Ronald Fatoullah & Associates - Elder Law

Proof of Citizenship - May Require More Then You Think


As of April 1, 2010, the face to face interview is no longer a requirement for Medicaid applicants in New York. This change, along with the new Medicaid application form, is intended to simplify the application process. Nevertheless, the documentation requirements mandated by the Deficit Reduction Act of 2005 are still in place.

Applicants must continue to submit original documentation verifying their citizenship. Client Representatives, Hospitals, Nursing Homes or Facilitated Enrollers can review original documents, make copies and write a statement on the copy that the originals were seen. Individuals who are in receipt of Medicare benefits or SSI/ SSD remain exempt from these validation requirements.

Medicaid applicants who do not receive Medicare, SSI or SSD can visit a local Medicaid office or a facilitated enroller, who will make a copy of the originals and note that they saw the original, the date seen, the entity's name and the staff member's name.

The new provisions do not affect immigrants. Individuals with satisfactory immigration status can continue to receive Medicaid benefits in New York.

States are at risk of losing their federal matching funds if they do not obtain documentary evidence from citizen applicants. There are four levels of documentation which can be used for submission. United States passports or Certificates of Naturalization or Certificates of U.S. Citizenship are considered "primary" documents. If the applicant does not have one of these documents, a birth certificate is acceptable as long as it is submitted with another document.

Secondary documents, such as a birth certificate, U.S. Citizen I.D. Card, final adoption decree, or U.S. military record, do not establish identity. Hence, an applicant who uses a secondary document to prove citizenship must also have another document, such as doctor or hospital record, school record, or affidavit (signed under penalty of perjury) to prove identity.

As long as there is nothing to indicate that the applicant is not a U.S. Citizen, when a primary or secondary document is not available, the applicant may provide a third level document, such as an extract of a hospital record on hospital letterhead, religious record, early school record or a life, health or other insurance record if it shows a U.S. place of birth and was created at least 5 years prior to the Medicaid application date.

Fourth level documents such as a Federal or State census record, hospital record or statement signed by a physician present at the time of birth, or two affidavits satisfying specific requirements including the fact that the affiant cannot be related to the applicant, may be used.

At the time of the application or re-determination, the Medicaid agency must give an applicant a reasonable opportunity to present documents establishing U.S. citizenship and identity. The agency should assist the applicant in securing the documentation if he/she tries in good faith to present the documentation.

Effective December 2009, individuals who file United States Citizenship and Immigration Services applications at certain USCIS facilities will now be able to receive an email or text message informing them of acceptance of their application. However, a copy of the email or text message will not be accepted as evidence to HRA that USCIS has granted immigration status to a Medicaid applicant.

It is recommended that citizenship and other personal documentation be kept in a secure location, and available for presentation, regardless of the need for a Medicaid application.

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