(1) You are eligible for refugee medical
assistance (RMA) if all the following conditions are met. You:
(a) Meet immigration status requirements of
WAC
182-507-0135;
(b) Have countable resources below $2,000 on
the date of application;
(c) Have
countable income equal to or below 200 percent of the federal poverty level
(FPL) on the date of application. The following income is not considered when
determining eligibility for RMA:
(i)
Resettlement cash payments made by the voluntary agency (VOLAG);
(ii) Income of a sponsor is not counted
unless the sponsor is also part of your assistance unit; and
(iii) Income received after the date of
application.
(d) Provide
the name of the VOLAG which helped bring you to the United States so that the
department of social and health services (DSHS) can promptly notify the VOLAG
(or sponsor) about the medical application.
(2) If you receive refugee cash assistance
(RCA) you are eligible for RMA if you have countable resources below $2,000 on
the date of application and you are not otherwise eligible for another medicaid
or children's health care program as described in WAC
182-505-0210. You do not have to
apply for or receive RCA in order to qualify for RMA.
(3) You are not eligible to receive RMA if
you are:
(a) Already eligible for another
medicaid or children's health care program as described in WAC
182-505-0210;
(b) A full-time student in an institution of
higher education unless the educational activity is part of a DSHS-approved
individual responsibility plan (IRP); or
(c) A nonrefugee spouse of a
refugee.
(4) If approved
for RMA, the agency or its designee issues an approval letter in both English
and your primary language. The agency or its designee also sends a notice every
time there are any changes or actions taken which affect your eligibility for
RMA.
(5) You may be eligible for
RMA coverage of medical expenses incurred during the three months prior to the
first day of the month of the application. Eligibility determination will be
made according to medicaid rules.
(6) If you are a victim of human trafficking
you must provide the following documentation and meet the eligibility
requirements in subsections (1) and (2) of this section to be eligible for RMA:
(a) Adults, 18 years of age or older, must
provide the original certification letter from the United States Department of
Health and Human Services (DHHS). No other documentation is needed. The
eligibility period will be determined based on the entry date on your
certification letter;
(b) A child
victim under the age of 18 does not need to be certified. DHHS issues a special
letter for children. Children also have to meet income eligibility
requirements;
(c) A family member
of a certified victim of human trafficking must have a T-2, T-3, T-4, or T-5
visa (derivative T-Visas), and the family member must meet eligibility
requirements in subsections (1) and (2) of this section.
(7) The entry date for an asylee is the date
that asylum status is granted. For example, you entered the United States on
December 1, 1999, as a tourist, then applied for asylum on April 1, 2000,
interviewed with the asylum office on July 1, 2000, and were granted asylum on
September 1, 2000. The date of entry is September 1, 2000, and that is the date
used to establish eligibility for RMA.
(8) RMA certification period.
(a) RMA ends on either:
(i) The last day of the eighth month from the
month the person entered the United States if they entered the United States on
or before September 30, 2021. For example, if they entered the United States on
September 30, 2021, they are eligible through April 30, 2022; or
(ii) The last day of the 12th month from the
month the person entered the United States if they entered the United States on
or after October 1, 2021. For example, if they entered the United States on
October 25, 2021, they are eligible through September 30, 2022.
(b) You may receive RMA benefits
for more months if you are in a category of persons for whom the federal Office
of Refugee Resettlement has extended the eligibility period.
(9) If you are approved for RMA
you are continuously eligible through the end of the initial RMA certification
period, regardless of an increase in income.
(10) The agency, or its designee, determines
eligibility for medicaid and other medical programs for your spouse when the
spouse arrives in the United States. If the spouse is not eligible for medicaid
due to your countable income, the spouse is still eligible for RMA under
subsection (8) of this section.
(11) If you disagree with a decision or
action taken on the case by the agency, or its designee, you have the right to
request a review of the case action(s) or request an administrative hearing
(see chapter
182-526 WAC). The request must be received by the agency, or its
designee, within 90 days of the date of the decision or action.
