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OTHER ELIGIBILITY REQUIREMENTS CITIZENSHIP AND IMMIGRATION STATUS

NATIVE AMERICANS

Category

Documentation WMS ACI CODE Federal Financial Participation SSN Requirement Native Americans born outside the U.S. who belong to a federally recognized tribe ► A membership card or other tribal document demonstrating membership in a federally recognized Indian Tribe under Section 4 (e) of the Indian Self- determination and Education Assistance Act [25 U.S.C. §450b (e)] and satisfactory evidence of birth outside the U.S.

C

YES

YES Canadian born Native Americans ►I-94 coded “S1-3”; ►I-551 Alien Registration Card stamped “S1-3”; ►Temporary I-551 stamp coded S1-3 in a Canadian passport; ►Tribal Record or document certifying at least 50% American Indian blood, as required by Section 289 of the INA; and satisfactory evidence of birth in Canada, such as a birth certificate or baptismal Certificate issued on a reservation;

C

YES

YES Native Americans born in Canada ►I-94 coded “S1-3”; ►I-551 Permanent Resident Card stamped “S1-3”; ►Temporary I-551 stamp coded S1-3 in a Canadian passport; ►Tribal Record or document certifying at least 50% American Indian blood, as required by Section 289 of the INA; and satisfactory evidence of birth in Canada, such as the following: -a Birth certificate or Baptismal Certificate issued on a reservation; -Letter from Canadian Department of Indian Affairs; or -School Records.

C

YES For the purpose of Medicaid, Native Americans are classified as U.S. citizens.

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

Note: Pregnant women are excluded from this requirement.

Native Americans belonging to a Federally recognized Tribe born outside the U.S. -Membership card or other tribal document demonstrating (i.e., tribal card), membership in U.S. federally recognized Indian tribe under Section 4(e) of the Indian Self-Determination and Education Assistance Act and satisfactory evidence of birth outside the U.S.

C YES

(MRG)