PRUCOL: How Asylum Seekers Qualify for Medicaid
Permanent Residence Under Color of Law, or PRUCOL, is a public benefit eligibility status, as opposed to an immigration status, that allows certain groups of individuals, including those seeking asylum, to be eligible for full Medicaid coverage. Eligibility for Medicaid depends on a variety of other factors (income, state residence, etc.), which PRUCOL applicants for Medicaid must also meet to be found eligible.
What does “Permanent Residence Under the Color of Law” really mean?
“Permanent” implies that the individual will be in the United States permanently. “Residence” indicates that the individual is a resident of New York State. “Under the Color of Law” means that the individual has some legal basis for being in the country. PRUCOL is more inclusive than the federal immigration requirements for Medicaid eligibility.
When is an asylum seeker eligible for PRUCOL?
An asylum seeker is eligible for PRUCOL once he/she obtains confirmation that his/her formal application for asylum has been received by USCIS. Proof that USCIS has received the application includes a I-797 Notice of Action or a postal service return receipt stating "signature confirmation" or "delivery confirmation.” Once individuals have been granted asylum status, they continue to be eligible for Medicaid under the status of Qualified Alien.
Prior to submitting their application for asylum, asylum seekers may be eligible for Emergency Medicaid, which is a more limited form of Medicaid for undocumented immigrants and other non-immigrants. Emergency Medicaid covers services needed to treat a condition that has acute, severe symptoms and which, if left untreated, could place the individual’s health in jeopardy. Once their application for asylum is received, asylum seekers are classified as PRUCOL immigrants and are eligible for full Medicaid. Contact email@example.com for more information.
Pregnant women are eligible for Medicaid regardless of immigration status, provided they meet the other eligibility requirements.
How does an asylum seeker apply for Medicaid under PRUCOL?
First, determine whether the individual would be categorized as MAGI or non-MAGI (“MAGI” stands for “Modified Adjusted Gross Income”). The majority of asylum seekers will be budgeted under the MAGI income limits. Please see attachment below for full criteria. MAGI asylum seekers should apply through the New York Health Exchange website (https://nystateofhealth.ny.gov/). Non-MAGI asylum seekers should apply at their Local Department of Social Services. Certified disabled, aged, or blind applicants who are not caretaker relatives of children under the age of 18 are subject to a resource limit.
Second, determine whether or not the applicant’s household income falls below the limit for his or her household size. Income limits are different for MAGI and non-MAGI applicants. Please see attachment below for more information.
Applicants for Emergency Medicaid are not required to have a social security number (SSN). However, PRUCOL applicants for Medicaid must at least be in the process of applying for an SSN. If their application for an SSN is denied, they cannot be denied Medicaid based on lack of an SSN.
Where can I get help applying for Medicaid?
Asylum seekers can receive free assistance with the Medicaid application. Visit https://nystateofhealth.ny.gov/agent/hx_brokerSearch to find a Navigator/Broker near you who will help you with your application and will guide you through the registration process. Navigators are available in dozens of different languages.
Specific questions about applying can also be directed to the Continuing Care team at WCCHR by emailing firstname.lastname@example.org.
What services will Medicaid Managed Care cover?
Primary care physician (PCP), mental health, gynecological, and dental services are all covered. Transportation to medical appointments and translation services are also covered.
**Information and attachments courtesy of The Legal Aid Society.