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N Cal Attorney
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Can a legal non-immigrant receive a health care benefits or

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Can a legal non-immigrant receive a health care benefits or assistance when having End Stage Renal Disease? The patient is in the united states on a diplomatic visa but is hospitalized currently and does not have any coverage besides travel insurance that does not cover dialysis outpatient. What are the options that are available for this patient and any financial assistance that is available? Private insurance and medi-cal has been denied due to the lack of social security number and lack of work authorization. Please if you could guide me and let me know if there are options for this patient. Thank you.

Submitted: 10 months ago.
Category: Legal
Expert:  N Cal Attorney replied 10 months ago.
I am sorry to hear this.

My opinion is that a person in the situation you describes is eligible for "limited Medi-Cal Special Treatment Program" and/or "Emergency Medi-Cal" benefits for dialysis because the person is a legal resident, even though holders of nonimmigrant visas are not eligble for regular Medi-Cal, see
http://www.dhcs.ca.gov/services/medi-cal/eligibility/Documents/Article17-Medi-CalTreatmentPrograms.pdf which states at page 5:
"Persons who need dialysis, or total parental nutrition (TPN), and related services may be eligible for limited Medi-Cal Special Treatment Programs coverage if all of the following conditions are met in a month:
o In need of dialysis, or TPN, and related services;
o Not eligible for regular Medi-Cal because of excess property;
o Not currently eligible for Medicare if under age 65 (applies only to Dialysis);
and
o Meet standard Medi-Cal requirements for citizenship or legal immigration status,
linkage, cooperation, and residency.
o For TPN 'Only": Medi-Cal linkage requirements are not necessary."

It is scandalous that whichever country sent the person here on a diplomatic visa is not itself paying for this type of necessary medical care.

http://healthconsumer.org/Medi-CalOverview2008Ch14.pdf
states:
"Those immigrants who are not eligible for full scope Medi-Cal still can receive emergency and pregnancy-related services under restricted or emergency Medi-Cal, as well as other types of services. This chapter explains the range of publicly funded health services available to these immigrants."
///
"Long-Term Care and Kidney Dialysis
Long-term care services are provided for “otherwise eligible” immigrants through a state-funded program. Initially, the state created a state-funded program of long-term care and renal dialysis for “not qualified” and undocumented immigrants as a result of a court decision. The Department of Health Care Services, formerly known as the Department of Health Services, acknowledged that “’in most cases renal dialysis does constitute ‘emergency’ treatment’ for which federal financial participation is available….” The court interpreted the statute as creating a “safety net” program to only fund long-term care and renal dialysis that did not qualify for federal reimbursement as an “emergency medical condition.” "

Here is a Court of Appeal opinion on the similar issue of emergency medical care for people wthout any type of visa at all. That opinion states: " plaintiffs were granted a preliminary injunction preventing DHS from (1) denying restricted-scope coverage under Medi-Cal to undocumented aliens needing long-term care or dialysis"

I hope this information is helpful.
Customer: replied 10 months ago.
Thank you for the information. Unfortunately medical was denied as it was mentioned in the question section. It is expected that the person on a diplomatic visa is suppose to pay for the survives and that was initially planned for a person to buy a private insurance with high premiums and deductibles but unfortunately US laws have many limitations where the person with no work visa but with legal non immigrant visa cannot file for social security in order to apply for that same private insurance. As a result the patient is not allowed to purchase private insurance but at the same time is not capable to pay for dialysis treatments 3 times a week around $500-600 per session resulting in $1500 a week! I do not think US citizens themselves would be able to pay this amount weekly. Also, what is very saddening is the fact that with loopholes existing in US laws, a person illegally residing in US can get medi-cal coverage but someone who is legally living in US on a non immigrant visa, and who unfortunately have to remain on dialysis treatment 3times a week to remain alive cannot get any assistance nor even private insurance with high premiums and diductibles. Now this loophole should be scandalous not the fact that no one person or state or country is crabapple of paying $1500 for treatment that a patient was placed here in US. There should be at least some clause that will allow the patient receive SS# XXXXX the insurance company can allow them to buy the private insurance?
Expert:  N Cal Attorney replied 10 months ago.
My opinion is that Medi-Cal should not have denied an application for emergency Medi-Cal.

I am sorry that health care is a for profit business, and that Medi-Cal is run by bureaucrats whose first instinct is to deny all applications.

I believe there is a real likelihood that a Medi-Cal appeal would succeed, and that social security is not going to assist the person. The person can reapply for Medi-Cal and make it clear to the caseworker that she is applying specifically for Emergency Medi-Cal.

N Cal Attorney, Attorney
Category: Legal
Satisfied Customers: 8152
Experience: since 1983
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Expert:  N Cal Attorney replied 10 months ago.
Thank you for the positive rating!

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