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Title 8: Medicaid Page 4 Iowa Department of Health and Human Services Employees’ Manual Chapter C: Nonfinancial Eligibility Citizenship Revised October 10, 2025 Declaring Citizenship or Alien Status Declaring Citizenship or Alien Status Legal reference: 42 CFR 435.407, 441 IAC 75.11(2)“b”, P. L. 99-603, Sec. 121, P. L. 104-193 Medicaid applicants must:  Declare their citizenship or alien status as part of the application process.  Have their status verified. (See Verifying Citizenship and Identity for citizenship verification requirements. For information about acceptable forms of verification for aliens, see 8-L.) As a condition of eligibility, an attestation of citizenship or alien status shall be made for all applicants and members:  On a state-approved Medicaid application or review form, or  On form 470-2549, Statement of Citizenship Status. Applicants and members must attest to their citizenship or alien status. The attestation may be signed by:  The applicant or member, or  Someone acting responsibly on the applicant’s or member’s behalf if the applicant or member is incompetent or deceased, or  By any adult member of a family or household for whom Medicaid is being requested or received. If this attestation is not made, the person for whom the attestation is required is not eligible for Medicaid (except emergency medical assistance). Persons Exempt from Verification Legal reference: 42 CFR 435.406, 435.407; 441 IAC 75 (Rules in Process), Sections 211(a) and 211(b)(3) of Public Law 111-3 Policy: Unless specifically exempted, all Medicaid applicants or members who claim to be United States citizens are required to have their citizenship and identity verified as a condition of eligibility. The requirement to verify citizenship and identity does not apply to the following people who claim to be United States citizens:  Current recipients of Supplemental Security Income (SSI), including 1619b individuals.