To receive emergency medical benefits, noncitizens who does not meet the federal qualifying Medicaid criteria, must need, or have received, emergency medical services during the month of application or during the 3 months before the month of application.
Emergency medical services are services required as a result of a medical condition with acute symptoms that are severe enough that, without immediate medical attention, a physician could reasonably expect the condition to result in:
- placing the noncitizen's health in serious jeopardy;
- serious impairments to bodily functions; or
- serious dysfunction of any organ or part.
The acute symptoms can include severe pain, and the medical condition can include lobor and delivery.
NOTE: Services provided in a hospital emergency room must meet the criteria.
Terminal illness or the need for long term care services alone does not qualify the person for emergency medical coverage. The person must also have an emergency medical condition as defined above.
Benefits for emergency labor and delivery should be authorized under the Family Assist, FamilyCare Assist or Moms & Babies programs, not Emergency Medical for noncitizens who does not meet the federal qualifying Medicaid criteria.
The applicant's doctor must verify the emergency in writing.
Emergency medical is provided only until the condition that caused the emergency stabilizes and there are no longer acute symptoms.
Noncitizens who does not meet the federal qualifying Medicaid criteria must also meet the requirements for:
- residence (a visa is not relevant to determining residence);
- institutional status;
- blind, disabled, or age 65 and over (AABD Medical Only);
- age, relationship, and living with (Assist);
- medical support rights;
- client cooperation;
- resources (AABD Medical Only);
- support from a responsible relative;
- personal injury awards; and
- third party liability.
Noncitizens who does not meet the federal qualifying Medicaid criteria are not required to meet the following program requirements:
- citizenship or immigration status; and
- furnishing or applying for a Social Security number.