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Issue Alert - Acceptable documents added to prove identity

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Jan 08, 2008

Program Area:


Issue Summary:

As of April, 2007, many applicants and recipients have had to produce specific documents to verify their identity and their U.S. citizenship. The Department of Human Services (DHS) has expanded the list of documents it will now accept as verification.

Persons Affected:

Proof of Citizenship - Medicaid applicants and recipients who claim U.S. citizenship and are not in foster care, not receiving SSI or Medicare, and not a newborn entitled to Medicaid because his/her mother received Medicaid at the time of birth.

Proof of Identity - For most programs, all U.S. citizens age 16 and above. For non-U.S. citizens, identity must be proven only if it is questionable.

For More Information:

Center for Civil Justice 320 S. Washington, 2nd Floor Saginaw, MI 48607 (989) 755-3120, (800)724-7441 Fax: (989) 755-3558 E-mail:

Michigan Poverty Law Program 611 Church Street, Suite 4A Ann Arbor, MI 48104-3000 (734) 998-6100 (734) 998-9125 Fax


The Deficit Reduction Act of 2005 and interim regulations issued by the Centers for Medicare and Medicaid Services (“CMS”), 42 C.F.R. 435.406 -.407, imposed new requirements for verification of U.S. citizenship and identity for all Medicaid applicants and recipients who are claiming that they are citizens. In addition, applicants and recipients must also prove their identity pursuant to the governing regulation at PEM 221.

No verification of citizenship and identity is needed for:

o Medicare recipients
o SSI (Supplemental Security Income) recipients
o Children in foster care
o Safe Delivery/Safe Haven babies
o Newborns who automatically receive 12 months of Medicaid under PEM 145 because their mother was receiving Medicaid at the time of birth
o Social Security recipients whose eligibility is based on disability
o Adoption assistance or adoption subsidy (Title IV-E) recipients.

Clients who receive Adoption Subsidies under Title IV-E or receive Social Security based on disability should seek legal advice if they are asked to provide verification of citizenship or identity.
PEM 225 p. 2.

Persons claiming U.S. Citizenship who do NOT have to verify identity - No verification of identity is needed for children under age 16.

Primary level evidence of BOTH citizenship and identity

o U.S. Passport
o Certificate of naturalization (Form N-550 or N-570)
o Certificate of U.S. Citizenship (N-560 or N-561)

Secondary evidence of citizenship

o Birth certificate (issued by state, commonwealth, or local jurisdiction) issued before the individual was 5 years old, showing birth in:
o one of the 50 states;
o D.C.;
o Puerto Rico (on or after 1/13/41);
o Guam (on or after 4/10/99);
o U.S. Virgin Islands (on or after 1/17/17);
o American Samoa, Swain’s Island, or Northern Mariana Islands (after 11/4/86).
o Certificate of report of birth (DS-1350) for U.S. citizen born outside the U.S.
o Report of birth abroad of a U.S. Citizen (FS-240) for children born outside U.S. to military personnel
o Certificate of birth issues by State Department (DS-1350 or FS-545) for U.S. Citizen born outside the U.S.
o U.S. Citizen ID card (Form I-197 or I-179)
o Northern Mariana ID Care (I-873)
o American Indian Card (I-872 ) with code “KIC”
o Final adoption decree with child’s name and U.S. Place of birth, or statement from State-approved adoption agency certifying the child’s name and U.S. place of birth as it appears in the original birth certificate if the adoption is not finalized
o Evidence of U.S. Civil Service employment prior to June 1, 1976
o U.S. Military record of service showing U.S. place of birth (DD 214 or similar document)

Secondary evidence of identity

o Current, valid driver’s license issued by a state or territory, with a photo or identifying information such as age, sex, race, weight, height, or eye color (Note: DHS policy mandates a photo but federal regulations allow the alternative information)
o ID card issued by federal, state, or local government, with a photo or identifying information such as age, sex, race, weight, height, or eye color (Note: DHS policy mandates a photo but federal regulations allow the alternative information)
o Document indicating receipt of benefits under a program requiring proof of ID, such as SSI or Social Security benefits
o School ID card with a photo
o U.S. military card or draft record
o Military dependent’s ID card
o Native American tribal document
o U.S. Coast Guard merchant mariner card
o Certificate of degree of Indian blood, or other U.S. Indian/ Alaska Native Tribal document with photo or other personal identifying information

Third level evidence of citizenship

o Extract of a hospital record on hospital letterhead established at time of person’s birth and created 5 years before initial Medicaid application date, which indicates a U.S. place of birth
o Life, health, or other insurance record showing a U.S. place of birth and created at least 5 years before initial Medicaid application date

Fourth level evidence of citizenship

o Federal or state census record showing U.S. place of birth or U.S. citizenship, and person’s age
o Document showing U.S place of birth created at least 5 years prior to initial date of Medicaid application, from:
o Seneca Indian tribal census,
o Bureau of Indian Affairs tribal census of the Navajo,
o U.S. Vital Statistics official notification of birth registration,
o Amended U.S. birth record issued more than 5 years after date of birth,
o Statement signed by midwife or physician present at the birth
o Institutional admission papers from nursing facility, skilled care facility or other institution showing U.S. place of birth
o Medical record indicating U.S place of birth, created at least 5 years prior to initial Medicaid application date (not including an immunization record)
o Written affidavits from two individuals having personal knowledge of the events establishing the person’s citizenship
o At least 1 must not be a relative
o Both must provide proof of their own citizenship and identity
o Neither may be the person whose citizenship is being verified

Must also have affidavit showing why documentation is unavailable, from the applicant/recipient or someone else (could be included with one of the two)

What's Happening?

The list of acceptable documents for verification of identity and citizenship has been expanded.

Identity -
For Family Independence Program (FIP), State Disability Assistance (SDA) and Medicaid (MA, non-U.S. citizens are not required to verify identity unless questionable. For those that do need to prove identity, additional sources of verification include:
- Federal, state, or local government issued identification card with the same information included on a driver’s license;
- A cross match with a federal or state governmental, public assistance, law enforcement, or correction agency’s data system;
• School records, such as report cards, are acceptable for children age 16-18.
• Three or more corroborating documents such as marriage
licenses, divorce decrees, high school diplomas, college degrees,
or employer ID cards. This option is only available to individuals
who submitted 2nd or 3rd tier proof of citizenship, NOT 4th tier.
See PEM 225 for citizenship tiers.
• Disabled individuals in residential care facilities may have their identity attested to by the facility director or administrator when the individual does not have or cannot get any document from the preceding list. The affidavit is signed under penalty of perjury but does not need to be notarized.
Note: Recently expired (thirty days) identity documents are acceptable as long as there is no reason to believe the document does not match the individual.

Citizenship - providing proof of citizenship is often more difficult than identity. There are four tiers of proof defined by DHS. The third level of evidence of U.S. citizenship can only be used when primary or secondary evidence is not available. PEM 225, page 19. Fourth level of evidence is only to be used on rare occasions, but is available, if necessary.

Additions to secondary evidence:

A verification with the Department of Homeland Security’s Systematic Alien Verification for Entitlements (SAVE) database.
• Evidence of meeting the automatic criteria for U.S. citizenship outlined in the Child Citizenship Act of 2000. The Child Citizenship Act of 2000 allows certain foreign -born, biological
and adopted children of American citizens to acquire American citizenship at birth, but they are granted citizenship when they enter the United States as lawful permanent residents (LPRs).

The child must meet all of the following requirements:
• Have at least one American citizen parent by birth or naturalization.
• Be under 18 years of age.
• Live in the legal and physical custody of the American citizen parent.
• Be admitted as an immigrant for lawful permanent residence.
If the child is adopted, the adoption must be full and final.

Additions to third level evidence:

Religious record recorded in the U.S. within 3 months of birth
showing the birth occurred in the U.S. and showing either the date
of the birth or the individual’s age at the time the record was made.
The record must be an official record recorded with the religious
organization. Entries in a family bible are not considered religious records.
• Early school record showing a U.S. place of birth. The school
record must show the name of the child, the date of admission to
the school, the date of birth, a U.S. place of birth, and the name(s) and place(s) of birth of the applicant’s parents.

Fourth level evidence:

A written affidavit, an affidavit should only be used in rare circumstances. The affidavit must be completed by the applicant or recipient and at least two additional individuals of whom one is not related to the applicant/recipient and who have personal knowledge of the event(s) establishing the person’s claim of citizenship. The individual making the affidavit must be able to provide proof of his/her own citizenship and identity. The affidavit is signed under penalty of perjury by the person making the affidavit but need not be notarized. The affidavit should include information explaining why other documentary evidence establishing the applicant’s claim of citizenship does not exist or cannot be obtained.

What Should Advocates Do?

1. Advise clients on alternative documents that may be acceptable if they do not have the particular documents that have been requested.
2. Assist clients who need help in obtaining documents.
3. Advise clients to promptly request help or extensions of time from DHS if they have difficulty obtaining the required verification and assist clients in documenting their attempts to obtain documents and that help has been requested.
4. Assist clients in requesting hearings if they are wrongfully denied or terminated from Medicaid. Clients have 90 days from the date that notice of denial/termination is sent to request a hearing, but recipients must request a hearing within 12 days of the date the notice is sent in order to retain benefits while the hearing request is pending.
5. Help clients seek legal advice if you are not a legal advocate. See the information on “Finding Help” below.

What Should Clients Do?

1. Let your DHS caseworker know if you have difficulty obtaining verification of citizenship or identity, and ask for the caseworker’s help. Keep a record of the dates and times of any voice mail messages you leave. Submit written, dated requests for help, and keep a copy of what you submit. If you local DHS office has a log book to record materials that are dropped off, be sure to use it.
2. Seek legal help if you are denied Medicaid or your Medicaid is terminated because of the verification requirements (see “Finding Help” below).
3. If you are told your Medicaid is being terminated, remember that DHS must receive your hearing request within 12 days of the date on the notice of termination, in order to keep your Medicaid during the hearing process.
4. if you receive an Adoption Subsidy under Title IV-E or receive Social Security based on disability, seek legal advice if you are asked to provide verification of citizenship or identity.

Finding Help

Most legal aid and legal services offices handle these types of cases, and they do not charge a fee.

You can locate various sources of legal and related services, including the free legal aid office that serves your county, at

You can also look in the yellow pages under "attorneys" or call the toll-free lawyer referral number, (800) 968-0738.