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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. Chart 1 – Primary Evidence of Citizenship Primary Documents Explanations and Notes on Documentation 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. Certificate of Naturalization (N-550 or N-570) Department of Homeland Security issues for naturalization. Certificate of Citizenship (N-560 or N-561) Department of Homeland Security issues certificates of citizenship to individuals who derive citizenship through a parent. MA Secondary Documents to Establish US Citizenship (Chart 2) Secondary evidence of citizenship is documentary evidence of satisfactory reliability that is used when primary evidence of citizenship is not available. In addition, a second document establishing identity MUST also be presented as described in Chart 5, Evidence of Identity. Available evidence is evidence that exists and can be obtained during the normal application period of 45 days for AR/AX applicants/recipients or 90 days for SR/QM applicants/recipients. Accept any of the documents listed in this Chart as secondary evidence of US citizenship 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). Chart 2 – Secondary Evidence of Citizenship Secondary Documents Explanations and Notes on Documentation A US public birth record showing birth in: • one of the 50 US The birth record document may be issued by the state, commonwealth, territory or local jurisdiction. It must have been issued before the person was 5 years of age.