Documentation of US citizenship is required by all applicants and recipients of federally-funded Medicaid, except that the following persons are exempt from the requirement:
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Persons who are not US citizens or nationals,
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Persons receiving Supplemental Security Income (SSI),
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Persons receiving Social Security Disability Income (RSDI),
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Persons eligible for any Part of Medicare,
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Children in Foster Care,
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Children receiving Adoption Subsidy Assistance, and
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Children born to mothers where the mother is a Medicaid recipient at the time of the child's birth.
At the time of application, US citizens who are not exempt must provide a valid and verifiable Social Security Number. Once provided, that SSN initially fulfills the citizenship documentation requirement. If otherwise eligible, approve the applicant for a full certification period. Once eligible, ESA conducts a computer match with the Social Security Administration. If SSA verifies US citizenship, the citizenship documentation requirement is fulfilled.
Reasonable Opportunity Period
If the computer match with SSA does not result in verification of US citizenship, the recipient must be notified of their responsibility to provide documentation of citizenship. The recipient has a ninety-day “reasonable opportunity period” to provide documentation. During this period, the recipient remains eligible for Medicaid. If no documentation is provided, terminate Medicaid after timely and adequate notice. Persons who are terminated from Medicaid for failure to provide citizenship documentation are not eligible for the DC HealthCare Alliance.
A recipient who contacts the agency and states that he/she is having difficulty obtaining the information may be given an additional 90 days to provide the needed documentation.
Acceptable Documentation
To establish US citizenship in cases where the computer match with SSA does not verify citizenship, the documentation must show:
· A US place of birth, or
· that the person is a US citizen.
Unless the document showing citizenship includes proof of identity, a document showing identity is also required.
To establish identity the document must show:
· evidence that provides identifying information that relates to the person named on the document
Proof of citizenship with identity is required for all members of an MA group, with the exception of the exempted person listed above.
All documents must be either originals or copies certified by the issuing agency. Copies or notarized copies may not be accepted. Faxed copies of documents may not be accepted. A copy of the document must be maintained in the case record.
Documents Establishing US Citizenship and Identity
The following charts list the acceptable evidence of US citizenship and/or identity. Charts 1 through 4 cover evidence of citizenship. Charts 1 and 5 cover evidence of identity. If an individual presents documents from Chart 1, no other information is required, since these documents verify citizenship and identity. If an individual presents documents from Charts 2 through 4 to verify citizenship, then an identity document listed in Chart 5 must also be presented. Charts 1 through 4 establish a hierarchy of reliability of citizenship documents. The applicant/recipients must provide the most reliable document that is available. The following instructions specify when a document of lesser reliability may be accepted.
Primary Documents to Establish Both US Citizenship and Identity (Chart 1)
Primary evidence of citizenship and identity is documentary evidence of the highest reliability that conclusively establishes that the person is a US citizen. In general, obtain primary evidence of citizenship and identity before using secondary evidence. Accept any of the documents listed in this chart as primary evidence of both US citizenship and identity if the document meets the criteria listed under “Explanations and Notes” and there is nothing indicating the person is not a US citizen (e.g. lost US citizenship).
Note: Persons born in American Samoa (including Swain’s Island) are usually US non-citizen nationals. References in these instructions to “citizens” should be read as references to non-citizen nationals with respect to these persons. There is no difference in terms of their Medicaid eligibility.
Note: References to documents issued by the Department of Homeland Security (DHS) include documents issued by its predecessor, the Immigration and Naturalization Services (INS). On March 1, 2003, the former INS became part of DHS, and its naturalization function was assumed by US Citizenship and Immigration service (USCIS) within DHS. However, even documents issued after this date may bear INS legends.
Applicants or recipients born outside the US who were not citizens at birth must submit a document listed under primary evidence of US citizenship.
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Chart 1 – Primary Evidence of Citizenship
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Primary Documents
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Explanations and Notes on Documentation |
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US passport |
The Department of State issues this. A US passport does not have to be currently valid to be accepted as evidence of U.S. citizenship, as long as it was originally issued without limitation.
Note: Spouses and children were sometimes included on one passport through 1980. US passports issued after 1980 show only one person. Consequently, the citizenship and identity of the included person can be established when one of these passports is presented.
Exception: Do not accept any passport as evidence of US citizenship when it was issued with a limitation. However, such a passport may be used as proof of identity.
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Certificate of Naturalization (N-550 or N-570)
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Department of Homeland Security issues for naturalization. |
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Certificate of Citizenship
(N-560 or N-561) |
Department of Homeland Security issues certificates of citizenship to individuals who derive citizenship through a parent.
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