Page 9

Official source

REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-004

2. Marital Status

Accept attestation. If information is conflicting for any reason, follow up with verifications. Primary Sources a. Bureau of Vital Statistics; b. Marriage license; c. Divorce papers; or d. Separation papers. Secondary Sources a. Local judicial records; b. Social Security Administration. C. Citizenship See 477-000-003. D. Identity Accept attestation. If information is conflicting for any reason, follow up with verifications. See 477-000-003. E. Residency See 477 NAC 6-002, 6-004 for residency requirements for institutionalized individuals and individuals entering a facility. Primary Sources 1. Rent or mortgage receipt, lease, agreement, etc.; 2. A signed statement from a landlord; 3. Property ownership records; or 4. A signed statement from an employer. Secondary Sources 1. A current driver’s license; 2. Utility bills or company records; 3. Verification of vehicle registration from the Department of Motor Vehicles; 4. County assessor records; 5. Post Office records; 6. Church or synagogue records; or 7. A signed statement from an individual(s) who has knowledge of the situation.

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Page 9

Official source

REV. MAY 3, 2018 NEBRASKA DEPARTMENT OF MEDICAID ELIGIBILITY MANUAL LETTER #43-2018 HEALTH AND HUMAN SERVICES 477-000-004

2. Marital Status

Accept attestation. If information is conflicting for any reason, follow up with verifications. Primary Sources a. Bureau of Vital Statistics; b. Marriage license; c. Divorce papers; or d. Separation papers. Secondary Sources a. Local judicial records; b. Social Security Administration. C. Citizenship See 477-000-003. D. Identity Accept attestation. If information is conflicting for any reason, follow up with verifications. See 477-000-003. E. Residency See 477 NAC 6-002, 6-004 for residency requirements for institutionalized individuals and individuals entering a facility. Primary Sources 1. Rent or mortgage receipt, lease, agreement, etc.; 2. A signed statement from a landlord; 3. Property ownership records; or 4. A signed statement from an employer. Secondary Sources 1. A current driver’s license; 2. Utility bills or company records; 3. Verification of vehicle registration from the Department of Motor Vehicles; 4. County assessor records; 5. Post Office records; 6. Church or synagogue records; or 7. A signed statement from an individual(s) who has knowledge of the situation.