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DMA ADMINISTRATIVE LETTER NO: 07-08, IRAQI AND AFGHANISTAN SPECIAL IMMIGRANTS

DATE: APRIL 25, 2008

SUBJECT: Iraqi and Afghanistan Special Immigrants

DISTRIBUTION County Directors of Social Services

Medicaid Eligibility Staff

i. bACKGROund

DMA Administrative letter No. 07-08

Page 2

II. medicaid Principles

DMA Administrative Letter 07-08

Page 3

III. DOCUMENTATION of Eligibility for Medicaid

Applicant

Documentation

Principal Applicant Iraqi or Afghan Special Immigrant

Iraqi or Afghan passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) category SI1 or SQ1 and DHS stamp or notation on passport or I-94 showing date of entry

Spouse of Principal Applicant Iraqi or Afghan Special Immigrant

Iraqi or Afghan passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) Category SI2 or SQ2

and DHS stamp or notation on passport or I-94 showing date of entry

Unmarried Child Under 21 Years of Age of Iraqi or Afghan Special Immigrant

Iraqi or Afghan passport with an immigrant visa stamp noting that the individual has been admitted under IV (Immigrant Visa) Category SI3 or SQ3

and DHS stamp or notation on passport or I-94 showing date of entry

Principal Applicant Iraqi or Afghan Special Immigrant

Principal Adjusting Status in the U.S.

DHS Form I-551 (“green card”) showing Iraqi or Afghan nationality (or Iraqi or Afghan passport), with an IV (Immigrant Visa) code for this category SI6 or SQ6

Spouse of Principal Applicant Iraqi or Afghan Special Immigrant

Principal Applicant Adjusting Status in the U.S.

DHS Form I-551 (“green card”) showing Iraqi or Afghan nationality (or Iraqi or Afghan passport), with an IV (Immigrant Visa) code for this category SI7 or SQ7

Unmarried Child Under 21 Years of Age of Iraqi or Afghan Special Immigrant

Principal Applicant Adjusting Status in the U.S.

DHS Form I-551 (“green card”) showing Iraqi or Afghan (or Iraqi or Afghan passport), with an IV (“Immigrant Visa”) code for this category SI9 or SQ9

DMA Administrative Letter 07-08

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iv. mEDICAID pROCEDURE

V. EIS Procedures

VI. Effective date and implementation

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