Medicaid, AEMA and Hospital Financial Assistance for Uninsured Immigrants

(Revised 12/06)

Note: this fact sheet is a basic overview and is not a complete summary of applicable rules                               

Most immigrants in these categories are eligible for full Medicaid:	Most immigrants in these categories are not eligible for full Medicaid:
Permanent residents who entered the US  on or before August 22, 1996, are living here lawfully, and who meet income and categorical requirements of Medicaid are eligible.	Permanent residents who entered the US after August 22, 1996 are ineligible, unless they meet 40 quarters work requirement, or veteran or active duty US military or by become a citizen). *
Refugees are eligible for 8 months after entry. Refugees, asylees, deportees, Cuban, Haitian and certain Amerasians who meet categorical and income requirements are eligible for the first 7 years.	People living in the US without documentation are not eligible for regular Medicaid.
Children born in the US (regardless of parents’ status) are citizens and are eligible if they meet income requirements.	*Citizenship requirements are found in rule 5101:1-38-02.3 of the Ohio Administrative Code.

 

AEMA is Available for Immigrants and Non-Citizens Who Are Not Eligible for Medicaid

Alien Emergency Medical Assistance, or AEMA, (Ohio Administrative Code 5101:1-41-20, effective 12/1/04) is a category of Medicaid that provides coverage for treatment of an emergency medical condition for certain “aliens” or non-citizen patients who do not meet  Medicaid citizenship requirements. Even patients who lack immigration documentation may be eligible for AEMA. Complete rule is in Ohio Administrative Code, 5101:1-41-20 . “Alien” also includes non-immigrants, such as visitors and students (see rule 5101:1-38-02.3 of the Ohio Administrative Code).

To be eligible for AEMA, “aliens” must meet the financial and categorical eligibility requirements of Medicaid and be residing  (even temporarily) in Ohio, but they do not have to meet Medicaid citizenship requirements.

To be eligible for AEMA, an individual must submit an application for Medicaid for each emergency medical assistance episode. The individual does NOT have to provide a social security number, provide proof of immigration status, or have a face-to-face interview. The individual is NOT subject to alien-sponsor deeming provisions.  

AEMA Only Covers Emergency Medical Conditions:

An emergency medical condition is defined as: after sudden onset, a medical condition, including labor and delivery, manifesting itself by acute symptoms of sufficient severity (including severe pain) such that the absence of immediate medical attention could reasonably be expected to result in placing the patient’s health in serious jeopardy, serious impairment to bodily function, or serious dysfunction of any bodily organ or part.. An emergency medical condition does not include care and services related to either an organ transplant procedure or routine prenatal or postpartum care.” OAC 5101:1-41-20 (B)(4).

Coverage: AEMA covers all medically necessary services covered by Medicaid, including hospital, physicians, tests and medicine. AEMA covers services during the whole “emergency medical condition episode” and “stops on the day on which the absence of immediate medical condition could no longer be expected to result in placing the patient’s health in serious jeopardy, serious impairment of bodily functions, or serious dysfunction of any bodily organ or part.” 5101:1-41-20.

NOTE: If coverage is denied for follow-up treatment, the patient should file an appeal and contact us or Legal Aid.

How to Apply for AEMA