What is Emergency Medicaid? – Overview
Emergency Medicaid is provided for services and care which is necessary to treat an emergency medical condition.
This provision is meant to specify temporary non-immigrants, tourists and foreign students who are ineligible to get health treatment. This initiative is aimed at helping eligible but undocumented non-citizens who meet all eligibility criteria, such as identity, proof of income.
Along with state residency which is essential to be eligible for emergency Medicaid coverage in urgent medical situations.
Persons who are considered to be temporary non-immigrants, and have been allowed into the US temporarily for a specific period.
They do not necessarily have to meet the particular state’s residency requirements to receive Medicaid emergency care. Such persons are classified under “Where Found” for District of Fiscal Responsibility uses.
Who is eligible for Emergency Medicaid?
There are two types of people who are eligible to receive emergency Medicaid services and include:
Undocumented citizens are individuals who are not lawfully present yet have entered the United States in a way as to avoid detection. These are also individuals who were admitted into the US temporarily but their permit of stay has expired.
In other words, undocumented citizens do not have valid or unexpired immigration documents.
Temporary non-immigrants are defined as individuals who are permitted in the US temporarily for a specific purpose.
The rest of the eligible non-immigrants are not considered to be residents of New York State. They need urgent medical care eligible to receive emergency Medicaid coverage for their treatment.
Such non-immigrant persons are liable to receive the benefits of emergency Medicaid on the condition. If they have not entered the US to specifically get medical treatment, such as those entering the US on a medical visa.
What is considered an urgent medical condition to qualify for Emergency Medicaid?
Emergency medical conditions are those health ailments, disorders and diseases that develop with acute symptoms.
They have noticeable severity, such as intense pain, including those where the absence of urgent medical care may result in the person:
- Experiencing severe health problem
- Suffering from impaired bodily functions
- Suffering from dysfunction of organs or part of their body
However, the definition of emergency medical assistance does not cover organ transplant procedures.
To be eligible to receive emergency Medicaid services, the patient should showcase the sudden onset of the medical disorder.
The patient should showcase the symptoms when the medical treatment is offered. Otherwise, it will not be considered an emergency medical situation and will therefore not be covered by Medicaid.
It is also not necessary that all medically necessary healthcare services come under the definition of emergency medical situation. For instance, debilitating conditions, such as heart problems or other problems that require rehabilitation, are not considered to be emergency medical conditions.
Discontinuation of Medicaid-covered care may result in an emergency medical situation that is not considered in emergency Medicaid.
What are the Healthcare Services not covered under Emergency Medicaid?
There are several different types of healthcare services usually provided to chronically ill patients. are not covered under emergency Medicaid benefits. These include:
- Alternate care in hospitals
- Services in nursing facilities, home-care, including personal care services, private nurse expense, and home health service charges
- Rehabilitative services, such as speech, occupational and physical therapies
These above-mentioned conditions are not considered to be emergency medical situations.
Because Medicaid does not provide emergency services to cover the cost of these services. Medicaid will also not cover the cost of transporting patients to receive the above-mentioned health conditions.
How long do Emergency Medicaid benefits last?
Under the Emergency Medicaid statute, eligible patients can receive coverage for treatment lasting for a single day to 15 months. This includes the cost of 3 months retroactive coverage from the date of application and 12 months’ prospective coverage from the date of application.
The authorization period for this service may begin from the 1st day of the 3rd month to the month of application. This continues up to the last day of the twelfth month.
Emergency Medicaid is an efficient way for undocumented and temporary non-immigrant persons to receive urgent medical treatment. This initiative has helped thousands of visitors to the US to undergo life-saving medical care and treatment success.
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