Citizenship, identification and income documentation required for approval of Medicaid

Fact Sheet

Citizenship, Identification and Income Documentation Required for Approval of Medicaid

Overview
The Georgia Department of Community Health (DCH) sets Medical Assistance eligibility policy, including Medicaid and PeachCare for Kids, based on state and federal laws and regulations. The Georgia Department of Human Services (DHS), Division of Family and Children Services (DFCS), implements Medical Assistance policies. County DFCS offices determine eligibility for Medical Assistance applicants. DCH provides DFCS with policy guidance to implement the Citizenship and Identity Documentation Requirement as defined in the Federal Deficit Reduction Act of 2005 (DRA).
An overview of the DRA Citizenship and Identity Documentation policy is below.
Note: Medical Assistance applicants and members are required to verify their citizenship and identity only once. It is not required at their next eligibility renewal. Original documentation of citizenship or identity is no longer required for the Medical Assistance eligibility determination.
Citizenship/Identification Policy Overview
In January 2006, the state of Georgia began requiring Medical Assistance applicants and members to verify their U.S. citizenship. The DRA provided further guidelines to Georgia about the documentary evidence required before Medical Assistance eligibility is granted or renewed. This guidance became effective July 1, 2006. The DRA provisions require that a person submit evidence of both citizenship and identity.
The DRA specifies certain forms of acceptable evidence of citizenship and identity and provides for the use of additional forms of documentation as established by federal regulations.

Exempt Groups from Citizenship, Identification and Income Documentation Requirements
Individuals who receive Supplemental Security Income (SSI) benefits.
Children who receive federal foster care or adoption assistance benefits.
Children in foster care receiving child welfare services.
Individuals on Social Security disability.
Individuals receiving Medicare.
No verification of citizenship/identity is required for newborns whose mother was enrolled in Medicaid on the newborn's date of birth.

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A required-order approach must be used in which documentary evidence of citizenship and identity is sought first from a list of primary documents. If an applicant or member presents evidence from the list of primary documentation, no other information will be required. When such evidence cannot be obtained, the state will look to the next tier of acceptable forms of evidence.
A reasonable opportunity period may be granted to an applicant who needs more time to provide these documents.
Citizenship and Identification Document Rules
To verify citizenship and identity: U.S. Passport (not limited passports). Certificate of Naturalization (N-550 or N-570). Certificate of Citizenship (N-560 or N-561).
If the above documents are not available, then any of the following documents may be accepted to verify citizenship only:
U.S. Public Birth Record showing birth in one of the 50 states; District of Columbia; American Territories; or Guam. U.S. birth certificate or data match with a State Vital Statistic Agency. Certification of Report of Birth (DS-1350). Consular Report of Birth Abroad of a Citizen of the U.S. (FS-240). Certification of Birth Abroad (FS-545). U.S. Citizen Identification Card (I-197 or the prior version I-179). American Indian Card (I-872) with the classification "KIC" (Issued by DHS to identify U.S. citizen members of the Texas Band of Kickapoos living near the US/Mexican border). Collective Naturalization document/Northern Mariana Identification Card (I-873). Final Adoption Decree (Showing child's name and U.S. birthplace). Evidence of civil service employment by the U.S. government. Official Military Record (Showing a U.S. birthplace).
Federal or state census record showing U.S. citizenship indicating a U.S. birthplace. Tribal census record for Seneca Indian Tribe or from the Bureau of Indian Affairs. Statement signed by the physician or midwife who was in attendance at the time of birth. One of the following documents created at least five years before the application for Medical Assistance showing a U.S. birthplace:

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Extract of hospital record on hospital letterhead issued at the time of person's birth. Life, health or other insurance record. An amended U.S. Public Birth Record. Medical clinic, doctor or hospital record indicating a U.S. birthplace. Institutional admission papers from nursing home, skilled nursing care facility or
other institution.
The DFCS Medicaid Eligibility Specialist (MES) may be able to complete a computer match with Vital Records to verify citizenship if the applicant was born in Georgia. Additional information may be required. The DFCS MES will contact the applicant if another document is still needed.
To verify identity only: State Driver's License bearing the individual's picture or Georgia Identification Card. Certificate of Indian Blood; U.S. American/Alaska Native Tribal Document; or Native American Tribal Document. U.S. Military Card or draft record; Military dependent's ID card with photograph; U.S. Coast Guard Merchant Mariner Card. Identification card issued by federal, state or local government agencies or entities with photo or identifying information. Official School Identification card with a photograph (Purchased ID cards offered by companies at the schools are not acceptable). U.S. Passport issued with limitations. Data matches or documents from law enforcement or corrections agencies such as police or sheriff's departments, parole office, Department of Juvenile Justice (DJJ) and Youth Detention Centers.
For individuals under age 16 who are unable to produce a document listed above, the following documents are acceptable to establish identity only:
School record including report card, day care or nursery school record; must verify record with issuing school. Immunization Certificate Form 3231. Clinic, doctor or hospital record showing birth date. Affidavit signed under penalty of perjury by a parent/guardian (Contact DFCS). A signed Declaration of Citizenship form that includes the child's date and place of birth (Contact DFCS).

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The document(s) must provide identifying information about the person named on the document. The DFCS MES will assist the applicant in locating additional documents that verify identity and citizenship if none of the documents listed above is available.
The Georgia eligibility system uses an automated process for verifying the citizenship/ID or nationality of Medical Assistance applicants declaring to be U.S. citizens or nationals using the State Verification Exchange System (SVES). Georgia submits to the Social Security Administration (SSA) an applicant's name, Social Security Number (SSN), and date of birth (DOB) for comparison with information that SSA has in its Master File of SSN Holders ("Numident"). A response from SSA that confirms the data submitted by the State is consistent with SSA data, including citizenship or nationality, meets the citizenship/ID verification requirements. No further action is required for the State or individual and no additional verification of either citizenship or identity is required.
If a SVES citizenship/ID match is not returned, eligibility staff will allow a reasonable opportunity period for the applicant to return required documentation.
Income Document Rules
Income can be either earned or unearned income. Some income is included in the applicant's budget to determine Medical Assistance programs and some income is not included. Per regulations, certain types of income are entitled to allowable deductions. It is important for the applicant to report all income.
Income consists of wages, Social Security, unemployment benefits, etc.
A month's worth of income verification is needed at a minimum to obtain a representative monthly amount to determine the applicant's Medical Assistance.
If an electronic source is not available, income can be verified using the most recent four weeks' worth of check stubs, employer statements, Social Security award letters, unemployment compensation award letters, court documents, tax records (for self-employment), etc.

The following Medical Assistance categories are subject to Modified Adjusted Gross Income (MAGI) rules effective January 1, 2014:
Pregnant Women Children under 19 years of age Parents Caretakers/with children under age 19 Planning for Healthy Babies (P4HB) PeachCare for Kids

Please Note
Georgia opted not to expand Medicaid for the New Adult Group people ages 19-64.

Modified Adjusted Gross Income (MAGI) is taxable income minus deductions. Allowable deductions under MAGI are pre-tax deductions, 1040 deductions and five percent of the federal poverty level (FPL) deduction.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

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For More Information
For additional information, contact DFCS at 877-423-4746.

Georgia Department of Community Health | 2 Peachtree Street NW, Atlanta, GA 30303 | www.dch.georgia.gov | 404-656-4507

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