Page 3
MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL MEDICAL VERIFICATION MATRIX MAABD Type of Verification MAGI Household Specialized Medicaid Institutional HCBW Medicare Beneficiary SSI Identification and Citizenship Verification of identity may be required as part of citizenship documentation. Identity documentation is not a separate requirement from citizenship. Verify Verify Verify Verify Verify Social Security Number Verified through the NUMIDENT system. Verify Verify Verify Verify Verify Household Composition Customer Statement Customer Statement Customer Statement Customer Statement Customer Statement Pregnancy & Unborn Count Customer Statement Customer Statement Customer Statement Customer Statement Customer Statement Caretaker Relative Customer Statement Customer Statement N/A N/A N/A Residency Customer Statement Customer Statement Customer Statement Customer Statement Verify Income (Earned/Unearned) Verify current monthly income using electronic data sources including SNAP/TANF case information. Use the most current source of information available. Verify Verify Verify Verify Verify Insurance/TPL Verify Post- Eligibility Verify Post- Eligibility Verify Post-Eligibility Verify Post-Eligibility Verify Post- Eligibility Duplicate Assistance (includes out of state benefits) Verify Verify Verify Verify Verify Resources N/A; *Verify only if Dual Eligible N/A Verify Verify N/A APPENDIX A INCOME RESOURCE CHARTS VERIFICATION MATRIX Division of Social Services Medical Assistance Manual 25 July MTL 06/25