D-8400, LAPR Conditions for Medicaid

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.