Citizenship and Alien Status Requirements for the Medicaid Program

Date:  October 26, 2004 

 

8 

Trans. No.  04 OMM/ADM-7 

 

Page No. 

 

 

UNITED STATES CITIZEN: For the purposes of qualifying as a United 

States citizen, the United States includes the 50 states, the 

District of Columbia, Puerto Rico, Guam, U.S. Virgin Islands and the 

Northern Mariana Islands.  Nationals from American Samoa or Swain’s 

Island are also regarded as United States citizens for the purpose 

 Medicaid eligibility. 

of

 

VETERAN: The term veteran means a person who served in the active 

military, naval or air service of the United States who fulfilled 

the minimum active duty service requirements and was honorably 

discharged or released, not on account of immigration status. 

 

VICTIMS OF A SEVERE FORM OF TRAFFICKING:  A “victim of a severe form 

of trafficking” is defined as anyone who: 

1)

 

has been subjected to a “severe form of trafficking in 

persons” which is defined as “sex trafficking in which a 

commercial sex act is induced by force, fraud, or coercion, or 

in which the person induced to perform such act has not 

attained 18 years of age; or the recruitment, harboring, 

transportation, provision, or obtaining of a person for labor 

or services, through the use of force, fraud or coercion for 

the purpose of subjection to involuntary servitude, peonage, 

debt bondage, or slavery; and 

2)

 

has not attained the age of 18 years or who is the subject of 

a certification issued by the federal government pursuant to 

Section 107(b)(1)(E) of the Victims of Trafficking and 

Violence Protection Act of 2000 (P.L. 106-386).  

 

 

B.

 

DOCUMENTATION AND VERIFICATION REQUIREMENTS 

 

This directive will instruct social services district workers 

regarding the types of documentation that can be used to establish a 

Medicaid applicant’s or recipient’s immigration status and the 

individual’s eligibility for Medicaid.  This documentation is fully 

outlined in the “Documentation Guide, Immigrant Eligibility for 

Health Coverage in New York State”, which is Attachment D-1 to this 

directive.  As a general rule, U.S. citizens, nationals, Native 

Americans, qualified immigrants and PRUCOL applicants for Medicaid 

must provide appropriate documentation of their citizenship or 

satisfactory immigration status.  In addition to the standard 

Medicaid eligibility questions regarding income, resources, family 

composition and living arrangements, the Medicaid program must ask 

an immigrant to verify his or her satisfactory immigration status.  

Such individuals must also sign a declaration, under penalty of 

perjury, that they are U.S. citizens, nationals, Native Americans, 

qualified or PRUCOL immigrants and must provide, or apply for, a 

Social Security Number or proof that s/he has applied for one, or 

tried to apply for a Social Security Number. 

 

NOTE:  Immigrant parents applying for Medicaid for citizen children 

do not have to supply any information about their own immigration 

status.  Parents only have to prove that the child is a U.S. 

citizen.  Pregnant women are not required to document their 

immigration status, complete the citizenship declaration, or provide 

a Social Security Number.  In the month following the month in which 

the 60 day postpartum period ends, the women must meet these and all 

other applicable requirements in order to remain Medicaid eligible. 

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Date:  October 26, 2004 

 

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Trans. No.  04 OMM/ADM-7 

 

Page No. 

 

 

C.

 

ELIGIBILITY FOR MEDICAID BENEFITS: CITIZENS, NATIONALS AND NATIVE 

AMERICANS 

 

1. CITIZENS 

 

Natural born citizens and individuals who acquire citizenship 

through naturalization and who are residents of the State of New 

York may receive Medicaid benefits, if otherwise eligible.  For 

the purposes of qualifying as a United States citizen, the United 

States includes the 50 states, the District of Columbia, Puerto 

Rico, Guam, U.S. Virgin Islands and the Northern Mariana Islands.  

Nationals from American Samoa or Swain’s Island are also regarded 

as United States citizens for the purpose of Medicaid 

eligibility. 

 

The following are examples of items which constitute primary 

documentation of U.S. citizenship (See Attachment D-1 to this 

directive): 

•

 

U.S. Birth Certificate 

•

 

U.S. Passport 

•

 

Naturalization Papers or Certificate (N-550 or N-570) 

•

 

Consulate Report of Birth Abroad (FS-240) 

•

 

Certification of Report of Birth (DS-1350) 

•

 

U.S. Citizen I.D. Card (I-197 or I-179) 

•

 

Information from a primary source Federal agency (such as 

SSA) verifying U.S. as place of birth 

•

 

Religious document such as baptismal record, recorded 

within 3 months of age showing the ceremony took place in 

the U.S. 

 

Many elderly individuals born in rural areas of the United States 

have particular difficulty in documenting their place of birth.  

Districts must provide assistance to such persons in exploring 

all possible sources of primary and secondary verification before 

denying such individuals on the basis of citizenship status. 

 

 

When primary documentation is not available, secondary 

documentation must be obtained.  At least two secondary documents 

are needed to establish United States citizenship. 

 

The following are examples of items which constitute secondary 

documentation of U.S. citizenship: 

 

a.) Letter of No Record:  This is a letter that indicates an 

attempt was made to find a birth certificate.  It is issued 

by the State where the individual was born stating the name, 

date of birth, years searched for a record and that there is 

no birth certificate on file for the person; AND, 

 

b.) One other document showing place of birth in the U.S. such 

as: 

 

•

 

Census record* 

•

 

Certificate of circumcision* 

•

 

Early school record* 

•

 

Family Bible record* 

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