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Manual Title Chapter Page Revision Date Virginia Medical Assistance Eligibility M02 October 2013 Subchapter Subject Page ending with Page M0220.000 CITIZENSHIP & ALIEN REQUIREMENTS M0220.100 2 M0220.100 CITIZENSHIP AND NATURALIZATION

A. Introduction A citizen or naturalized citizen of the United States meets the citizenship requirement for medical assistance (MA) eligibility, and is eligible for all MA services if he meets all other eligibility requirements. B. Citizenship Determination 1. Individual Born in the United States An individual born in the United States, any of its territories (Guam, Puerto Rico, United States Virgin Islands, or Northern Mariana Islands), American Samoa, or Swain's Island is a United States citizen. A child born in the United States to non-citizen parents who are in the United States as employees of a foreign country’s government may not meet the United States citizen requirement. When a child born in the United States to non- citizen parents is a United States citizen by birth, the child may not meet the Virginia residency requirements in M0230.201 because of the parents’ temporary stay in the United States. 2. Individual Born Outside the U.S. a. Individual Born to or Adopted by U.S. Citizen Parents A child or individual born outside the United States to U.S. citizen parents (the mother, if the child was born out-of-wedlock) automatically becomes a citizen by birth. A child under age 18 years who is a lawful permanent resident, who is currently residing permanently in the U.S. in the legal and physical custody of a U.S. citizen parent, and who meets the requirements applicable to adopted children under immigration law automatically becomes a citizen when there is a final adoption of the child, and does not have to apply for citizenship. b. Individual Born to Naturalized Parents A child born outside the United States to alien parents automatically becomes a citizen after birth, if his parents (the mother, if the child was born out-of- wedlock) are naturalized before he becomes 16 years of age. c. Naturalized Individual A child or individual born outside the U.S. and not automatically a citizen as in a) or b) above must have been naturalized to be considered a citizen. C. Verification 1. Requirements The DRA requires that satisfactory documentation of citizenship and identity must be obtained for all enrollees who claim to be U.S. citizens. Enrollees who claim U.S. citizenship must have a declaration of citizenship AND documentary evidence of citizenship and identity in their case records. 2. Exceptions to Verification Requirements The following groups of individuals are NOT required to provide verification of C&I. Document in the case record why an individual is exempt from verifying C&I: