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:
(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).