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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Arizona Last update 09/27/2016 Section B2. Use of Electronic Data Sources Non-Financial: Electronic Data Source To Be Used (Y/N) Social Security Number Citizenship Immigration Status Residency Age/DOB Pregnancy Household Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Application (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollment (Y/N) If Used for Post- Enrollment Frequency Used (i.e. monthly, quarterly) Comments 1. Social Security Arizona uses the Hub for SSN, Age/DOB, Administration and citizenship. Will only be used for (SSA) YES YES YES NO YES YES NO NO NO YES YES NO YES YES NO Medicare, Residency at Renewal. Will be used for application for potential benefits at application and renewal. 2. Department of Arizona uses steps 1 and 2 through the Hub. Homeland Security YES NO YES YES NO NO NO NO NO NO NO NO YES NO NO For step 3, AZ uses its direct connection to (DHS) - SAVE SAVE. 3. Vital Statistics Vital Statistics is used to verify citizenship YES NO YES NO NO YES NO NO NO NO NO NO YES NO NO and age/DOB if not verified through the Hub. 4. Department of Motor Vehicles YES NO NO NO YES NO NO NO NO NO NO NO YES YES NO (DMV) MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 7