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UPDATED: NOVEMBER 2009 600

OTHER ELIGIBILITY REQUIREMENTS CITIZENSHIP AND IMMIGRATION STATUS

CITIZENS

Documentation Guide Citizenship and Immigrant Eligibility for Health Coverage in New York State Category 1: U.S. Citizens Category Documentation WMS ACI Code Federal Financial Participation (FFP) Social Security Number (SSN) Requirement United States Citizen: (Includes the 50 U.S. States, the District of Columbia, Puerto Rico, Guam, U.S. Virgin Islands, and American Samoa, Swain’s Island and the Northern Mariana Islands for purposes of Medicaid eligibility.)

Note: Listed are the most common documents used to prove U.S. citizenship. The list is not exhaustive and there are other documents that can establish U.S. citizenship.

CITIZENSHIP REMINDERS: A birth certificate can no longer be accepted as proof of both citizenship and identity. If the birth certificate is presented as proof of citizenship, the worker must obtain another form of identity document from the Identity documentation list, such as a driver’s license. All documents must be originals or copies certified by the issuing agency. Workers are required to photocopy the original/certified copy and annotate the copy with their initials and the date of the review. Primary Documents (No other document required) ►U.S. Passport; ►Certificate of Naturalization (N-550 or N-570); or ►Certificate of U.S. Citizenship (N-560 or N-561). __________________________________________ Secondary Documents (When a primary document is unavailable, a secondary document may be used, but also requires ONE identity document from the identity documentation list below.) ►U.S. Birth Certificate showing birth in one of the 50 U.S. States, District of Columbia, American Samoa, Swain’s Island, Puerto Rico (if born on or after 1/13/1941), Virgin Islands of the U.S. (on or after 1/17/1917), Northern Mariana Islands (after 11/4/1986 [NMI local time]), or Guam (on or after 4/10/1899); ►Certification of Report of Birth issued by the Department of State (DS-1350); ►Report of Birth Abroad of a U.S. Citizen (FS-240); ►Certification of birth issued by Department of State (Forms FS-545 or DS-1350); ►U.S. Citizen Identification Card (I-197 or I-179); ►Northern Mariana Identification Card (I-873); ►American Indian Card with classification code of “KIC” (I-872); ►Final adoption decree showing U.S. place of birth; ►Evidence of U.S. civil service employment before 6/1/1976; ►Military record of service showing U.S. place of birth (i.e., DD-214); or ►Evidence of qualifying for U.S. citizenship under the Child Citizenship Act of 2000.

C

YES

A SSN is an eligibility requirement for all citizens applying for Medicaid or FHP.

Note: Pregnant women are excluded from this requirement. (MRG)