A qualified alien is:

a. an alien who is lawfully admitted for permanent residence under the Immigration and Nationality Act (INA).

b. a refugee who is admitted to the United States under §207 of the INA.

c. an alien who is granted asylum under §208 of the INA.

d. an alien whose deportation is being withheld under §243(h) of the INA or §241(b)(3) of the INA.

e. an alien who is paroled into the United States under §212(d)(5) of the INA for a period of at least 1 year.

f. an alien granted conditional entry pursuant to §203(a)(7) of the INA as in effect before April 1, 1980.

g. honorably discharged veterans and aliens on active duty in the U.S. armed forces and the spouse or unmarried dependent children of a veteran or active duty serviceman. The discharge must not be due to alien status and the active duty status must not be for training. For example, the 2 weeks of active duty training usually required of members of the National Guard does not meet the definition of active duty. Hmong and other Highland Lao veterans who fought on behalf of the Armed Forces of the U.S. during the Vietnam conflict and who have lawfully been admitted for permanent residence are considered veterans.

h. an alien granted status as a Cuban and Haitian entrant (as defined in Section 501(e) of the Refugee Education Assistance Act of 1980).

i. an alien admitted to the U.S. as an Amerasian immigrant pursuant to Section 584 of the Foreign Operations, Export Financing, and Related Programs Appropriations Act, 1988.

j. aliens who have been subjected to battery or extreme cruelty and who meet certain criteria, including an alien whose child has been battered or an alien child whose parent has been battered.

k. an American Indian born in Canada who is at least one-half American Indian blood and to whom the provisions of §289 of the INA apply or who is a member of an Indian tribe under section 4(e) of the Indian Self-Determination and Education Assistance Act.

Effective January 1, 1998, all qualified aliens, regardless of the date of entry into the U.S., may be found eligible for full Medicaid benefits. This does not include long term care services. Legally residing nonqualified aliens may be found eligible for Medicaid long term care services upon residing in the United States for five years. Certain qualified aliens will be Medicaid eligible. Other qualified aliens will receive state funded benefits. The adult expansion population, under the 1115 demonstration waiver entitled, Diamond State Health Plan, is not eligible for emergency services and labor and delivery only or the state funded benefits.

The Delaware legislature appropriated state only funds to restore full Medicaid benefits to legally residing noncitizens who are eligible for full Medicaid because of PRWORA. Under PRWORA, certain qualified aliens entering the U.S. on or after 8/22/96 were subject to a 5 year bar on eligibility. Coverage for full Medicaid benefits for the qualified aliens who are under the 5-year PRWORA bar, is subject to the availability of state funds.

The PRWORA policy (as amended by the Balanced Budget Act) which follows describes the eligibility for qualified aliens prior to the appropriation of state funds. In the event such state funding is exhausted, eligibility for qualified aliens will be determined using the PRWORA policy described below.

Under PRWORA, there are both mandatory and optional coverage groups for qualified aliens depending upon the alien's date of entry into the U.S. Delaware has decided to cover both the mandatory and optional groups.

The date of entry is significant for the Qualified Aliens (Section 14320) listed as a), e), f), j). These aliens who enter the U.S. on or after 8/22/96 are not eligible for full Medicaid benefits for 5 years after date of entry. These aliens are eligible only for emergency services and labor and delivery services during the first 5 years in the U.S.

The following qualified aliens may be found eligible for Medicaid regardless of their date of entry into the U.S.:

• Refugees (§207 of INA)

• Asylees (§208 of INA)

• Aliens who have had deportation withheld under §243(h) or §241(b)(3) of the INA

• Honorably discharged veterans and aliens on active duty in the U.S. armed forces and the spouse or unmarried dependent children of a veteran or active duty serviceman.

• Cuban and Haitian entrants

• Amerasians

• American Indian born in Canada, Mexico or who is a member of an Indian tribe under section 4(e) of the Indian Self-Determination and Education Assistance Act

In addition, title IVE Foster Children and Adoption Assistance children may be found eligible for Medicaid regardless of date of entry provided the foster or adoptive parent of the child is also a qualified alien or a citizen. The IVE agency is responsible for making that determination about the parent. If a IVE payment is being made on behalf of the child, then the child is deemed eligible for Medicaid.

For the following qualified aliens, eligibility under PRWORA is determined based upon the date of entry into the U.S.:

• Lawful permanent residents

• Aliens granted parole (parolees)

• Aliens granted conditional entry (conditional entrants)

• battered immigrants

If these aliens (lawful permanent residents, parolees, conditional entrants, battered immigrants) were living in the U.S. before August 22, 1996, they may be found eligible for Medicaid. If these aliens entered the U.S. on or after August 22, 1996, they are not eligible for full Medicaid benefits for 5 years from the date of entry into the U.S. They may be found eligible for emergency services only during the first 5 years after entering the U.S. Once these aliens have been in the U.S. for 5 years, they may be found eligible for full Medicaid.

The following qualified aliens who enter the U.S. on or after 8/22/96 and are subject to the 5 year PRWORA bar may be found eligible for state funded benefits:

• Lawful permanent resident

• Aliens granted parole (parolees)

• Aliens granted conditional entry (conditional entrants)

• Battered immigrants

Once these aliens have been in the U.S. for five years, they may be found eligible for Medicaid.