PM 03-01-01-b: Documentation of Citizenship for Medical

WAG 03-01-01-b

  1. Persons not Required to Provide Verification of U.S. Citizenship
  2. Newborns Whose Births Are Covered by HFS Medical Benefits
  3. SSA verification of Citizenship and Identity
    1. 90 day Reasonable Opportunity Period
  4. Acceptable Documents
    1. Good Faith Effort

Persons not Required to Provide Verification of U.S. Citizenship

The following are not required to provide evidence of Revised Text.U.S. citizenship or identity:

  • Medicare recipients New Text.(Do not use the receipt of Medicare as proof of U.S. citizenship),
    •  New Text.An individual's citizenship status should not be changed to U.S. citizen based solely on the receipt of Medicare. Review the Federal Services Hub (FDSH) clearance for verification of U.S. citizenship.
      • New Text.Send a VCL when an individual declares they are a U.S. citizen receiving Medicare benefits, but the FDSH clearance does not provide verification.
  • SSI recipients, and
  • RSDI recipients.

Revised Text.Documentation of U.S. citizenship and identity is required for all other persons receiving medical assistance. This includes persons who received SSI or RSDI at one time and no longer receive it, and the spouse or child of a person receiving RSDI or SSI.

Newborns Whose Births Are Covered by HFS Medical Benefits

Babies born in the U.S. on or after July 1, 2006, to mothers covered by HFS Medical benefits for the newborn's birth are deemed to have met U.S. citizenship and identity documentation requirements. These newborns are not required to submit further documentation of citizenship and identity.

SSA verification of Citizenship and Identity

Social Security Administration (SSA) crossmatch information can be used to meet U.S. citizenship and identity documentation requirements for applicants and recipients of medical benefits. For persons who report to be a U.S. citizen and have an SSN, complete the SSA citizenship inquiry instead of requesting that they present proof of citizenship during the application or REDE process. In IES, ensure that a citizenship Federal Data Services Hub Verification clearance is triggered for all persons who have an SSN and report to be a U.S. citizen.

You may also complete a manual query for persons reporting to be U.S. citizens (who have an SSN) in the following situations:

  • When an application is registered (for each person for whom citizenship and/or identity has not yet been documented).
  • At REDE for each person for whom citizenship and identity has not yet been documented.
  • When a person is being added to a medical case.

A manual SSA citizenship inquiry Revised Text.may be completed from the Wire Third Party Query (WTPY) screen in BlueZone. See WAG 22-14-03-e for instructions about how to complete the inquiry.

90 day Reasonable Opportunity Period

If the SSA inquiry response cannot verify citizenship, certify medical benefits if otherwise eligible. Allow the person a 90 day reasonable opportunity period to provide proof of citizenship.

Acceptable Documents

An individual's citizenship only needs to be established one time. For reapplications, however, the documents used to establish citizenship and identity must be in the case record. If necessary, obtain a copy of the documents from the Revised Text.previous case record and file them in the case record used for the new case.

Some documents contain a statement "DO NOT COPY." Staff are permitted to copy and file these documents in the case record for the official purpose of establishing eligibility for medical programs.

Acceptable documents to establish U.S. citizenship are listed in WAG 03-01-01-b in order of reliability or preference. Request documents from the highest level available to the applicant or recipient. Primary Evidence documents establish both citizenship and identity. Secondary, third-level, and fourth-level documents establish citizenship only, and must be accompanied by identity verification; see PM 03-01-01-c.

Good Faith Effort

For individuals who state they cannot provide the documentation needed, review the list of third and fourth level citizenship documents. If an individual reports that they were unable to obtain the documentation within the 90 day reasonable opportunity period, determine if they made a good faith effort to obtain the documentation. A good faith effort is determined based on all the facts and conditions of each case. Examples of good faith effort include, but are not limited to:

  • individual provides evidence showing that they ordered a copy of their birth certificate from the vital records agency of the state or county where they were born,
  • individual reports to be a naturalized citizen who lost original documents in a fire and provides evidence that they requested the required document from the US Citizenship and Immigration Service.