219.03 Required Verification SR 94-59, 07/94 (FAM-A)

The individual who signs Form 800, Application, on behalf of the child must provide verification of all eligibility criteria.

• Require written verification of the child’s:

- residency,

- date of birth,

- enumeration status,

- alien or citizenship status, and

- income information.

• Require verification of resources for CH coverage.

Exception: Written verification is not required with Form 800P, Application for Medical Assistance for Low Income Pregnant Women and Children. The required verification listed above will be provided to the prenatal clinic worker. The worker provides a written statement to the District Office which includes the types of verifications seen, for whom the verification is provided and signs the statement. Copies of verification are not mandatory but encouraged when feasible.