Medi-Cal Eligibility Period

Cash-Linked Medi-Cal and RMA/EMA

Recipients of Refugee Cash Assistance (RCA), Entrant Cash Assistance (ECA), CalWORKs or SSI/SSP automatically receive twelve months of guaranteed medical assistance. Refugees that are discontinued from cash assistance must continue to receive RMA benefits without redetermination or change in benefits. If receiving RMA/EMA only, and the refugee receives increased earnings from employment, the refugee must continue to receive RMA until the end of the twelfth month eligibility period without redetermination or a change in benefits.

Note: DHCS has extended the RMA coverage period from 8 to 12 months for anyone whose RMA eligibility period began October 1, 2021 or later, and their first month of eligibility was less than 12 months ago.

Exception: Clients receiving RCA with the Trafficking and Crime Victims Assistance Program (TCVAP) aid code 1V are entitled to MC, however, MC is not included in the aid code (providers will not see eligibility when they check for MC eligibility). The client must be granted an MC aid code for MC based on the TCVAP process.

Refugee Medical Assistance (RMA)/Entrant Medical Assistance (EMA)

Only those Refugees and Entrants who are not otherwise eligible for MC under federally-funded CalWORKs, SSI/SSP, MAGI MC, Non-MAGI MC Medically Needy or Medically Indigent Child programs
may be eligible for MC through the federal RMA program. Refugees and Entrants are considered eligible for twelve months from the date of entry into the U.S.

Note: Asylees are considered eligible for twelve months from the date asylum is granted. Victims of a severe form of trafficking use the date on their certification letter.

Eligibility Criteria

To be eligible for RMA, a refugee must:

Have no other MC linkage
Not be receiving CalWORKs, RCA (except the 1V aid code), ECA, or SSI
Provide the name of the resettlement agency
Have resided in the U.S. for 8 months or less (exception: asylees and victims of a severe form of
trafficking)
Have not been denied, or terminated from RCA for failure or refusal to comply with registration,
employment, education or training requirements.

Exception: Refugees who are full-time students in an institution of higher education are not eligible for RMA
unless their school attendance is part of an employability plan developed by the county Social
Services Agency or it is part of a plan for an unaccompanied minor.

Social Security Number Requirement

Under the Privacy Act of 1974 and the Federal Office of Refugee Resettlement (ORR) State Letter 00-23, refugees applying for RMA benefits are NOT required to obtain, provide or disclose a Social Security Number. RMA applicants or beneficiaries must NOT be denied or discontinued for failure to provide an SSN.

Eligibility at Date of Application

Eligibility for RMA must be determined as of the date of application. Only the refugee’s countable income and resources at the time of application are considered. If the refugee gains employment during the month of application, but after the application date, the earnings are exempt.

The following is an example of a refugee family with different arrival dates.

Examples of Eligibility at Date of Application

If a Refugee is...	And...	Then the EW must...
A mother and child arriving in the United States after the arrival of the father,	The father is now employed,	Place the child on MC (zero SOC or OTLIC) or refer to Healthy Kids, if otherwise eligible, and place the mother in RMA for twelve months if she is not eligible for zero SOC MC.
Note: The father’s income is not counted when determining eligibility for his wife and child under RMA. Only the countable income and property belonging to the mother and child are counted, if any.
An individual who entered the U.S. on 05/16/16,	Is granted asylum on 10/28/2017,	Place the asylee on RMA for twelve months if he/she is not eligible for a zero SOC MC program effective 10/17.
A trafficking victim who was a refugee from another country and then was sent to the U.S.,	Has a certification letter dated 9/25/2017,	Place the trafficking victim on RMA for twelve months, if he/sh is not eligible for zero SOC MC, effective 9/2017.

ExampleExample

A refugee mother and a child arrive in the United States one year or more after the arrival of the father. The father is now employed, so the child may qualify for either MC/OTLIC or Healthy Kids, but the mother may not be eligible for zero SOC MC due to the father’s income. Therefore, the child should be placed on MC or referred to Healthy Kids, if eligible; the mother is placed on RMA if she is not eligible for zero SOC MC.