Title 16
14000 Medicaid Common Eligibility
14330 Legally Residing Nonqualified Aliens
These are aliens who do not meet the above definition of qualified aliens. Individuals formerly known as PRUCOL are now considered nonqualified aliens. Nonqualified aliens have to provide a Social Security Number (SSN) if one is available, or apply for a SSN if the applicant does not have one.
Legally residing nonqualified aliens include the following:
• aliens granted permission to remain and work in the U.S.
• individuals who have been paroled into the U.S. for less than 1 year
• applicants for immigration status such as applicants for asylum, adjustment to lawful permanent resident status, suspension of deportation
• aliens in Temporary Protected Status (TPS)
• aliens in temporary resident status
• Family unity beneficiaries
• aliens under deferred enforced departure
• aliens in deferred action status
• aliens who are the spouses or children of U.S. citizens with approved visa petitions and pending adjustment of status application.
14330.1 Medicaid Eligibility For Legally Residing Nonqualified Aliens
Under PRWORA, legally residing nonqualified aliens, who meet the technical and financial requirements of a specific Medicaid eligibility group, are only eligible for the treatment of an emergency medical condition, as defined in this section, and labor and delivery services. Under PRWORA, legally residing nonqualified aliens (Section 14330) are not eligible for any long term care Medicaid program.
14330.2 Eligibility For State Funded Benefits (Nonqualified Aliens)
Effective January 1, 1998, legally residing nonqualified 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. The adult expansion population, under the 1115 demonstration waiver, entitled Diamond State Health Plan, is not eligible for state funded benefits.
The Delaware legislature appropriated state only funds to restore full coverage of Medicaid benefits to legally residing noncitizens who are ineligible for full Medicaid benefits because of PRWORA. Coverage for full Medicaid benefits for these legally residing nonqualified aliens is subject to the availability of state funds.
In the event such state funding is exhausted, eligibility for legally residing nonqualified aliens will be determined using the PRWORA policy described in Section 14330.1
