

Spouse of Veteran/Active Duty Member

Eligibility as a spouse of a veteran or active duty member of the armed forces ends with the month after the month any of the following occur:

• Remarriage after the veteran's or service member's death.
• Divorce or annulment of the marriage.
• A determination that a marital relationship does not exist.
• Separation of the person and the spouse, which results in the person not being considered a member of the couple.
• The active duty member separates from the armed forces with a discharge that is not characterized as honorable or that is based on alien status.

Unmarried Dependent Child of Veteran/Active Duty Member

Eligibility as an unmarried dependent child of a veteran or active duty member ends with the month after the month any of the following occur:

• Marriage of the child.
• Loss of dependent status.
• The active duty member separates from the armed forces with a discharge that is not characterized as honorable or that is based on alien status.
• Legal adoption by someone other than the veteran or active duty member of the armed forces or the veteran/active duty member's spouse.

 

D-8420 American Indians Born Outside the U.S.

Revision 17-4; Effective December 1, 2017

Although born outside the U.S., the following American Indians are considered qualified aliens and are immediately eligible for full Medicaid and/or MSP, provided they meet all other eligibility criteria.

Certain Canadian-born Indians — Canadian-born Indians who establish "one-half American Indian blood" are considered qualified aliens and may freely cross borders and live and work in the U.S. without Department of Homeland Security (DHS) documentation. Accept as evidence of "one-half American Indian blood" a document that indicates the percentage of American Indian blood in the form of a:

• birth certificate issued by the Canadian reservation; or
• letter, card or other record issued by the tribe.

If the person cannot present any listed document to verify the American Indian status, refer the person to DHS to determine the alien status. Do not accept a Certificate of Indian Status card ("Band" card) issued by the Canadian Department of Indian Affairs or any other document not directly issued by the individual's tribe.

Federally recognized U.S. Indian tribes — U.S. Indian tribes federally recognized under Section 4(e) of the Indian Self-Determination and Education Assistance Act are each authorized by the Bureau of Indian Affairs to define the requirements for tribal membership. Some tribes afford membership to non-U.S. born individuals. If a foreign-born person claims membership in a federally recognized Indian tribe, request a membership card or other tribal document showing membership in the tribe. If the person has a membership card or other tribal document showing membership in the tribe, contact state office. State office will determine if the tribe is included on the list of recognized Indian tribes published annually by the Bureau of Indian Affairs in the Federal Register.

See Appendix V, Levels of Evidence of Citizenship and Acceptable Evidence of Identity Reference Guide, for information on Form I-872, American Indian Card, as evidence of U.S. citizenship. Form I-872 showing the class code "KIC" indicates citizenship status.

 

D-8430 LPR Residing in the U.S. on Aug. 22, 1996

Revision 17-4; Effective December 1, 2017

To be immediately eligible for full Medicaid and/or MSP, an alien living in the U.S. on Aug. 22, 1996 must:

• have received SSI and/or Medicaid on Aug. 22, 1996, and be lawfully residing in the U.S. on or before Aug. 22, 1996 (see Note:); or
• meet another LPR condition or alien classification (see D-8300, Qualified Alien Categories, through D-8400, LPR Conditions for Medicaid).

Note: This includes non-qualified aliens who received Medicaid on Aug. 22, 1996, due to permanent residence under color of law (PRUCOL) and continue to meet PRUCOL criteria.

Consider Medicaid for the treatment of an emergency medical condition if the alien described in this section does not meet another LPR condition or alien classification. See D-8600 Non-Qualified Aliens through D-8620 Illegal Aliens.

Revision 17-4; Effective December 1, 2017

To determine the alien status for retroactive coverage, use the policy in the following:

• Section D-8310, Qualified Aliens Subject to a Seven-Year Limited Period
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period
• Section D-8330, Qualified Aliens with a Five-Year Waiting Period

Note: Before denying SSI, the Social Security Administration (SSA) will test the person for an extension beyond the seven-year limited period. Qualified aliens who were lawfully residing in the U.S. on Aug. 22, 1996 and who are blind or disabled may continue to be eligible for SSI beyond the seventh year, assuming all other factors of eligibility are met, regardless of:

• the alien's age;
• whether onset of blindness or disability occurred before, on or after Aug. 22, 1996; or
• when the SSI application was filed.

If a denied SSI recipient applies for an MEPD program, determine the reason for the SSI denial. If the SSI denial was based on alien status (for example, expiration of the seven-year limited period) to be eligible for an MEPD program, the qualified alien must:

• become a naturalized citizen;
• meet citizenship status; or
• meet an LPR condition in Section D-8320.

Note:  Individuals denied SSI whose alien classification is lawfully residing in the U.S. on Aug. 22, 1996 and are blind or have a disability, are not eligible for continued Medicaid or a Medicare Savings Program.

Revision 14-4; Effective December 1, 2014

Generally, non-qualified aliens are divided into two groups:

• ineligible aliens, and
• illegal aliens.

These groups of non-qualified aliens are not eligible for regular Medicaid and/or MSP. They may be eligible for Medicaid coverage for treatment of an emergency medical condition.

 

D-8610 Ineligible Aliens

Revision 21-3; Effective September 1, 2021

Except for cases involving undocumented aliens, use the Systematic Alien Verification for Entitlements (SAVE) Verification Information System (VIS) to verify the alien status on all noncitizens.

Some aliens may be lawfully admitted to the U.S. as "legal nonimmigrants," but only for a temporary or specified time.

The following categories of people are "legal nonimmigrants":

• foreign government representatives on official business and their families and servants;
• visitors for business or pleasure, including exchange visitors;
• aliens in travel status while traveling directly through the U.S.;
• crewmen on shore leave;
• treaty traders and investors and their families;
• foreign students;
• international organization representation and personnel and their families and servants;
• temporary workers, including agricultural contract workers; or
• members of foreign press, radio, film or other information media and their families.

These aliens are called “ineligible aliens” because they are not eligible for full Medicaid, MSP or ME-A&D Emergency due to the temporary (non-resident) nature of their admission status.

Exception: In some cases, an alien in a currently valid legal nonimmigrant classification may meet the residence rules of Texas. When the residency requirement is met, the person is eligible for Medicaid for the treatment of an emergency medical condition if all other eligibility criteria also are met.

Example 1: A domestic employee for a foreign government representative currently conducting business in Texas receives emergency medical care. She files an application for assistance with the medical expenses. The individual states she does not intend to remain in Texas; she is here only while her employer concludes his business. Result: The individual is not eligible for full Medicaid, MSP or ME-A&D Emergency due to the temporary nature of her admission status.

Example 2: An agricultural contract worker suffers an injury while on the job and is hospitalized. He files an application for assistance with the medical expenses, as he does not have any medical insurance. The person states he intends to remain in Texas. He provides verification of his permanent address and rental agreement. Result: The person is potentially eligible for ME-A&D Emergency because he meets residence requirements.

Reminder: If a legal nonimmigrant’s time has expired with no changes to the classification status, follow the illegal aliens procedures.

Related Policy

Eligibility, D-3200
Illegal Aliens, D-8620

 

D-8611 Documents of Ineligible Aliens

Revision 13-4; Effective December 1, 2013

Types of Department of Homeland Security (DHS) documentation for ineligible aliens who are legal nonimmigrants include, but are not limited to:

• Form I-766, valid employment authorization documents;
• Form I-94, Arrival-Departure Record;
• Form I-185, Canadian Border Crossing Card;
• Form I-186, Mexican Border Crossing Card;
• Form SW-434, Mexican Border Visitor's Permit;
• Form I-95A, Crewman's Landing Permit; and
• Visitor visas, such as a B1 visa for business or a B2 visa for pleasure, tourism or medical treatment.

Explore eligibility for Medicaid coverage for treatment of an emergency medical condition for an alien if there is no proof of alien status.

 

D-8620 Illegal Aliens

Revision 13-1; Effective March 1, 2013

Illegal aliens were either never legally admitted to the United States for any period of time or were admitted for a limited period of time and did not leave the United States when the period of time expired.

Illegal aliens are only eligible for Medicaid for treatment of an emergency medical condition if they meet all other eligibility criteria, including residency requirements. See Section D-3200, Eligibility. Illegal aliens do not have to provide a Social Security number.

When an alien receives a final deportation order but continues to stay, consider the alien to be illegal.

Except for cases involving undocumented aliens, use SAVE VIS to verify the alien status on all non-citizens.

Contact with the Department of Homeland Security (DHS) is not allowed except when the person has given written approval and a request to do so.

If an alien does not wish to contact DHS or give permission, explore eligibility for Medicaid coverage for treatment of an emergency medical condition.

Revision 19-4; Effective December 1, 2019

If otherwise eligible, only qualified aliens are eligible for full Medicaid, Medicare Savings Programs or both (MSP). As part of the Medicaid eligibility determination, verify:

• the alien's qualifying classification; and
• the date the alien obtained the qualifying classification.

Complete verification by:

• obtaining a U.S. Citizenship and Immigration Services (USCIS) document showing alien classification or the immigrant registration number as explained in Section D-8710, Documentary Evidence by Classification, through Section D-8780, Qualified Alien Based on Battery or Extreme Cruelty; and
• using the Systematic Alien Verification for Entitlements (SAVE) Verification Information System (VIS).

Document the:

• alien's status and how you verified it;
• date of entry;
• continuous presence, if necessary to establish eligibility;
• DHS document's expiration date, if any; and
• basis for the alien's eligibility or ineligibility.

If a certified alien's document expires before the next redetermination, re-verify the alien's immigration status. The alien’s immigration status does not require reverification if the USCIS documents have not expired.

Note: If the alien’s USCIS document is expired and the SAVE response shows the person is a Lawful Permanent Resident - Employment Authorized and the Date Admitted is “Response is Indefinite,” the person meets the alien status criteria.

Related Policy

Documentation and Verification Guide, Appendix XVI
Initial Request at Time of Application, D-5510
Date of Qualifying Classification, D-8221
Documentary Evidence by Classification, D-8710
Secondary Verification of Alien Immigration Status, D-8840
Reasonable Opportunity to Provide Verification of Alien Immigration Status, D-8841
Entry Before 1996, D-8910
Entry on or After Aug. 22, 1996-Qualifed Alien No Waiting Period, D-8920
LPR Aliens With or Without Five-Year Waiting Period, D-8930

 

D-8710 Documentary Evidence by Classification

Revision 19-4; Effective December 1, 2019

Use SAVE VIS to verify the alien status of all documented non-citizens. If a person is undocumented, do not run SAVE.

Explore eligibility for Medicaid coverage for treatment of an emergency medical condition for non-citizens who do not have a Medicaid qualifying immigration status or who are undocumented.

Documentary evidence in conjunction with DHS verification is provided via the online SAVE response.

Once the documentary evidence (usually an alien status card) and the SAVE verification have been completed, use the charts in Section D-8900, Alien Status Eligibility Charts, for treatment of the alien status in the eligibility determination process.

Related Policy

Documentation and Verification Guide, Appendix XVI
Initial Request at Time of Application, D-5510
Date of Qualifying Classification, D-8221
Verification of Alien Status, D-8700
Secondary Verification of Alien Immigration Status, D-8840
Reasonable Opportunity to Provide Verification of Alien Immigration Status, D-8841
Entry Before 1996, D-8910
Entry on or After Aug. 22, 1996-Qualifed Alien No Waiting Period, D-8920
LPR Aliens With or Without Five-Year Waiting Period, D-8930

D-8720 Lawfully Admitted for Permanent Residence (LAPR)

Revision 13-1; Effective March 1, 2013

If the alien presents an I-551 (Alien Registration Receipt Card) or other acceptable evidence of LAPR status, query SAVE online to verify the document and status. Some LAPR aliens have conditional permanent resident status. This is indicated by an I-551 valid for only a two-year period. These aliens must apply for removal of the conditional basis 90 days before the second anniversary of the admittance date to the U.S. Failure to do so results in termination of the alien's lawful status. A conditional I-551 is identified by an expiration date two years later than the admittance/adjudication date, and status must be re-verified upon expiration. If the alien is a national of Cuba or Haiti who adjusts to LAPR status under the Nicaraguan and Central American Relief Act (NACARA) or the Haitian Refugee Immigration Fairness Act (HRIFA), contact state office for more information on treatment.

For a LAPR, follow policy in:

• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period; or
• Section D-8330, Qualified Aliens with a Five-Year Waiting Period.

 

D-8721 Description of Common Resident Alien Cards

Revision 17-4; Effective December 1, 2017

Permanent Resident Card and Employment Authorization Document (EAD)

As of May 1, 2017, the Permanent Resident Card and EADs:

• display the individual’s photos on both sides;
• show a unique graphic image and color palette:
  • Permanent Resident Cards have an image of the Statue of Liberty and a predominately green palette;
  • EAD cards have an image of a bald eagle and a predominately red palette;
• have embedded holographic images;
• no longer display the individual’s signature; and
• no longer have an optical stripe on the back.

Note:  Permanent Resident Cards and EADs will remain valid until the expiration date shown on the card.  Some older Permanent Resident Cards do not have an expiration date. The older Permanent Resident Cards without an expiration date also remain valid.

Revised I-551

A revised I-551, Alien Registration Receipt Card (Type 1), was first issued in late 1989.

Card Front — Form I-551 is a laminated card. The background is off pink. The agency name is shown in white on a blue background just under the words “RESIDENT ALIEN.” The seal is light blue. The front includes a photograph of the alien's face, fingerprint and signature. An expiration date is always shown. Cards expire 10 years after issue, but may be renewed.

Note: A modified I-551 was first issued in January 1992. All cards issued Feb. 1, 1993, or later are modified. The only difference is a noticeable removal of the background printing behind the fingerprint block.

Card Back — A map of the U.S. appears on the upper portion of the card back, surrounded by an overlapping rainbow print. The lower portion of the back contains four lines of text, the bottom three of which are machine readable and on a white background.

Original I-551

The original Alien Registration Receipt Card (Type 1) was issued from 1977 to late 1989.

Card Front — Form I-551 is a laminated card. The agency name is shown in white on a pastel blue background just under the words "RESIDENT ALIEN." The seal is light pastel blue. The front includes a photograph of the alien's face, fingerprint and signature.

Card Back — A map of the U.S. appears on the card back, overlaid by machine readable typed data. The first digit of the issue/type code indicates the number of alien registration cards issued to the person. The second digit identifies the type card.

I-151

Form I-151 is the version of the Alien Registration Receipt Card issued to aliens by the former Immigration and Naturalization Service (INS) from July 1946 through late 1977. Form I-151 is not a valid immigration document. The card lacks security features and presents more opportunities for alteration and fraud than the immigration documents currently being issued. From 1992 through 1996, the INS conducted a “Green Card Replacement” project to replace the I-151 cards in circulation. Although the card is not a valid immigration document, the person may still retain lawful permanent status.

For pictures of these cards, see Appendix LIV, Description of Resident Alien Cards.

 

D-8730 Refugees

Revision 17-4; Effective December 1, 2017

If an alien presents Form I-766 annotated with "274a.12(a)(3)" or "A3" as evidence of refugee status, query SAVE online to verify the document and status. If the SAVE online response results in a determination of ineligibility, verify alien status using Form G-845 and supplement to Form G-845. The Form I-94 annotated with stamp showing admission under section 207 of the Immigration and Nationality Act (INA) is also a DHS document for refugees.

For a refugee, follow policy in:

• Section D-8310, Qualified Aliens Subject to a Limited Period; or
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

 

D-8740 Parolee

Revision 17-4; Effective December 1, 2017

A parolee may present a DHS Form I-94 that indicates the bearer has been paroled pursuant to Section 212(d)(5) of the Immigration and Nationality Act (INA), with an expiration date of at least one year from the date issued or indefinite.

DHS Form I-766 annotated "A4" or "C11" indicates status as a parolee, but does not reflect the length of the parole period.

If the individual cannot provide Form I-94, contact DHS to verify status and length of the parole period before certification.

For a parolee, follow policy in:

• Section D-8310, Qualified Aliens Subject to a Limited Period; or
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

 

D-8750 Asylee

Revision 17-4; Effective December 1, 2017

An asylee may present a Department of Homeland Security (DHS) Form I-94 annotated with a stamp showing grant of asylum under Section 208 of the Immigration and Nationality Act (INA), a grant letter from the Asylum Office or an order of an immigration judge.

Derive the date status granted from the date on Form I-94, the grant letter or the date of the court order. If the date is missing from Form I-94, request the grant letter from the alien. If it is not available, verify the date status was granted with DHS.

DHS Form I-766 annotated "A5" indicate status as an asylee. However, the date of the form does not reflect when the status was granted. Request Form I-94, the grant letter from the Asylum Office of DHS or the alien's copy of a court order of the immigration judge granting asylum to obtain the date status was granted. Verify with DHS if none of these are available.

If the alien alleges having been granted asylum within the previous seven years, contact DHS using Form G-845 and Form G-845 supplement with a copy of Form I-551 attached.

For an asylee, follow policy in:

• Section D-8310, Qualified Aliens Subject to a Limited Period; or
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

 

D-8760 Deportation Withheld

Revision 17-4; Effective December 1, 2017

For an alien whose deportation was withheld under Section 243(h) of the Immigration and Nationality Act (INA) or whose removal was withheld under Section 241(b)(3) of the INA, obtain one of the following:

•  Form I-766 annotated "A10."
• The alien's copy of the order from an immigration judge showing deportation withheld under Section 243(h) of the INA as in effect prior to 4/1/97 or removal withheld under Section 241(b)(3) of the INA.
• Letter from asylum officer granting withholding of deportation under Section 243(h) of the INA as in effect prior to 4/1/97 or withholding of removal under Section 241(b)(3) of the INA.

Department of Homeland Security (DHS) Form I-766 annotated "A10" indicate deportation was withheld under Section 243(h) of the INA or removal was withheld under Section 241(b)(3) of the INA, but normally do not reflect the date of withholding. Request the alien's copy of the court order to obtain the date of withholding. If not available, verify with DHS.

If the alien alleges having had deportation/removal withheld within the previous seven years, contact DHS using Form G-845 and supplement with a copy of Form I-551 attached.

Note: Aliens who have been granted a suspension of deportation are not eligible for Medicaid benefits on the basis of that status alone. The description and annotations on the DHS documents must be as shown above in order to establish eligibility based on withholding of deportation or removal.

For an alien whose deportation was withheld, follow policy in:

• Section D-8310, Qualified Aliens Subject to a Limited Period; or
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

 

D-8770 Cuban/Haitian Entrants

Revision 13-1; Effective March 1, 2013

An alien could meet more than one classification. The seven-year period of limited eligibility, if applicable, begins with the earliest date an alien meets "Cuban/Haitian entrant" classification or one of the other seven-year classifications, such as asylee, refugee, etc. Absent evidence to the contrary, accept any of the following as convincing evidence of Cuban or Haitian nationality for purposes of determining whether an alien is a "Cuban/Haitian entrant:"

• SAVE primary verification (see Section D-8820, Primary Verification of Alien Status).
• DHS or Executive Office of Immigration Review (EOIR) document(s) showing Cuban/Haitian entrant status, or Cuban or Haitian nationality, or Cuba or Haiti as the place of birth.
• Cuban or Haitian passport or identity card.
• Cuban or Haitian birth certificate.
• Secondary verification determination of "Cuban/Haitian entrant" (see Section D-8840, Second Verification of Alien Immigration Status).

For a Cuban/Haitian entrant, follow policy in:

• Section D-8310, Qualified Aliens Subject to a Limited Period; or
• Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period.

 

D-8780 Qualified Alien Based on Battery or Extreme Cruelty

Revision 17-4; Effective December 1, 2017

An alien who has been, or whose child or parent has been, battered or subjected to extreme cruelty in the United States by a U.S. citizen or lawful permanent resident spouse or parent can be considered a qualified alien.

For the alien and children to emigrate or remain in the United States, the alien’s spouse must file a petition for lawful permanent residence status for the alien relative. Unless the spouse files this petition, the alien and children have no lawful immigrant status and face being deported.

Since the 1994 enactment of the Violence Against Women Act, a battered alien may self-petition for lawful permanent residency via INS Form I-360, Petition for Amerasian, Widow(er) or Special Immigrant, without the cooperation or knowledge of the abuser.

The alien must provide DHS documentation that identifies the alien as the self-petitioning spouse and/or child of an abusive U.S. citizen or lawful permanent resident and does not live with the abuser.

Examples of acceptable DHS documents include:

• I-551 annotated with one of the following status codes: IB-1 to IB-3 or IB-6 to IB-8;
• an I-797, Action Notice, which identifies the alien as a self-petitioning battered alien; or
• other forms of documentation, such as a letter from a DHS judge.

Qualified aliens with a battered alien status do not need to be credited with 40 qualifying quarters of Social Security coverage nor do they have a seven-year limited eligibility period. The following battered aliens meet the alien status criteria if they:

• entered the U.S. and acquired "qualified alien" status prior to Aug. 22, 1996;
• resided in the U.S. before Aug. 22, 1996, adjusted to "qualified alien" status on or after Aug. 22, 1996, and provide proof of continuous residence;
• resided in the U.S. before Aug. 22, 1996, adjusted to "qualified alien" status on or after Aug. 22, 1996, did not provide proof of continuous residence, but meet the five-year waiting period ; or
• entered the U.S. on or after Aug. 22, 1996 and meet the five-year waiting period.

Consider Medicaid for the treatment of an emergency condition when the battered alien does not meet alien status criteria.

 

D-8790 Victims of Severe Human Trafficking

Revision 17-4; Effective December 1, 2017

The U.S. Department of Health and Human Services certifies individuals who meet the victims of severe human trafficking requirements so they may remain in the U.S. up to four years. Law enforcement authorities can extend the status beyond four years for individuals whose presence is required for a continuing investigation.
 
These individuals meet the alien status criteria to be potentially eligible for benefits without a five-year waiting period and continue to meet the eligibility criteria without a limited eligibility period as long as the law enforcement extension continues, or they adjust to another acceptable alien status.
 
Staff must request a copy of the USCIS Notice of Extension to verify the individual has an approved extended Victims of Severe Human Trafficking status based on the law enforcement need. SAVE does not provide verification for victims of trafficking. Staff must call the trafficking verification toll-free number at 866-401-5510 to confirm the validity of the USCIS extension letter.  

After four years or expiration of a law enforcement extension, individuals who have not adjusted to another alien status must leave the U.S. If they remain, they are considered undocumented and ineligible for ongoing benefits.

Revision 17-4; Effective December 1, 2017

The Systematic Alien Verification for Entitlements (SAVE) program's Verification Information System (VIS) is a web-based application that provides alien status information using the applicants' alien registration number.

The SAVE System provides the following types of responses:

• Initial Verification Results: First Name, Last Name, Country, Date of Entry, Date of Birth, Class of Admission (COA) and System Response; and
• Additional Verification Results: Department of Homeland Security (DHS) Response, Expires On, Response Date and DHS Comments.

If the alien’s U.S. Citizenship and Immigration Services (USCIS) document is expired and the SAVE response shows the individual is a Lawful Permanent Resident - Employment Authorized and the Date Admitted is “Response is indefinite,” the individual meets alien status criteria.

Use the SAVE Verification Information System:

• at application;
• when adding a new household member identified as an alien; or
• if a person's alien documentation has expired.

Exceptions:

When SAVE does not contain information about victims of severe trafficking or non-alien family members, call the trafficking verification toll-free number at 866-401-5510 to confirm the validity of the certification letter or Derivative T Visa and to notify the Office of Refugee Resettlement of the benefits for which the individual is applying.

SAVE does not normally contain information about American Indians born outside of the U.S. See Section D-8420, American Indians Born Outside the U.S.

 

D-8810 Getting Permission to Access SAVE

Revision 09-4; Effective December 1, 2009

Supervisors complete and route Form 4743, Request for Applications and System Access, to the regional security officer for employees who need access to the SAVE system.

 

D-8820 Primary Verification of Alien Status

Revision 13-4; Effective December 1, 2013

To obtain primary verification of alien status, follow these steps to access the Systematic Alien Verification for Entitlements (SAVE) System:

1. Open the Verification Information System (VIS) website at https://save.uscis.gov/Web/vislogin.aspx?JS=YES, or in Data Broker through TIERS.
2. Enter your User ID and password.
3. Select Initial Verification from the Case Administration menu. The Initial Verification Information page appears.
4. Enter the document type the applicant provided.
5. Enter the applicant's information as it appears on the document:

• Alien Number – Do not include the letter A when entering the information in SAVE. If the A number has fewer than nine digits, add leading zeros to make it a nine-digit number. USCIS is used on the new I-551 cards instead of Alien Number.
• I-94 Identification Number – Known as the admission number, it consists of an 11-digit field. Enter leading zeros if the I-94 number provided has less than 11 digits.
• Card Number – On older versions of cards, the card number is on the front of the card. It is 13 digits and has three letters in front of the number. On newer versions of the card, the card number is on the back of the card. It is still 13 digits and has three letters in front of the number.
• Last name.
• First name.
• Date of birth.
• Document expiration date, if applicable.

6. Select the benefit type from the Benefits List (Supplemental Nutritional Assistance Program (SNAP) [formerly known as food stamps], Medicaid, TANF).
7. Select Submit Initial Verification. The response appears in the Initial Verification Results section of the same page.
8. The screen displays one of the following messages:

• LAWFUL PERMANENT RESIDENT – EMPLOYMENT AUTHORIZED
• INSTITUTE ADDITIONAL VERIFICATION
• TEMPORARY RESIDENT/TEMPORARY EMPLOYMENT AUTHORIZED

Use the policy found in Section D-8610, Ineligible Aliens, if the message is TEMPORARY RESIDENT/TEMPORARY EMPLOYMENT AUTHORIZED.

9. Review the results and select Print Case Details if using the stand-alone SAVE system. SAVE Case Details should then be imaged and put in the individual's case.

Note: If using Data Broker through TIERS, a copy of the SAVE screen is not needed, as the inquiry will be stored in the Data Broker history.

10. Select Complete and Close Case to close the case (only if additional verification is not necessary). Once a case is closed, the user can view it for an additional 90 days.

Note: Staff should enter the correct alien number as listed on the document, not a default or fictitious number (for example, AAA000000, etc.).

 

D-8830 Additional Verification — Online Process of Alien Status

Revision 09-4; Effective December 1, 2009

To request additional verification:

1. In the Initial Verification Results section, select Request Additional Verification. The Enter Additional Verification Data section appears.
2. Edit the default information, if necessary; enter required information, and include as much information as possible. Use the Special Comments box to enter additional information to the Immigration Status Verifier (ISV) staff.
3. Submit the request by selecting Submit Additional Verification. The response section appears indicating that the request is in process and will return the response within three working days.
4. To view the status of the case, select View Cases from the Case Administration menu. The Case Search page appears.
5. Enter the Case Search Criteria to search for cases based on the following case status:

• all open cases
• cases requiring action
• cases with additional verification responses
• cases in process
• closed cases

Select Display Case Summary List to open the Case Summary List page. The list displays the Case Status for cases that require action, cases in process and closed cases. Click the Verification Number to view the Case Details. The user is able to print the case details, request additional verification and close the case.

If the system is unable to verify the immigration status with the information provided by the user in the automated additional verification request, or the document appears counterfeit, altered or expired, use the manual process in Section D-8840, Secondary Verification of Alien Immigration Status.

 

D-8840 Secondary Verification of Alien Immigration Status

Revision 19-4; Effective December 1, 2019

If staff are unable to verify an alien's immigration status through primary verification procedures, use SAVE to request additional information from the U.S. Citizenship and Immigration Services (USCIS) by requesting a Data Broker Combined Report through TIERS or the Data Broker Portal.

Once a request from USCIS is obtained for verification of immigration status, the information received must be processed. Staff receive one of the following responses from SAVE via the Combined Report in TIERS or in the Data Broker Portal:

• 1st Level Verification - initial verification request in TIERS;
• 2nd Level Verification - situations that require additional (secondary) verification in the Data Broker Portal; and
• 3rd Level Verification - situations that require staff to upload documents for verification in the Data Broker Portal via SAVE.

For the 1st Level Verification, staff enter the information provided by the person into TIERS. Once the information is entered and SAVE is requested, SAVE will return an immediate response back indicating if the information entered was able to be verified with USCIS or if more information is needed.

If the information entered can be verified on the 1st Level Verification, staff will see the alien status, category code, and entry date. If the information entered is unable to be verified against USCIS records, then staff will have to proceed to 2nd or 3rd Level Verification responses to correctly verify the person’s citizenship and alien status.

For 2nd Level Verification and 3rd Level Verification responses, Data Broker automatically requests additional verification from SAVE. Once obtained from SAVE, staff receive an email from the Data Broker vendor notifying them that the verification requested has been returned from SAVE.

For 2nd Level Verification responses:

• The Data Broker vendor sends a subsequent email notifying staff that the verification has been returned from SAVE.
• Staff must then:
  • login to the Data Broker Portal to retrieve the information; and
  • update the Alien/Refugee Details page in TIERS accordingly.

For 3rd Level Verification responses:

• Staff must:
  • upload the verification documents requested into the Data Broker Portal;
  • not mail the documents to USCIS; and
  • ensure only one PDF file containing all required verification documents is uploaded.
• The Data Broker vendor sends a subsequent email notifying staff SAVE has returned the verification.
  • staff must then login to the Data Broker Portal to retrieve the information; and
  • update the Alien/Refugee Details page in TIERS accordingly.

Note: SAVE only populates alien sponsor information into TIERS for the additional verification response. This is unlike initial verification that populates the response data for the applicant in the appropriate ELDS tables on the TIERS Alien/Refugee-Details page.

Related Policy

Documentation and Verification Guide, Appendix XVI
Initial Request at Time of Application, D-5510
Verification of Alien Status, D-8700
Documentary Evidence by Classification, D-8710
Reasonable Opportunity to Provide Verification of Alien Immigration Status, D-8841
Entry Before 1996, D-8910
Entry on or After Aug.22,1996-Qualifed Alien No Waiting Period, D-8920
LPR Aliens With or Without Five-Year Waiting Period, D-8930

 

D-8841 Reasonable Opportunity to Provide Verification of Alien Immigration Status

Revision 14-2; Effective June 1, 2014

If you are unable to verify an alien's immigration status through primary or secondary verification procedures, allow the applicant a reasonable opportunity of 95 days following the date on which a notice is sent to an individual to provide another source of citizenship or alien status verification.

Revision 13-1; Effective March 1, 2013

An alien's eligibility is based on the Department of Homeland Security’s qualifying classification and other criteria as shown in the MEPDH and in the following charts.

D-8910 Entry Before 1996

Revision 17-4; Effective December 1, 2017

Chart A — Entry Before 1996

If the alien entered the U.S. before Aug. 22, 1996, and the USCIS document is an ...

then the alien is ...

I-94 annotated with one of the following INA sections: 207 – Refugee 208 – Asylee 241(b)(3) or 243(h) – Deportation Withheld 212(d)(5) – Cuban/Haitian Entrant 212(d)(5) – showing admission for at least one year – Parolee 203(a)(7) – Conditional Entrant I-766, employment authorization document annotated with one of the following status codes: A3 – Refugee A3 – Conditional Entrant A5 – Asylee A10 – Deportation Withheld I-551 annotated with one of the following status codes: AM1, AM2, AM3, AM6, AM7 or AM8 – Amerasians R8-6 or RE1 to RE9 – Refugees AS6 to AS9 – Asylees R8-6, CH-6, CU-6 or CU-7 – Cuban/Haitian Entrants U.S. Citizenship and Immigration Services (USCIS) letter from Asylum Office Order from an immigration judge: granting asylum, or showing deportation withheld under INA Section 243(h) or 241(b)(3). Consider the date of entry as the date the status is assigned.

eligible if the alien meets the criteria in Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period. Unless the alien meets the criteria in Section D-8320, consider Medicaid for the treatment of an emergency medical condition.

Note:  Follow your policy clearance request procedures for questions about documents or immigration statuses not listed in this chart.

D-8920 Entry On or After Aug. 22, 1996 – Qualified Alien No Waiting Period

Revision 23-2; Effective June 1, 2023

Chart B — Entry On or After Aug. 22, 1996 – Qualified Aliens With No Waiting Period

If the alien entered the U.S. on or after Aug. 22, 1996, and the USCIS document is an	and
I-94 annotated with one of the following INA sections: 207 – Refugee 208 – Asylee 243(h) or 241(b)(3) – Deportation Withheld 212(d)(5) – Cuban/Haitian Entrant I-766, employment authorization document annotated with one of the following status codes: A3 – Refugee A5 – Asylee A10 – Deportation Withheld I-551 annotated with one of the following status codes: AM1, AM2, AM3, AM6, AM7 or AM8 – Amerasians R8-6 or RE1 to RE9 – Refugees USCIS letter from Asylum Office Derivative T visa annotated with T-1 – victim of severe trafficking (four-year limit) Derivative T visa annotated with T-2, T-3, T-4 or T-5 – family member of victim of severe trafficking (four-year limit) Original certification letter from Office of Refugee Resettlement (ORR) Order from an immigration judge: granting asylum; or showing deportation withheld under INA Section 243(h) or 241(b)(3). Consider the date of entry as the date the status is assigned.	If less than seven years have passed since the date of qualified alien classification, usually the entry date, then the alien is eligible if the alien meets the criteria in as a qualified alien subject to a seven-year limited period. Unless the alien meets the criteria as a qualified alien subject to a seven-year limited period, consider Medicaid for the treatment of an emergency medical condition. Note: Victims of Severe Human Trafficking are limited to four years unless status is extended by law enforcement. If seven years or more have passed from the date of qualified alien classification, usually the entry date, then the alien is eligible if the alien meets the criteria as a qualified alien not subject to a waiting period or limited period. Unless the alien meets the criteria as a qualified alien not subject to a waiting period or limited period, consider Medicaid for the treatment of an emergency medical condition. Note: The refugee retains this eligibility period even if the refugee has adjusted to lawful permanent resident (LPR) status during the seven-year limited period.
I-94 annotated with one of the following INA sections: Section 212(d)(5) – showing admission for at least one year – Parolee Section 203(a)(7) – Conditional Entrant	Not eligible, unless the alien has applied for and been approved by DHS for LPR. If LPR, the alien must meet the LPR conditions as a qualified alien not subject to a waiting period or limited period. Unless the alien meets the criteria as a qualified alien subject to a seven-year limited period, consider Medicaid for the treatment of an emergency medical condition.
Afghan or Iraqi Special Immigrant – Special immigrant status under 101(a)(27) of the INA may be granted to Iraqi and Afghan nationals who have worked on behalf of the U.S. government in Iraq or Afghanistan. Acceptable documentation includes: Passport with a Machine Readable Immigrant Visa (MRIV) or stamp noting that the person has been admitted under a special immigrant visa category IV with one of the following codes: SI-1 or SQ-1 for the principal applicant; SI-2 or SQ-2 for the spouse of the principal applicant; or SI-3 or SQ-3 for the unmarried child under 21 of the principal applicant; and a DHS stamp or notation on the passport (includes DHS/CBP or DHS/USCIS temporary Form I-551 Alien Documentation Identification and Telecommunication (ADIT) stamp) or I-94 showing the date of entry.      or I-551 annotated with an IV code for category SQ-1, SQ-2 or SQ-3. or I-765, Employment Authorization Document (EAD) receipt notice with code SQ-1, SQ-2, SQ-3, SQ-6, SQ-7, and SQ-8. or I-766, Employment Authorization Document (EAD), with code SQ-1, SQ-2, SQ-3, SQ-6, SQ-7, and SQ-8. For special immigrants who are Special Immigrant Parolees (SI/SQ Parole), acceptable documentation includes: I-94 noting Special Immigrant Status (SQ/SI) Parole Section 602(B)(1) AAPA/Sec 1059(a) NDAA 2006 or SQ4/SQ5 SI Parolee notation signed and dated by a USCIS officer: SQ-4 for the principal applicant; or SQ-5 for the spouse or unmarried child under 21 of the principal applicant. or I-765, Employment Authorization Document (EAD), receipt notice with code C11. or I-766, Employment Authorization Document (EAD), with code C11. For special immigrants who are adjusting to LPR status in the U.S., acceptable documentation includes: I-551 annotated with one of the following status codes: SI-6 or SQ-6 for the principal applicant; SI-7 or SQ-7 for the spouse of the principal applicant; or SI-8 or SQ-8 for the unmarried child under 21 of the principal applicant. These special immigrants may also demonstrate nationality with an Afghan or Iraqi passport. For special immigrants who are conditional permanent residents (SI CPRs) adjusting to LPR status in the U.S., acceptable documentation includes: Passport with an MRIV or DHS/CBP stamp noting admission under IV Category with one of the following codes: CQ1 for the principal applicant; CQ2 for the spouse of principal applicant; or CQ3 for the unmarried child under 21 of principal applicant, and a DHS stamp or notation on passport (includes DHS/CBP or DHS/USCIS temporary Form I-551 Alien Documentation Identification and Telecommunication (ADIT) stamp) or I-94, showing the date of entry.      or I-551 with an IV code for category CQ-1, CQ-2, or CQ-3.      or I-765, Employment Authorization Document (EAD) receipt notice with code C11.     or I-766, Employment Authorization Document (EAD), with code C11. Note: The entry date for an Afghan special immigrant must be Dec. 26, 2007, or later. The entry date for an Iraqi special immigrant's entry date must be Jan. 26, 2008, or later.	If less than seven years have passed since the date of qualified alien classification, usually the entry date, then the alien is eligible if the alien meets the criteria as a qualified alien subject to a seven-year limited period. Unless the alien meets the criteria as a qualified alien subject to a seven-year limited period, consider Medicaid for the treatment of an emergency medical condition. If seven years or more have passed from the date of qualified alien classification, usually the entry date, then the alien is eligible if the alien meets the criteria in as a qualified alien not subject to a waiting period or limited period. Unless the alien meets the criteria as a qualified alien subject to a seven-year limited period, consider Medicaid for the treatment of an emergency medical condition. Note: The special immigrant retains this eligibility period even if the special immigrant has adjusted to LPR status during the seven-year limited period.

Note: Submit Form H0005, Policy Clarification Request, for questions about documents or immigration statuses not listed in this chart.

Related Policy

Qualified Aliens Subject to a Seven-Year Limited Period, D-8310

Qualified Aliens Not Subject to a Waiting Period or Limited Period, D-8320 
 

D-8930 LPR Aliens With or Without Five-Year Waiting Period

Revision 17-4; Effective December 1, 2017

Chart B — Entry On or After Aug. 22, 1996 – Qualified Aliens With No Waiting Period

If the LPR alien entered the U.S. on or after Aug. 22, 1996, and the DHS document is an ...

then ...

I-551, Resident Alien Card, and does not meet one of the classification codes in Charts A or B,   Notes: Any status code that appears on the I-551 is acceptable. No I-151s were issued after 1978; therefore, any alien admitted after 1978 will have an I-551. If the LPR alien loses the I-551, the LPR alien may present either an I-94 or a passport with the following annotation: "Processed for I-551, Temporary Evidence of Lawful Admission for Permanent Residence, valid until ______, Employment Authorized." Allow aliens with a DHS document or card showing an entry date on or after Aug. 22, 1996, who claim to have entered before that date, an opportunity to submit evidence of their claimed date of entry.

If five years or less have passed since the date of qualified alien classification, usually the entry date, then the LPR alien is not eligible. Unless the alien meets criteria other than 40 qualifying quarters in Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period, the LPR alien is only potentially eligible for Medicaid for the treatment of an emergency medical condition during the five-year waiting period. (Having 40 qualifying quarters does not exempt a person from the five-year waiting period.) If more than five years have passed since the date of qualified alien classification, usually the entry date, then the LPR alien is eligible if the LPR alien meets the criteria in Section D-8320. Unless the LPR alien meets the criteria in Section D-8320, consider Medicaid for the treatment of an emergency medical condition.

Chart C — LPR Aliens With or Without the Five-Year Waiting Period

If the LPR alien entered the U.S. before Aug. 22, 1996, and the DHS document is an ...

then ...

I-551, Resident Alien Card, and does not meet one of the classification codes in Charts A or B, Notes: Any status code that appears on the I-551 is acceptable. No I-151s were issued after 1978; therefore, any alien admitted after 1978 will have an I-551. If the LAPR alien loses the I-551, the LAPR alien may present either an I-94 or a passport with the following annotation: "Processed for I-551, Temporary Evidence of Lawful Admission for Permanent Residence, valid until ______, Employment Authorized." Allow aliens with a DHS document or card showing an entry date on or after Aug. 22, 1996, who claim to have entered before that date, an opportunity to submit evidence of their claimed date of entry.

The LPR alien is eligible if the LPR alien meets the criteria in Section D-8320, Qualified Aliens Not Subject to a Waiting Period or Limited Period, or Section D-8430, LPR Residing in the U.S. on Aug. 22, 1996. Unless the LPR alien meets the criteria in Section D-8320 or Section D-8430, consider Medicaid for the treatment of an emergency medical condition.

Follow your policy clearance request procedures for questions about documents or immigration statuses not listed in this chart.

D-8940 Reserved for Future Use

Revision 17-4; Effective December 1, 2017