Oregon Oregon Health Authority, Health Systems Division: Medical Assistance Programs

Rule Rule 410-200-0240
Eligibility for Individuals Who Do Not Meet the Citizen and Non-Citizen Status Requirements


(1) Citizen/Alien Waived Emergency Medical (CAWEM) provides coverage for emergency services.
(a) With the exception of subsection (b) below, to be eligible for CAWEM benefits, an individual must:
(A) Be age 19 or older; and
(B) Be ineligible for Plus level HSD Medical Program benefits solely because he or she does not meet the Citizen and Non-Citizen Status Requirements (OAR 410-200-0215 (Citizenship and Non-Citizen Status Requirements)).
(b) Children under age 19 are eligible for CAWEM benefits through December 31, 2017, if the requirement outlined in section (1)(a)(B) is met.
(2) Citizen/Alien Waived Emergency Medical Plus (CAWEM Plus) provides:
(a) CAWEM Plus benefits provide an enhanced benefit package (OAR 410-120-1210 (Medical Assistance Benefit Packages and Delivery System)) for the duration of a recipient’s pregnancy:
(A) To be eligible for the CAWEM Plus benefits, an individual must:
(i) With the exception of paragraph (B) of this part, be age 19 or older;
(ii) Be pregnant; and
(iii) Be ineligible for Plus level HSD Medical Programs solely because they do not meet the Citizen and Non-Citizen Status Requirements (OAR 410-200-0215 (Citizenship and Non-Citizen Status Requirements)).
(B) Children under age 19 are eligible for CAWEM Plus benefits through December 31, 2017, if the requirements outlined in (2)(a)(A) are met;
(C) CAWEM Plus benefits end as follows:
(i) CAWEM Plus benefits continue through and end on the last day of the pregnancy; and
(ii) Through March 31, 2018, the individual remains eligible for CAWEM benefits through the end of the calendar month in which the 60th day following the last day of the pregnancy falls (see OAR 410-200-0135 (Assumed, Continuous, and Protected Eligibility for Children and Pregnant Individuals)).
(b) Reproductive Health Equity Fund (RHEF) benefits, effective April 1, 2018, provide an enhanced benefit package (OAR 410-120-1210 (Medical Assistance Benefit Packages and Delivery System)) and begin on the day following the pregnancy end-date:
(A) An individual is eligible for RHEF benefits through the end of the calendar month in which the 60th day following the last day of the pregnancy falls;
(B) An individual who is receiving CAWEM benefits under section (2)(a)(C)(ii) of this rule shall receive RHEF benefits effective April 1, 2018, through the end of the month in which the 60th day following the last day of the pregnancy falls.
(3) Effective January 1, 2018, Cover All Kids provides the OHP Plus-equivalent benefit package (OAR 410-120-1210 (Medical Assistance Benefit Packages and Delivery System)). To be eligible for Cover All Kids benefits, an individual must:
(a) Be under the age of 19; and
(b) Meet all eligibility requirements for an HSD Medical Program, except they do not meet the Citizen and Non-Citizen Status Requirements (OAR 410-200-0215 (Citizenship and Non-Citizen Status Requirements)).
Source

Last accessed
Jun. 8, 2021