303.05 Verification of Citizenship and Identity (MAM) |
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Verify citizenship and identity of each assistance group member at the initial determination of eligibility. Verify the identities of new members before adding them to the group.
For most applicants of medical assistance, citizenship and identity is verified via an electronic data crossmatch process through the federal services data hub, which uses the medical assistance applicant's SSN, name, and date of birth to verify citizenship and identity information with SSA records. If the hub crossmatch fails to verify an applicant's citizenship and identity, or the applicant is unable or is not required to provide a SSN, acceptable documentary proof of citizenship and identity must be provided.
The documents detailed in the chart below are considered the only acceptable forms of documentary proof for citizenship and identity when applying for most categories of medical assistance. See the list of individuals who are exempt from these requirements below.
Citizenship and identity documents that are photocopied, faxed, scanned or otherwise copied are considered valid proofs, unless the information on the copy is inconsistent with other available information or the validity of the copied document is questionable.
PROOFS THAT VERIFY BOTH CITIZENSHIP and IDENTITY NO OTHER DOCUMENTATION IS NECESSARY TO VERIFY CITIZENSHIP AND/OR IDENTITY IF A DOCUMENT FROM THIS TOP SECTION IS PROVIDED |
. US Passport or Passport Card (valid or expired if issued without limitation) |
. Certificate of Naturalization |
. Certificate of US Citizenship |
"Enhanced" State Driver's License (from a state that verifies US Citizenship before issuing license. License must say "Enhanced Driver License") |
Documents issued by a federally recognized Indian Tribe |
Verification of Citizenship via a Federal or Another State Agency (if done after 7/1/06) |
OR
To verify CITIZENSHIP, an individual can submit: 1 Citizenship Document from Column A along with 1 Identity Document from Column B.
COLUMN A CITIZENSHIP DOCUMENTS |
COLUMN B IDENTITY DOCUMENTS |
. US Birth Certificate from one of the 50 states and DC; Or PR, Guam, USVI, American Samoa, Swain's Island, or CNMI (some date restrictions apply) . Certification of Report of Birth of US Citizen . Report of Birth Abroad of US Citizen . Certification of Birth . Birth Record Documented by Cross-Match with State Vital Statistics . US Citizen ID Card |
. Picture Driver's License (issued only by a US state or territory) . Picture School ID . US Military or Draft Card . State, Federal, or local government ID Card . Certificate of Degree of Indian Blood or Tribal Document with Picture . Military Dependent ID Card . US Coast Guard Merchant Marine Card |
. Northern Mariana ID Card (birth prior to 11/4/86) . Evidence of US Civil Service Employment (prior to 6/1/76) . Final Adoption Decree with child's name and US birthplace (If the adoption is not final, a statement from a state approved adoption agency showing the child's name and US birthplace.) . US Military Record showing US birthplace . Data Verification with SAVE Program (or other Dept. of Homeland Security verification process) . Proof of a child meeting the requirements in Section 101 of the Child Citizenship Act of 2000 . Hospital, clinic, doctor, nursing facility, skilled care facility or other medical institution records showing a US birthplace. . Life, health or other insurance records indicating a US birthplace. . Official religious documents, recorded in the US, showing a US birthplace. |
. Voter's Registration Card . Proof of Identity Verified by a Federal or State Gov't. Agency, such as: A Public Assistance, Law Enforcement, Internal Revenue, Tax Bureau, or Corrections Agency
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. 2 or more documents together, having the individual's name and consistent identifying information, such as: - Employer ID Cards - High School/HS Equivalency or College diplomas - Marriage Certificates - Divorce Decrees - Property Deeds/Titles |
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. Pre-school, school, Head Start or daycare records with child's name and US birthplace . Federal or state census records showing US citizenship or US birthplace |
Special Identity Rules for Children Aged 19 and Younger Clinic, doctor, hospital, or school records, including nursery/daycare records or report cards. |
If the above citizenship documents are unavailable, an individual can submit an affidavit to prove citizenship. It must be signed, under penalty of perjury, by another person who can attest to the individual's citizenship. The affidavit must contain the individual's name, date of birth, and US place of birth. It does not have to be notarized. |
If the above identity documents are unavailable, an individual can submit an affidavit, signed under penalty of perjury, by another person who can attest to the individual's identity. The affidavit must contain the individual's name and other identifying information, such as age, sex, race, height, weight, eye color or address. It does not have to be notarized. |
Individuals must be assisted in obtaining acceptable documentary evidence of citizenship, if assistance is needed. |
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Exceptions to the Above Citizenship & Identity Requirements:
The following individuals are exempt from the more restrictive identity and citizenship requirements described above:
. individuals who are entitled to or enrolled in Medicare (Part A, Part B, or Part D, for example);
. individuals who receive SSI, verified via the SDX;
. individuals who receive SSDI;
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. newborn infants born to women who are current Medicaid recipients. Consider newborns who meet this criteria to have met citizenship and identity requirements at birth. No further proof is needed at subsequent redeterminations. This group includes children whose births were covered by Emergency Medicaid for Non-Citizens; and
. children receiving either Title IV-B services or Title IV-E adoption or foster care payments.
These exempted individuals can verify:
. citizenship with acceptable forms of proof such as birth or hospital records, voter registration cards, U.S. passport, and Bureau of Citizenship and Immigration Services (BCIS) documentation; and
. identity using any document that reasonably establishes the individual's identity. If no document is available, use a collateral contact.
Deny medical assistance to any individual who does not provide proof of citizenship and identity.
Exception: If applicants for medical assistance meet all other program eligibility requirements and the inability to verify citizenship and/or identity is the only reason that prevents a determination of eligibility for the applicant household because.
. the SSA data crossmatch failed to verify the applicant's citizenship and/or identity; or
. the applicant is unable to provide citizenship and/or identity documentation; or
. the applicant is unable or not required to provide a SSN.
.do not automatically deny assistance. Instead, allow the applicant 95 days from the date of the notice of decision (NOD) to provide the required citizenship and/or identity documentation.
. For applicants who are able to use the SSA data crossmatch, the NOD is the New HEIGHTS-generated DX0011, Citizenship Verification Request.
. For applicants who are not able to use the SSA data crossmatch, the NOD is the generic open notice for medical assistance.
If the required documentation is not provided within 95 days from the date of the NOD, terminate medical assistance for the individuals who have failed to provide documentation.
References: He-W 606.02, He-W 606.28, 42 CFR 435.406-407, 45 CFR 233.50, 8 USC 1611-1613