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MEDICAL SERVICES POLICY MANUAL,SECTION D D-200 General Citizenship and Alien Status Requirements

D 220 Alien Status

• The child is under the age of 18. • The child is residing in the U.S. in the legal and physical custody of the U.S. citizenparent after having been lawfully admitted into this country as an immigrant for lawful permanent residence. • If the child has been adopted, the adoption must be final. If a child’s citizenship is questionable, the following documents can be used if needed to verify that the child has acquired U.S. citizenship: • Certificate of Citizenship (N-560 or N-561). • Certificate of Naturalization (N-550 or N-570). If proof of citizenship is needed but documentation is not available, refer the person to the United States Department of Homeland Security (USDHS) for a determination of U.S. citizenship.

D-220 Alien Status MS Manual 01/01/18 431 of PRWORA This section contains policy relating to eligibility requirements for individuals who are aliens or immigrants. The immigration status of aliens who appear to be eligible for Medicaid must be verified. If the applicant claims alien status, he or she must provide documentation from the USDHS verifying their status. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), P. L. 104-193, enacted August 22, 1996, changed Medicaid eligibility for individuals who are not citizens of the United States. This act divides immigrants into two basic categories: • “Qualified Aliens” - those legally living in the United States and meeting one of the conditions at MS D-223 or MS D-224. • “Nonqualified Aliens” - those living in the United States without meeting legal conditionsor those admitted legally but notmeeting one of the conditions at MS D-223 or MS D-224. Medicaid eligibility for aliens is determined by whether the alien is qualified or nonqualified and whether the individual meets the other eligibility requirements for Medicaid. In addition to alien status, the individual must meet all eligibility factors for the category for which he/she is applying. Applicants must provide documentation of qualified alien status for each person for