R—410  General Policy

A child within the required degree of relationship does not need to live in the home. Single adults, couples with children, an independent child, a child with a payee and couples without children may receive Refugee Medical Assistance (RMA).

Household composition determination:

• A refugee under age 18 must be certified with a caretaker/payee, or as an independent child.
• A refugee age 18 may be certified with a caretaker/payee, as an independent child.
• A refugee age 19 must be certified as an adult.
• Non-related applicants must be certified separately; however, a payee does not have to be a refugee or a relative.

Determine household composition by considering the relationship of the household members and what is most beneficial for the individual. Note: Adult refugee children living in the home with there parents must submit a separate application.

R—420  Children Born to a Woman Certified for Refugee Medical Assistance (RMA)

When a woman certified for RMA delivers a child/children, the newborn child is not eligible to receive MA-Newborn Coverage, TP 45. If medical coverage is requested for the newborn child, an application must be submitted for HHSC to determine if the newborn child is eligible for MA-Children under 1, TP 43 or Children's Health Insurance Program (CHIP).

R—430  Marriage to a U.S. Citizen

If a refugee marries a U.S. citizen, only the refugee is eligible for RMA. To determine the refugee's eligibility, include the income of the refugee's spouse. Children of the marriage are not eligible for RMA. The spouse and children of the marriage will be included in the budget group.

R—440  Marriage to an Ineligible Refugee

If an eligible refugee is married to an ineligible refugee, certify the eligible refugee only. Include the income of the ineligible spouse. The ineligible spouse will be included in the budget group.

Children of the marriage who were not born in the U.S. can be included on the eligible parent's case if they meet the eight-month limit criteria.