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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 102 – Non-Financial Requirements Page |28 Effective Date: July 2025 Verification through SAVE for a Naturalized Citizen Verification through the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) database to verify U. S. citizenship for a naturalized citizen when original naturalization papers are not available. Secondary evidence of citizenship is documentary evidence of satisfactory reliability that is used when primary evidence of citizenship is not available within the reasonable opportunity period. In addition, a second document establishing identity must be presented. Secondary Documents Explanation A U.S. public birth record showing birth in one of the following: • One of the 50 U.S. States; • District of Columbia; • American Samoa • Swain’s Island • Puerto Rico (if born on or after January 13, 1941); • Virgin Islands of the U.S. (on or after January 17, 1917); • Northern Mariana Islands (after November 4, 1986 (NMI local time); A birth certificate may be issued by the State, Commonwealth, territory, or local jurisdiction. The birth record must have been recorded before the person was 5 years of age. A delayed birth record document recorded after 5 years of age is considered fourth level evidence of citizenship. ***NOTE: If the document shows the individual was born in Puerto Rico, the Virgin Islands of the U.S. or the Northern Marinara Islands before these areas became part of the U.S. the individual may be a collectively naturalized citizen. Collective naturalization occurred on