Effective Date: March 1, 2026

Previous Policy

Effective July 1, 2006, Medicaid applicants and recipients must document U.S. Citizenship and identity for household members applying for or receiving Medicaid. See 205 and Table IV

An individual is a U.S. citizen if any of the following criteria are met:

Birth in the United States. U.S. citizenship is automatic for individuals born in any of the 50 states, the District of Columbia, Puerto Rico, Guam, the U.S. Virgin Islands, the Northern Mariana Islands. EXCEPTION: Children born in the U.S. to foreign sovereigns or diplomatic officers are not U.S. citizens because they are not subject to the jurisdiction of the United States. It should be noted that for Medicaid purposes, there is not a distinction between U.S. Citizenship and Naturalized citizens.

Naturalization and non-citizen U.S. Nationals. Citizenship may be granted to an individual who was not born in the U.S. or one of its territories if that individual satisfies the legal requirements for naturalization, or the individual is a non-citizen U.S. National from American Samoa or the Swain’s islands. It should be noted that for Medicaid purposes, there is not a distinction between U.S. Citizenship and Naturalized citizens.

Born outside of the U.S. to a U.S. Citizen Parent. If a child is born outside of the United States to a person who is a United States citizen at the time the child is born and citizenship has been claimed, the child is also considered a U.S. citizen for Medicaid purposes.

Automatic Citizenship.

Children, biological or adopted, born in a foreign country automatically become U.S. Citizens when they meet all of the following criteria at the same time on or after February 27, 2001.

At least one parent (biological or adoptive, but not a step-parent) is a U.S. Citizen either by birth or naturalization. The parent may become naturalized after the birth or adoption of a foreign born child; and

The child is under age 18. If an individual has turned 18 before February 27, 2001, or if the child turns 18 before a parent becomes a U.S. citizen, automatic citizenship does not apply; and

The child lives in the United States pursuant to a lawful admission for permanent residence and resides in the legal and physical custody of a U.S. Citizen parent. Permanent resident status could have been granted before, on or after February 27, 2001. The child must be residing with the U.S. Citizen parent on or after February 27, 2001; and

For an adopted child born outside the U.S., the adoption has been finalized either in the country from which the child is being adopted or in the United States. The adoption can take place in another country or in the U.S., and finalization may occur before, on or after February 27, 2001.

Summary: To receive automatic citizenship, the child must be the adopted or biological child of the U.S. Citizen parent, have permanent resident status in the U.S., be residing with a U.S. citizen parent and still be under age 18, on or after February 27, 2001.

When is Automatic Citizenship Effective?

The effective date for automatic citizenship cannot be earlier than February 27, 2001. The effective date is the date when all the criteria are true at the same time on or after February 27, 2001. Once the individual has met this citizenship criteria, a change in circumstances does not affect citizenship status.

Proof of Citizenship.

These children will receive proof of citizenship only upon application to USCIS (formerly known as INS).

If the child does not have a Certificate of Citizenship or U.S. passport, one parent must certify on form N-6006 that the child satisfies the criteria for automatic citizenship, and

Provide documentation of the parent's citizenship, and alternative documentation for the child that establishes that the child meets these requirements. Such documents need to show the child's place of birth (a birth certificate or other medical record), adoption records showing the relationship to the parent and proof of finalization either in the foreign country or the U.S., and USCIS residency status documents.