Medical Copays and Out-of-Pocket Costs in the URM Program
Policy Letter 18-02
Date: April 2, 2018
ORR-funded medical assistance is available only to those participants in the URM program who are ineligible for Medicaid and CHIP, pursuant to 45 CFR 400.100(a)(1). State Letter #15-02, “Medical Assistance in the Unaccompanied Refugee Minors Program,” clarified that URM participants who are eligible or enrolled in Medicaid or CHIP are not eligible to receive ORR-funded medical assistance in the form of supplementary funding. This includes copays and out-of-pocket costs not covered by Medicaid.
States currently covering copays and out-of-pocket costs with ORR funding must find an alternative by June 1, 2018. States may no longer include a line item in their ORR-1 to pay for copays or out-of-pocket costs. The use of ORR funding to cover these costs is out of compliance with ORR regulations and State Letter #15-02.
States may need to coordinate with their state foster care agency and Medicaid office to better understand the services available to youth in their state. If a state wishes to provide services beyond the range of services provided by Medicaid, the state may need to explore opportunities for private partnership, including pro bono services.
If you have questions about the information in this Policy Letter, please contact Anne Mullooly at 202-401-5369.
E. Scott Lloyd