State of Wisconsin Department of Health Services

Release 24-03 December 18, 2024

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4.3 Immigrants

"Immigrants" refers to all people who reside in the U.S. but are not U.S. citizens or nationals. Immigrants may be eligible for BadgerCare Plus and other categories of health care benefits, if they meet all eligibility requirements and in addition:

• Declare that they have a satisfactory immigration status (see Section 4.3.1 Declaration of Satisfactory Immigration Status), and
  • Are "Qualified Immigrants" (see Section 4.3.3.1 Qualifying Immigrants), or
  • Are "Lawfully Present" (see Section 4.3.3.2 Lawfully Present Immigrant Children, Young Adults, and Pregnant Women), and
    • Are under age 19,
    • Are under age 21 and residing in an IMD, or
    • Are pregnant.

Immigrants who do not meet these additional requirements may still be eligible for the BadgerCare Plus Prenatal Program or Emergency Services.

Before health care benefits may be issued to immigrants, their immigration status must be verified with the Department of Homeland Security through the Federal Data Sources Hub or SAVE (see Section 4.3.2 Verification). Prior to verification of immigration status, benefits may also be issued for a temporary period under a Reasonable Opportunity Period (see Section 4.3.2.2 Reasonable Opportunity Period for Verification of Immigration Status).

4.3.1 Declaration of Satisfactory Immigration Status

To qualify for BadgerCare Plus, persons who are not U.S. citizens or nationals must declare (or have an adult member of their household declare on their behalf) a satisfactory immigration status, except for:

• Persons applying for Emergency Services.
• Pregnant women applying for the BadgerCare Plus Prenatal Program.
• Persons who are not requesting benefits.

This declaration is normally provided as part of a signed application for health care that provides some basic information regarding the immigration status of household members. However, in some cases, a person may only indicate on their paper or ACCESS application that they are not a U.S. citizen and not provide any information about their immigration status. In such a situation, it is not known whether the person is stating that they are lawfully present in the U.S. (that is, that they have a satisfactory immigration status) or that they are undocumented.

Federal law requires that agencies obtain a declaration of satisfactory immigration status before taking any action to verify a person's immigration status, including granting eligibility during a reasonable opportunity period (see Section 4.3.2.2 Reasonable Opportunity Period for Verification of Immigration Status). To meet this declaration requirement, everyone who indicates that they are not a U.S. citizen or national must provide one of the following:

• Their immigration status
• Their immigration number (including an I-94, passport, SEVIS, or similar number)
• A signed declaration that says they have a satisfactory immigration status

Anyone who is required to and fails to provide immigration information or a declaration (or have an adult in the household provide it on their behalf) within standard verification timeframes must be denied health care benefits and must not be granted a reasonable opportunity period.

4.3.2 Verification

Primary verification of immigration status is done through the Department of Homeland Security by use of the Federal Data Services Hub (FDSH) or SAVE, which is an automated telephone and computer database system. A worker processing an application can simply enter the immigrant’s alien number and immigration document type into CWW. That information, along with demographic information of the individual, is sent in real time to the FDSH. The FDSH will immediately return verification of the immigrant’s status, date of entry, and the date the status was granted if it's available from the Department of Homeland Security, along with other information. If the FDSH cannot provide verification of the immigration status, workers are directed to seek secondary verification though SAVE or take other action.  

The verification query via the FDSH or SAVE most likely results in returning the latest date of any qualified alien status update for an individual, not their original date of arrival. The only way to obtain an accurate date of arrival for those who do not meet an exemption category and who report a date of arrival prior to August 22, 1996, is through the secondary verification procedure. The FDSH or SAVE will describe the immigrant’s current status which may have changed from the original status. In some situations described later workers will need to maintain the original status in CARES.

It may be necessary to complete a secondary or third level verification procedure with the U.S. Citizenship and Immigration Services (USCIS), including confirming the date of arrival, in the following situations:

• The applicant does not fall into any of the categories of non-citizens who are exempt from the five-year ban (for example, refugees, asylees, those with military service).
• An IM worker has made an initial or primary verification inquiry using the SAVE database. The information from the inquiry conflicts with information on the applicant's immigration documents or what they are telling the IM worker.
• A non-citizen applicant tells an IM worker that they came to the U.S. prior to August 22, 1996. If they arrived in a legal or documented status, the IM worker needs to verify the date of arrival to ensure that the correct alien eligibility rules are being applied.
• The FDSH or SAVE returns the message "Institute Secondary Verification."
• The IM worker finds any questionable information in the initial verification process.
• Cuban/Haitian entrants when SAVE or the Hub indicates the need.

An Immigration Status Verifier at Department of Homeland Security will research the alien's records and complete the response portion of the verification request.

See Process Help, Chapter 82 SAVE for more information.

Additional verifications from sources other than the Department of Homeland Security are sometimes required as well. For example, persons who are in an immigration status subject to the 5-year bar and who indicate that they, their spouse or parent is in the military service or is a veteran, that military status must also be verified.

The following documents are considered valid verification of military service:

• A signed statement or affidavit form from an applicant attesting to being a veteran, surviving spouse, or dependent child.
• Military records

To establish a date of arrival for a qualified immigrant who originally arrived as an undocumented immigrant prior to August 22, 1996, the applicant must provide at least one piece of documentation that shows their presence in the U.S. prior to August 22, 1996. The following documents are considered valid verification of presence in the U.S.: 

• Pay stubs 
• A letter from an employer 
• Lease  
• Rent receipts 
• Utility bills 

To establish continuous presence, require a signed statement from the applicant stating they were continuously present for the period in question. The signed statement will be sufficient unless a worker believes the information is fraudulent or information received is questionable. 

Signed Statement Example

I, first and last name, hereby declare that I have continuously resided in the United States between the day I arrived in the United States, date here, and the date I received qualified immigrant status, date here. I have not left the United States in that time for any single period longer than 30 days or for multiple periods totaling more than 90 days.    Applicant or Authorized Representative Signature and Date

Immigration statuses for most immigrants are permanent and most often change when the immigrant become a U.S. citizen. For this reason, immigration status for most members should only be verified once, unless the status for an individual is questionable or it's a status subject to reverification (see Section 4.3.2.1 Reverification of Immigration Status). Even if an immigrant loses health care eligibility for a period of time, their immigration status does not need to be re-verified unless the status is subject to reverification.

See Process Help, Section 44.3.9 Immigrant/Refugee Information Page for additional information on using the FDSH or the procedures in the SAVE Manual.

4.3.2.1 Reverification of Immigration Status

The following people with a Registration Status Code of 20 – Lawfully Residing are required to verify their immigration status at application and renewal, even if they have previously verified their immigration status:

• Immigrant children under age 19
• Youths under age 21 in an Institution for Mental Diseases (IMD)
• Pregnant people

Typically, these people will be labelled with a "Non-immigrant" status by the United States Citizenship and Immigration Services. Reverifications are not to be done for children and pregnant people with other Registration Status Codes, as those statuses are permanent.

The reverification requirement is only to be applied at the time of subsequent applications, renewals, or when an agency receives information indicating that the member may no longer be lawfully residing in the U.S. For pregnant people, the reverification is not to occur until the renewal is done to determine the person's eligibility after the end of the 60-day postpartum period.

4.3.2.2 Reasonable Opportunity Period for Verification of Immigration Status

Applicants who have declared that they are in a satisfactory immigration status, are otherwise eligible and are only pending for verification of immigration status must be certified for health care benefits within the normal application processing timeframe (30 days from the filing date). They are to continue receiving health care benefits for which they are eligible, while the IM agency waits for immigration status verification. Applicants who are otherwise eligible and are only pending for verification of immigration will have 90 days after receiving a request for immigration verification to provide the requested documentation. This 90-day period is called the Reasonable Opportunity Period (ROP). The 90-day ROP starts on the date after the member receives the notice informing the member of the need for the member to provide immigration verification by the end of the reasonable opportunity period. Federal regulations require that a minimum of five days be allotted for applicants to receive notices. For this reason, the end of the ROP must be set no less than 95 days after the date on the notice, even when the member receives the notice in less than five days. It also means that if a member shows that a notice was received more than five days after the date on the notice, the deadline must be extended to 90 days after the date the member received the notice.

The 90-day ROP applies when immigration verification is needed from a person at any time: applications, renewals, and when a person is newly requesting benefits on an existing case.

Applicants are eligible for benefits beginning with the first of the month of application or request. However, they are not eligible for backdated health care benefits while waiting for verification of their immigration status. Once verification of an eligible immigration status is provided, the applicant’s eligibility must then be determined for backdated health care benefits if they have been requested.

When requested verification is not provided by the end of the ROP, the worker must take action within 30 days to terminate eligibility, unless one of the following situations occurs where the worker is allowed to extend the reasonable opportunity period:

• The agency determines that the person is making a good faith effort to obtain any necessary documentation.
• The agency needs more time to verify the person’s status through other available electronic data sources.
• The agency needs to assist the person in obtaining documents needed to verify their status.

Persons whose health care benefits were terminated for failure to provide verification of immigration status by the end of the ROP are not eligible to have their benefits continued if they request a fair hearing.

A person may receive a reasonable opportunity period more than once in a lifetime.

Example 1

Vladimir is a 12-year-old lawfully present in the United States on a visa applying for health care benefits with his parents. When verification is attempted through the FDSH, the response requires a secondary verification request to SAVE. Vladimir is otherwise eligible for BadgerCare Plus and is enrolled in BadgerCare Plus and the ROP notice is sent to the family while waiting for the SAVE response. A week later, SAVE verifies the child is lawfully present in the U.S. under a Temporary Protected Status and the reasonable opportunity period ends. A year later, the case is up for renewal. Since Vladimir has a Registration Status Code of 20 – Lawfully Residing, his immigration status must be verified again. Once more, the FDSH response requires verification of the child's status through SAVE. If Vladimir is otherwise eligible for BadgerCare Plus, they will be enrolled without delay and be sent a new reasonable opportunity period notice to the family. Again, Vladimir may be eligible for up to 90 days after receiving the notice while his immigration status is being verified.

 

Example 2

Sasha is a 22-year-old applying for health care benefits. Information received from the FDSH indicates she is a victim of trafficking. Confirmation of her status as a victim of trafficking is needed, and she must submit a letter from the U.S. Department of Health and Human Services Office on Trafficking in Persons (HHS OTIP). She is enrolled in BadgerCare Plus and is sent the ROP notice requesting Sasha submit a letter from HHS OTIP. Sasha never submits a letter from HHS OTIP and her benefits end when the ROP expires.  One year later, Sasha again applies for health care benefits. Once more, the FDSH returns the same results. Sasha is otherwise eligible for BadgerCare Plus. She must be enrolled in BadgerCare Plus without delay and sent a new ROP notice requesting a letter from HSS OTIP. Again, Sasha is eligible for BadgerCare Plus for 90 days after receiving the notice while waiting for Sasha to provide a letter from HHS OTIP.

Benefits issued during a reasonable opportunity period to a person otherwise eligible for BadgerCare Plus are not subject to recovery, even if the person turns out to have an immigration status that makes them ineligible for BadgerCare Plus benefits.

4.3.3 Immigrants Eligible for BadgerCare Plus

Immigrants may be eligible for BadgerCare Plus if they meet all other eligibility requirements and are either Qualifying Immigrants (see Section 4.3.3.1 Qualifying Immigrants) or are Lawfully Present (see Section 4.3.3.2 Lawfully Present Immigrant Children, Young Adults, and Pregnant People).

4.3.3.1 Qualifying Immigrants

Immigrants of any age meeting the criteria listed below are considered Qualifying Immigrants. Unless otherwise specified, categories of qualifying immigrants are enumerated in 8 U.S.C § 1641(b) and (c).

Types of Qualifying Immigrants

Short Name	Qualifying Immigrant Description	Eligible if:	Additional Eligibility Information	CWW Registration Status
Refugee	A refugee admitted under Immigration and Nationality Act (INA) Section 207. A refugee is a person who flees their country due to persecution or a well-founded fear of persecution because of race, religion, nationality, political opinion, or membership in a social group.	No additional criteria	An immigrant admitted under this status may be eligible for BadgerCare Plus, without a 5-year wait, even if their immigration status later changes.	04
Refugee-Like	An immigrant who has benefits eligibility to the same extent as refugees due to an act of Congress	See section 4.3.3.1.1 Refugee-Like Immigrants Who Have Benefit Eligibility As Refugees Because of an Act of Congress  for more information.	N/A	04
Asylee	An asylee admitted under INA Section 208.  An asylee is a person who seeks asylum and is already present in the U.S. when they request permission to stay.	No additional criteria.	An immigrant admitted under this status may be eligible for BadgerCare Plus, without a 5-year wait, even if their immigration status later changes.	05
Deportation Withheld	An immigrant whose deportation is withheld under INA Section 243(h) and such status was granted prior to April 1, 1997, or an immigrant whose removal is withheld under INA Section 241(b)(3) on or after April 1, 1997.	No additional criteria.	An immigrant admitted under this status may be eligible for BadgerCare Plus, without a 5-year wait, even if their immigration status later changes.	15
Cuban-Haitian Entrant	Cuban-Haitian Entrants are defined as certain nationals of Cuba or Haiti who have permission to reside in the U.S. based on humanitarian considerations or under Section 501(e) of the Refugee Education Assistance Act of 1980 (REAA).	No additional criteria. See Section 4.3.3.1.2 Cuban- Haitian Entrants for more information.	The term “Cuban-Haitian Entrant” (CHE) relates to benefit eligibility rather than an immigration status. Individuals who meet the definition of a CHE may be eligible for certain public benefits.	11
Foreign Born American Indian	An American Indian born in Canada who is at least 50% American Indian by blood, as defined by §289 of the Immigration and Nationality Act   or  An American Indian born outside the U.S. who is a member of a federally recognized Indian tribe, as defined in 25 U.S.C. 450b(e).	No additional criteria.	N/A	18
COFA Citizen	A person who is a citizen of a country in the Compacts of Free Association (COFA)	No additional criteria. See Section 4.3.3.1.3 Citizens of the Compacts of Free Association Countries for more information.	COFA citizens who later become lawful permanent residents must meet additional criteria at the time they become LPRs.	22
Trafficking Victim’s child, spouse, or parent	Victims of a severe form of trafficking, and their child, spouse, or parent in accordance with 107(b)(1) of the Trafficking Victims Protection Act of 2000 (P.L. 106-386).	See Section 4.3.3.1.4 Victims of Trafficking for more information.	An immigrant admitted under this status may be eligible for Medicaid, without a 5-year wait, even if their immigration status later changes.	19
Trafficking Victim		Meet one additional criterion:  Have been in a qualifying immigration status for at least five years. Be a child younger than 19 years old.   Be younger than 21 years old and reside in an Institution for Mental Diseases. Be pregnant.  Have arrived in the U.S. before August 22, 1996, and have been continuously present.  Have a military service/connection. Be an Amerasian immigrant.  See Section 4.3.3.1.5 Additional Criteria for Certain Qualifying Immigrants for more information.	Be certified by the Department of Health and Human Services (HHS) as a victim of trafficking (applies to T1 visa holders and others).	19 - Meets one additional criterion or is certified by HHS as a victim of trafficking.  Or  21- 5-year wait applies
LPR	An immigrant lawfully admitted for permanent residence under INA 8 USC 1101 et seq		LPRs who were first refugees, asylees, Cuban or Haitian entrants, certain trafficking victims, or had their deportation withheld maintain that status for benefits eligibility purposes.	01
Parolee	An immigrant paroled into the U.S. under INA Section 212(d)(5) for at least one year		Certain parolees are treated as refugees for benefits eligibility purposes due to acts of Congress (see Section 4.3.3.1.1 Refugee-like Immigrants Who Have Benefit Eligibility as Refugees Because of an Act of Congress). Parolees who are nationals of Cuba or Haiti may be Cuban Haitian Entrants for benefits eligibility purposes (see Section 4.3.3.1.2 Cuban- Haitian Entrants).	06
Conditional Entrant	An immigrant granted conditional entry under immigration law in effect before April 1, 1980 [INA Section 203(a)(7)].		N/A	03
Battered Immigrants	An immigrant as described at 8 U.S.C. §1641(c)(1) who has been battered or subjected to extreme cruelty in the U.S. and meets certain other requirements		N/A	16
	An immigrant as described at 8 U.S.C. §1641(c)(2) whose child has been battered or subjected to extreme cruelty in the U.S. and meets certain other requirements.		N/A	16
	An immigrant child as described at 8 U.S.C. §1641(c)(3) who resides with a parent who has been battered or subjected to extreme cruelty in the U.S. and meets certain other requirements.		N/A	16

4.3.3.1.1 "Refugee-Like" Immigrants who have Benefit Eligibility as Refugees Because of an Act of Congress

4.3.3.1.1.1 Iraqis and Afghans with Special Immigrant Status

Special Immigrants from Iraq or Afghanistan (Class of Admission (COA) Codes SI, and SQ-1, 2, 3, 6, 7, and 8 and SW1, 2, and 3) are to be treated like they are refugees when determining their eligibility for BadgerCare Plus for as long as they have this Special Immigrant status. This policy applies to these immigrants regardless of when they received this status.

Class of Admission (COA) Code	Description	CARES Alien Registration Status Code
SI1 or SQ1	Principal Applicant Afghan or Iraqi Special Immigrant	Code 04
SI2 or SQ2	Spouse of Principal Applicant Afghan or Iraqi Special Immigrant	Code 04
SI3 or SQ3	Unmarried Child Under 21 Years of Age of Afghan or Iraqi Special Immigrant	Code 04
SI6 or SQ6	Principal Applicant Afghan or Iraqi Special Immigrant Principal Adjusting Status in the U.S.	Code 04
SI7 or SQ7	Spouse of Principal Applicant Afghan or Iraqi Special Immigrant Principal Applicant Adjusting Status in the U.S.	Code 04
SI8 or SQ8	Unmarried Child Under 21 Years of Age of Afghan or Iraqi Special Immigrant Principal Applicant Adjusting Status in the U.S.	Code 04
SW1	Surviving Spouse or child of an SQ1-eligible person	Code 04
SW2	Current Spouse of SW1	Code 04
SW3	Unmarried child of SW1	Code 04

 

In addition, immigrant Afghan spouses and children of former Special Immigrants who have become United States citizens are also to be treated like they are refugees when determining their eligibility for BadgerCare Plus. This treatment is to continue for as long as they have a status of Special Immigrant Conditional Permanent Resident (SI CPR). The Class of Admission (COA) codes for SI CPRs are CQ1, CQ2, and CQ3.

4.3.3.1.1.2 Afghan Humanitarian Parolees

Afghans and persons with no nationalities who were residing in Afghanistan and subsequently paroled into the United States on July 31, 2021, through September 30, 2023, are to be treated as refugees when determining their eligibility for BadgerCare Plus.  

In addition, Afghans and persons with no nationalities who were residing in Afghanistan and subsequently paroled into the United States after September 30, 2022, are to be treated as refugees when determining their eligibility for BadgerCare Plus if they are one of the following:

• The spouse or child of a person paroled on July 31, 2021, through September 30, 2023.
• The parent or legal guardian of a person paroled on July 31, 2021, through September 30, 2023, who is determined to be an unaccompanied child.

Afghan Humanitarian Parolees are to continue to be treated as refugees until either March 31, 2023, or the date their parole status expires, whichever is later. 

The table below shows the Class of Admission (COA) Codes that are used for these groups:

Class of Admission (COA) Code	Description	CARES Alien Registration Status Code
SQ4, SQ5	Special Immigrant Parolee (SI Parolee)	Code 04
DT, OAR, OAW, PAR	Humanitarian Parolee	Code 04

4.3.3.1.1.3 Ukrainian-Humanitarian Parolees

Ukrainians and persons with no nationalities who were residing in Ukraine and subsequently paroled into the United States between February 24, 2022, and September 30, 2024, are to be treated as refugees when determining their eligibility for BadgerCare Plus.  

In addition, Ukrainians and persons with no nationalities who were residing in Ukraine and subsequently paroled into the United States after September 30, 2023, are to be treated as refugees when determining their eligibility for BadgerCare Plus if they are one of the following:

• The spouse or child of a person described above paroled between February 24, 2022, and September 30, 2024.
• The parent or legal guardian, or primary caregiver(s) of an unaccompanied child described above who was paroled between February 24, 2022, and September 30, 2024.

Ukrainian Humanitarian Parolees are to continue to be treated as refugees until the date their parole status expires or as long as they remain in a qualifying immigrant status.

The table below shows the Class of Admission (COA) codes that are used for these groups:

Class of Admission (COA) Code	Description	CARES Alien Registration Status Code
UHP, DT, PAR, or U4U	Humanitarian Parolee	Code 04

 

See Process Help, Section 82.6 SAVE Responses Mapping to CARES Immigration Status Codes Chart for detailed information including Class of Admission (COA) codes for Ukrainian humanitarian parolees.

4.3.3.1.2 Cuban-Haitian Entrants

The term "Cuban-Haitian Entrant" (CHE) relates to benefit eligibility rather than an immigration status. Cuban-Haitian entrants are defined as certain nationals of Cuba or Haiti who have permission to reside in the U.S. based on humanitarian considerations or under Section 501(e) of the Refugee Education Assistance Act of 1980 (REAA). CHEs are qualified immigrants with no waiting period. 

The following individuals meet the definition of Cuban-Haitian Entrant:

• An individual granted parole as a Cuban-Haitian Entrant (Status Pending) or any other special status subsequently established under the immigration laws for nationals of Cuba or Haiti, regardless of the status of the individual at the time assistance or services are provided; or
• A national of Cuba or Haiti who is not subject to a final, non-appealable and legally enforceable removal order, and:
  • Was paroled into the United States and has not acquired any other status under the Immigration and Nationality Act; or
  • Is in removal proceedings under the Immigration and Nationality Act; or
  • Has an application for asylum pending with USCIS (U.S. Citizenship and Immigration Services).

Cuban-Haitian Entrants who later have a change in status and become Lawful Permanent Residents are not subject to the 5-year waiting period as Lawful Permanent Residents.

4.3.3.1.3 Citizens of the Compacts of Free Association Countries

Citizens of the Compacts of Free Association (COFA) countries are not considered U.S. citizens or nationals. The Compacts of Free Association countries include the Republic of the Marshall Islands, the Federated States of Micronesia, and the Republic of Palau. COFA citizens have a special status with the U.S. that allows them to enter the country, work here, and acquire an SSN without obtaining an immigration status.

As of December 27, 2020, COFA citizens may be eligible for health care if they meet all other eligibility requirements. In addition, COFA citizens are not subject to the five-year waiting period. However, COFA citizens who have a change in their status and become Lawful Permanent Residents (LPRs) are subject to the five-year waiting period.

4.3.3.1.4 Victims of Trafficking

The U.S. Department of Health and Human Services Office on Trafficking in Persons (HHS OTIP) provides adult victims of trafficking with Certification Letters which allow those whose immigration status would otherwise prevent them from being eligible to receive BadgerCare Plus to be eligible to receive benefits. The certification process typically takes only a few days after HHS is notified by DHS that a person has made a bona fide application for a T visa or has been granted a T visa or Continued Presence. 

• Applicants with a victim Certification Letter from the HHS OTIP qualify for benefits as a Victim of Trafficking regardless of their immigration status. 
• Applicants who are victims of trafficking with class of admission (COA) codes ST6 or T1 and are: 
  • Under 18 at the time of application do NOT require a Certification Letter. 
  • 18 or older must either have a victim Certification Letter or meet one of the additional qualifying criteria for certain qualifying immigrants (see Section 4.3.3.1.5 Additional Criteria for Certain Qualifying Immigrants)

Children, spouses, and parents of trafficking victims (COA codes: ST0, ST1, ST7, ST8, ST9, T2, T3, T4, T5, or T6) do not need a Certification Letter to be eligible for benefits.

Trafficking victims who are confirmed as eligible for Medicaid without a 5-year wait and who later have a change in their status and become Lawful Permanent Residents are not subject to the 5-year waiting period as Lawful Permanent Residents.

4.3.3.1.5 Additional Criteria for Certain Qualifying Immigrants

Certain qualifying immigrants must meet one additional criterion to be eligible for full-benefit Medicaid and BadgerCare Plus. These groups include: 

• Lawful permanent residents (LPR) 
• People whose deportation is withheld under INA Section 243(h) and such status was granted prior to April 1, 1997, or an immigrant whose removal is withheld under INA Section 241(b)(3) on or after April 1, 1997. 
• People who are paroled into the U.S. under INA Section 212(d)(5) for at least one year. 
• People considered to be battered immigrants who suffered domestic abuse.

The groups listed above must meet one of the following additional criteria:  

1. Have been in a qualifying immigration status for five years. These immigrants who arrived in the U.S. on or after August 22, 1996, are subject to a five-year waiting period to receive federal benefits (including BadgerCare Plus and Medicaid), other than emergency services. For these immigrants, the five-year waiting period is calculated beginning when they first receive their qualifying immigration status. 
2. Are less than 19 years old.  
3. Are less than 21 years old and reside in an Institution for Mental Diseases.
4. Are pregnant.
   • Pregnant applicants are eligible for full-benefit Medicaid and BadgerCare Plus. Pregnant people will have the 5-year waiting period lifted when their pregnancy is reported to the agency. The waiting period will be lifted until 60 days after the last day of pregnancy and through the end of the month in which the 60th day occurs.
5. Arrived in the U.S. before August 22, 1996, and have been continuously present. Applicants who alleged an arrival date in the U.S. before August 22, 1996, and obtained legal qualified immigrant status after August 22, 1996, may be eligible to receive BadgerCare Plus. The immigrants described below, who apply for BadgerCare Plus and meet all eligibility requirements, are entitled to receive BadgerCare Plus benefits:  
   • A non-citizen who: 
     • Arrived in the U.S. before August 22, 1996, in a legal, but non-qualified, immigration status, and 
     • Had a change in their status to a qualified immigrant on or after August 22, 1996, and
     • Remained continuously present from their date of arrival in the U.S. until the date they gained qualified immigration status. 
   • A non-citizen who: 
     • Arrived in the U.S. before August 22, 1996, in undocumented status, or
     • Overstayed their original visa, and
     • Remained continuously present from their date of arrival in the U.S. until the date they gained qualified immigration status.
   • For those non-citizens who arrived in the U.S. before August 22, 1996, but whose continuous presence cannot be verified, the five-year waiting period applies from the date the individual obtained a qualified immigrant status.
   An individual meets the continuous presence test if they:
   •  Did not have a single absence from the U.S. for more than 30 days, or
   •  Did not have a cumulative number of absences totaling more than 90 days 
6. Have a military service/connection. 
   
   Applicants may be eligible for BadgerCare Plus if they meet any of the following criteria related to military service:
   • Honorably discharged veterans of the U.S. Armed Forces. This is defined as persons who were honorably discharged after any of the following:
     • Serving for at least 24 months in the U.S. Armed Forces
     • Serving for the period for which the person was called to active duty in the U.S. Armed Forces.
     • Serving less than 24 months but was discharged or released from active duty for a disability incurred or aggravated in the line of duty.
     • Serving less than 24 months but was discharged for family hardship.
     • Serving in the Philippine Commonwealth Army or as a Philippine Scout during World War II.
   • On active duty (other than active duty for training) in the U.S. Armed Forces.
   • The spouse, unmarried and non-emancipated child under age 18, or surviving spouse of either an honorably discharged veteran or a person on active duty in the U.S. Armed Forces. A surviving spouse is defined as meeting all the following criteria:
     • A spouse who was married to the deceased veteran for at least one year.
     • A spouse who was married to the deceased veteran either:
       • Before the end of a 15-year time span following the end of the period of military service, or
       • For any period to the deceased veteran and a child was born of the marriage or was born before the marriage.
     • A spouse who has not remarried since the marriage to the deceased veteran.
7.  Are an Amerasian immigrant. 
   • Amerasian immigrants, defined under §584 of the Foreign Operations, Export Financing and Related Programs Appropriations Act of 1988, may be eligible for BadgerCare Plus. 
8. Also be considered a Cuban-Haitian Entrant. 
9. Lawful permanent residents (LPRs) who were previously a refugee, asylee, or had their deportation withheld under INA Section 243(h). 
   • Immigrants admitted under these statuses continue to be treated as refugees, asylees or immigrants who had their deportation withheld for benefits eligibility. 
   • See Section 4.3.3.1.4 Victims of Trafficking for additional details.

4.3.3.2 Lawfully Present Immigrant Children, Young Adults, and Pregnant People

Children younger than 19 years old, young adults younger than 21 years old who are residing in an Institute for Mental Diseases (IMD), and pregnant people may qualify for BadgerCare Plus if they are lawfully present in the U.S. under many of the immigrant and nonimmigrant statuses. For those who are not in a qualifying Immigrant category, but are lawfully present, use the Registration Status Code of 20 (see Process Help, Section 82.6 SAVE Responses mapping to CARES immigration Status Codes Chart for a list of SAVE Responses and the appropriate Registration Status Code in CWW to apply). 

4.3.3.3 Immigrants Eligible for Other Health Care Programs

Immigrants who are not a qualifying immigrant nor lawfully present (for example, someone who is undocumented) and who apply for BadgerCare Plus and meet all eligibility requirements except for citizenship and immigration status may be entitled to receive BadgerCare Plus Emergency Services only (see CHAPTER 39 EMERGENCY SERVICES).

Pregnant immigrants who are not a qualifying immigrant nor lawfully present and who apply for BadgerCare Plus and meet the eligibility requirements, except for citizenship and immigration status, are entitled to receive BadgerCare Plus Prenatal Program benefits (see CHAPTER 41 BADGERCARE PLUS PRENATAL PROGRAM), BadgerCare Plus Emergency Services (see CHAPTER 39 EMERGENCY SERVICES), or both.

4.3.3.4 Impact of Immigrant Status on Household

Immigration status is an individual eligibility requirement. An individual's immigration status does not affect the eligibility of the BadgerCare Plus Group. The citizen spouse or child of an ineligible immigrant may still be eligible even though the immigrant is not.

4.3.4 Public Charge

Public charge determinations are part of longstanding immigration policy that can impact a non-U.S. citizen’s ability to gain entry to the U.S or obtain lawful permanent resident (LPR) status (get a green card). A public charge is someone who the government believes is likely to rely on cash assistance or government-funded institutionalization for long-term care to survive.

Many non-U.S. citizens are exempt from public charge determinations. These include LPRs, also known as green card holders (unless they travel outside the U.S. for six months or more), asylees, refugees, special immigrant juveniles, survivors of trafficking, and other protected groups.

For non-U.S. citizens who are subject to public charge determinations, enrolling in BadgerCare Plus does not make them a public charge.

The only category of BadgerCare Plus services considered in public charge determinations is long-term institutionalization paid for by Medicaid. The following institutionalization situations are not considered in public charge determinations:

• Short-term institutionalization for rehabilitative purposes
• Sporadic or intermittent periods of institutionalization, even on a recurring basis. 

No services provided under the Children’s Health Insurance Program (CHIP) are considered in public charge determinations.

4.3.5 Immigration Customs Enforcement (ICE) Reporting

BadgerCare Plus member information cannot be used for immigration enforcement purposes. Do not refer an immigrant to ICE.

4.3.6 Undocumented Non-Citizens

In cases in which it is known that the applicant originally arrived in the U.S. in undocumented status, do not attempt to verify their status with the U.S. Citizenship and Immigration Services (USCIS). Undocumented immigrants do not have any official documentation regarding their date of arrival.

4.3.7 Immigration Status Chart

See Process Help, Section 82.6 SAVE Responses mapping to CARES immigration Status Codes Chart for a list of Systematic Alien Verification for Entitlement (SAVE) Responses and the appropriate Registration Status Code in CWW to apply.

CARES Registration Status Code	Immigration Status	Arrived Before August 22, 1996	Veteran*  Arrived before August 22, 1996	Arrived on or after August 22, 1996	Veteran*  Arrived on or after August 22, 1996	Children under age 19 and pregnant people; Arrived on or after August 22, 1996
01	Lawfully admitted for permanent residence	Eligible	Eligible	Ineligible for 5 years	Eligible	Effective October 1, 2009, Eligible
02	Permanent resident under color of law (PRUCOL)	Ineligible	Ineligible	Ineligible	Ineligible	Ineligible
03	Lawfully present under Section 203(a)(7)	Eligible	Eligible	Ineligible for 5 years	Eligible	Effective October 1, 2009, Eligible
04	Lawfully present under Section 207(c)	Eligible	Eligible	Eligible	Eligible	Eligible
05	Lawfully present under Section 208	Eligible	Eligible	Eligible	Eligible	Eligible
06	Lawfully present under Section 212(d)(5) and paroled for at least one year	Eligible	Eligible	Ineligible for 5 years	Eligible	Effective October 1, 2009, Eligible
07	IRCA (No longer valid)	N/A	N/A	N/A	N/A	N/A
08	Lawfully admitted - temporary	Ineligible	Ineligible	Ineligible	Ineligible	Ineligible
09	Undocumented Immigrant	Ineligible	Ineligible	Ineligible	Ineligible	Ineligible
10	Illegal Immigrant	Ineligible	Ineligible	Ineligible	Ineligible	Ineligible
11	Cuban/Haitian Entrant	Eligible	Eligible	Eligible	Eligible	Eligible
12	Considered a Permanent Resident by USCIS	Ineligible	Ineligible	Ineligible	Ineligible	Eligible
13	Special agricultural worker under Section 210(A)	Ineligible	Ineligible	Ineligible	Ineligible	Eligible
14	Additional special agricultural worker under Section 210(A)	Ineligible	Ineligible	Ineligible	Ineligible	Eligible
15	Withheld deportation - Section 243(h)	Eligible	Eligible	Eligible	Eligible	Eligible
16	Battered Immigrant	Eligible	Eligible	Ineligible for 5 years	Eligible	Effective October 1, 2009, Eligible
17	Amerasian	Eligible	Eligible	Eligible	Eligible	Eligible
18	Foreign Born Native American	Eligible	Eligible	Eligible	Eligible	Eligible
19	Victims of Trafficking**	Eligible	Eligible	Eligible	Eligible	Eligible
20	Lawfully Residing	Ineligible	Ineligible	Ineligible	Ineligible	Eligible
21	Victims of Trafficking Subject to 5 Year Waiting Period	Eligible	Eligible	Ineligible for 5 years	Eligible	Eligible
22	Citizen of Compacts of Free Assoc (COFA)	Eligible	Eligible	Eligible	Eligible	Eligible

* "Veteran" includes certain veterans and active-duty service members, their spouses, dependent children, or certain surviving spouses.

** Some victims of trafficking may need to provide certain verification to be exempt from the five-year waiting period (see Section 4.3.3.1.4 Victims of Trafficking).

4.3.9 Refugee Assistance Programs

The federal Office of Refugee Resettlement (ORR) provides resources for refugees, asylum seekers, and other new arrivals to the U.S. to assist with their integration into their new community. Several benefit programs overseen by the ORR and operated by the Bureau of Refugee Programs in the Department of Children and Families are discussed here.

4.3.9.1 Counting Refugee-Related Income

Refugee Cash Assistance Program payments are not counted as income for BadgerCare Plus. Refugee Cash Assistance is administered by W-2Wisconsin Works agencies and is made available for refugees who do not qualify for W-2.

Refugee "Reception and Placement" payments are not counted as income for BadgerCare Plus. Reception and Placement payments are made to refugees during the first 30 days after their arrival in the U.S. Reception and Placement payments are made by voluntary resettlement agencies and may be a direct payment to the refugee individual or family or to a vendor.

4.3.9.2 Refugee Medical Assistance

If an individual does not meet the other eligibility requirements for BadgerCare Plus, they may apply for Refugee Medical Assistance, which is not funded by BadgerCare Plus or Medicaid. Refugee Medical Assistance is a separate benefit from BadgerCare Plus but provides the same level of benefits. Refugee Medical Assistance is available only in the first 12 months after a special immigrant’s date of entry. If it is not applied for in that 12-month period, it cannot be applied for later.

While W-2 agencies have contractual responsibility for providing Refugee Medical Assistance, they must coordinate with economic support agencies to ensure eligibility for all regular BadgerCare Plus or Medicaid subprograms is tested first.

More information about this program is in the Wisconsin Works (W-2) Manual, Section 18.3 Refugee Medical Assistance.

Note	The federal Medicaid eligibility for all other refugees admitted under Registration Status Code 04 remains the same.

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The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.

Notice: The content within this manual is the sole responsibility of the State of Wisconsin's Department of Health Services (DHS). This site will link to sites outside of DHS where appropriate. DHS is in no way responsible for the content of sites outside of DHS.

Publication Number: P-10171