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.