Medicaid, a federal and state funded program of health care coverage, provides important benefits to low-income and disabled Americans. Some immigrants, aliens who travel to the United States permanently to live and work, are also eligible for Medicaid coverage. To be eligible, an immigrant must meet the definition of a qualified alien. Additionally, a five-year bar on immigrant benefits applies to many qualified aliens, so this period must expire before immigrants subject to the bar may receive benefits.

What Is A Qualified Alien?

Medicaid coverage is only available to aliens who are defined as "qualified" under a federal statute. Qualified aliens include at least nine classes of aliens:

• Lawful permanent residents;
  
• Refugees;
  
• Aliens who were granted asylum;
  
• Cuban and Haitian Entrants, as defined by statute;
  
• Aliens who were granted at least one year of parole under a specific statutory provision;
  
• Aliens whose deportation was withheld under specific statutory provisions;
  
• Aliens who were granted conditional entry under a former statutory provision;
  
• Battered aliens who meet certain statutory definitions; and
  
• Severe trafficking victims.

Additionally, three classes of aliens are eligible for Medicaid coverage even though they are not considered "qualified:"

• Aliens who receive SSI but are not eligible for Medicaid, if the state in which they live gives automatic eligibility to SSI recipients;
  
• Members of federally recognized Indian tribes and American Indians born in Canada, under certain statutory provisions; and
  
• Undocumented immigrants and other aliens, for emergency treatment only.

How Does The Five-Year Bar Work?

Immigrants who entered the U.S. on or after August 22, 1996 are subject to a five-year period of ineligibility for federal funded benefit programs, such as Medicaid. For that reason, a qualified alien who wishes to receive Medicaid coverage must either be exempt from the five-year bar or the five-year bar must have passed. Although there are many exemptions, most aliens are covered by this bar, including lawful permanent residents (LPRs), parolees for longer than one year, and victims of battering. Some of the many exempt classes, however, include refugees, asylees, victims of severe trafficking, honorably discharged U.S. veterans, active duty service members, members of federally recognized Indian tribes, and certain American Indians born in Canada. Additionally, the bar does not apply to emergency treatment nor does it apply to aliens who entered the U.S. before August 22, 1996, as long as they were continuously present in the country for five years until they obtained qualified alien status. Continuous presence is interrupted by either a single absence of more than 30 days or an aggregate of absences of longer than 90 days.

The five-year bar begins to run from the date an immigrant obtains qualified alien status. After the five-year period expires, state Medicaid programs must cover LPRs with sufficient Social Security work credits; refugees, asylees, and Cuban and Haitian entrants, for a seven-year period; aliens whose deportation is being withheld and Amerasian immigrants, for seven years; active duty service members and honorably discharged former service members, and the spouses and unmarried children of both active duty and honorably discharged service members.

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