FAQ: Medical Assistance Citizenship
Per Public Law 109-171 Deficit Reduction Act (DRA) of 2005, beginning July 1, 2006, when initially applying for Medical Assistance (MA) or upon a recipient's first MA renewal, individuals who declare they are U.S. citizens must provide satisfactory documentary evidence of citizenship or nationality and identity. Below are answers to some frequently asked questions and examples of acceptable documentary evidence of citizenship and identity.
Why must I declare that I am a citizen or a national of the United States?
Before enactment of this provision, in order to qualify for MA in Pennsylvania, the applicant had to declare on an application, under penalty of perjury, that the applicant was a citizen or national of the United States and if not a citizen or national, that the individual was in satisfactory immigration status. Individuals who declared they were citizens did not have to do anything else to support that claim. Individuals who declared they were aliens in a satisfactory immigration status were required to provide documentary evidence of that claim. The new provision now requires that the Department of Human Services (DHS) obtain satisfactory documentation of citizenship. Under the law, simply declaring you are a U.S. citizen is no longer an acceptable practice.
What do we mean by "declare to be a citizen or national of the United States?"
This means that you affirmatively state on your signed application that: you were born in the United States; or, you were born in the Commonwealth of the Northern Marianas, American Samoa, or Swain's Island; or, you were not born in the United States you have become a naturalized citizen of the United States.
What do we mean by satisfactory documentary evidence of citizenship?
This means you must present to your local county assistance office (CAO) documents that show you are a citizen of the United States. To establish U.S. citizenship the document must show that you were born in the U.S. or that you are a naturalized U.S. citizen.
What do we mean by satisfactory documentary evidence of identity?
This means you must present to your local local CAO documents that show you are the person you claim to be. To establish your identity the document must provide identifying information that relates to the person named on the document. For naturalized citizens, a copy of your naturalization certificate will be sufficient, if the picture on the certificate is clear and readable.
What if I do not have a birth certificate, driver's license, or state identification card?
Your local CAO can accept a number of alternative documents that will establish your citizenship and/or identity. If you do not have or cannot get documentary evidence of citizenship and/or identity, you should explain your situation to your caseworker as soon as you apply or when you are asked at the time your eligibility is renewed. Your caseworker will then explain what alternatives you may use and what assistance can be provided.
What if I had my citizenship documented when I applied for MA, will I have to document my citizenship again?
No. Generally you will not have to repeat documentation after July 1, 2006, if your local CAO documented your citizenship according to the DRA guidelines before July 1, 2006, and has a record of that documentation.
What if I am already receiving MA benefits? When do I have to provide documentation of citizenship?
If you are already an MA recipient, you will remain eligible unless determined ineligible. You will be asked to provide these citizenship documents at your next renewal on or after July 1, 2006. You will be given a reasonable amount of time to present evidence of citizenship and you must make a good faith effort to present the documents requested.
May I bring copies of documents that prove I am a citizen?
Local CAOs are not permitted to accept copies of satisfactory documentary evidence that you are a citizen. All documents must be either originals or copies certified by the issuing agency.
What if I do not bring documents to show I am a citizen when I go to apply for MA?
Your local CAO will give you a reasonable opportunity to present satisfactory documentary evidence that shows you are a citizen. If you do not provide the requested documents after you have been given a reasonable opportunity to present evidence of citizenship, or your local CAO determines that you have not made a good faith effort to present satisfactory documentary evidence of citizenship, your eligibility for Medical Assistance benefits will be denied.
What if I apply for MA by mail, phone or through COMPASS?
You will be given the same opportunity to provide evidence of citizenship and identity as you are given to provide evidence of any other fact about your eligibility. An office visit is not required. These documents may be mailed to your local CAO.
What appeal rights do I have if during my renewal for Medical Assistance eligibility, or in applying for Medical Assistance, my application is rejected?
DHS is not obligated to make or keep eligible any individual who fails to cooperate with the requirement to present documentary evidence of citizenship and identity. Failure to provide this information is no different than the failure to provide any other information that is material to the eligibility determination.
An applicant or recipient who fails to cooperate with the local CAO in presenting documentary evidence of citizenship and/or identity may be denied or terminated. Failure to cooperate consists of failure by an applicant/recipient or that individual's representative, after being notified, to take the required action. Notice and appeal rights and adequate and timely notice must be given to beneficiaries if the local CAO denies or terminates an individual for failure to cooperate with the requirement to provide documentary evidence of citizenship and/or identity. In the case of individuals already receiving MA, the notice must be in advance.
If I am caring for a foster child who receives MA, does the foster child also have to have documentary evidence of citizenship and identity?
Foster children receiving MA must have in their MA file documentation of citizenship or satisfactory immigration status, as well as identity.
Can I still receive MA benefits while I am trying to get the necessary documents?
Your local CAO will give you a reasonable opportunity to present satisfactory documentary evidence of identity and citizenship. If you continue to make a good faith effort to present satisfactory documentary evidence of citizenship and identity, you can continue to receive MA benefits.
Will CAOs have to help people get the necessary documents? Who will pay the fee for getting a birth certificate?
Local CAOs will try to obtain verification of citizenship through the Pennsylvania Department of Health and of identity through PennDOT. They will not obtain actual copies of birth certificates, driver's licenses, or state identification cards for you. The CAO will, however, pay for you to obtain out-of-state birth certificates. CAOs are required to give extra assistance to applicants or recipients who are experiencing homelessness, are an amnesia victim, mentally impaired, or physically incapacitated and lack someone who can act for individuals on their behalf.
Is anyone exempt from these requirements?
The new citizenship and identity requirements do not apply to the following applicants/ recipients:
- Individuals eligible for Supplemental Security Income (SSI) benefits either currently or in the past.
- Individuals eligible for or receiving Medicare Part A and/or B.
- Pregnant women determined to be presumptively eligible (PS17) for MA.
- Individuals who are applying for or receiving General Assistance (GA) cash benefits and GA-related categories of Ma.
- Individuals who are applying for or receiving Temporary Assistance for Needy Families (TANF) cash benefits.
If I am a qualified alien in this country as a legal immigrant, must I also provide documentary evidence?
The new law applies to those applicants or recipients who declare they are a U.S. citizen or national. There is no change in the current policy regarding documentation that aliens must submit.