Family and Children's Medicaid MA-3332 US CITIZENSHIP REQUIREMENTS
VI. CITIZENSHIP AND IDENTITY DOCUMENTATION
A. Citizenship/Identity Documentation Criteria
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(1) Applicants residing outside of Puerto Rico may mail the completed and signed application to the following address:
Puerto Rico Vital Statistics Record Office
P.O. Box 11854
San Juan, PR 00910
(2) Include a photocopy of a valid government issued photo identification document (A passport or drivers license may be used). All other forms of government issued photo ID will be subject to approval.
(3) Include a $5.00 Money Order payable to the Secretary of the Treasury of Puerto Rico (If multiple copies are requested with one application, all additional copies after the first will cost $4. Fees will be waived for all veterans and persons over the age of 60.)
(4) Include a self-addressed envelope with paid postage.
SEE HIERARCHY CHART (Refer to VII below): Acceptable Documentation of Citizenship and Identity.
a. The type of document used;
b. How it was obtained (e.g. applicant, located in data match, etc.);
c. The date it was provided, and
d. Any other information the worker feels pertinent.
If a screen print is used, document the source of the evidence. Once citizenship and identity documentation is obtained, do not request documentation again unless you learn the previous document is questionable. Ensure any future reviewers or workers can find this file.
3. Citizenship documents must be either originals or copies certified by the issuing agency. Do not accept notarized copies. However, once you have seen the original or certified copy, document the record and make a copy of that document. In some situations, such as a mail-in application or redetermination, a copy of the original document is accepted. Do not ask the a/r to mail original documents such as driver’s licenses. Ask the a/r to mail you a copy of the original document or come to the agency, if possible, so a copy can be made. A mother’s copy of a birth certificate is not acceptable.
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4. Place copies of the original documents, certified copies, or data match screen prints used to document citizenship and identity in a sub-folder or file in the a/r’s permanent record labeled “Citizenship/Identity Documentation”. Complete the DMA-5177, Documentation of Identity and Citizenship for US Citizens, with the appropriate C/I code.
5. Use the following Citizenship/Identity (C/I) codes to document the appropriate hierarchy level. See EIS 4000, Codes Appendix.
a. 10 is a document from Chart 1 (no further identity verification needed).
b. 11 is a document from Chart 1 (the allegation of citizenship is consistent with SSA data and no further identity verification needed). Code 11 is automatically entered by EIS.
c. 12 is a document from Chart 1 (the allegation of citizenship is consistent with SSA data and no further identity verification needed). Code 12 is used when manually entered by the IMC.
d. 25 is a document from Chart 2 and a document from Chart 5.
e. 35 is a document from Chart 3 and a document from Chart 5.
f. 45 is a document from Chart 4 and a document from Chart 5.
g. 50 shows permanently exempt, SSI, Medicare, Social Security Disability Insurance (SSDI), Title IV-B child, and Title IV-E (IAS) recipients of foster care maintenance or adoption assistance payments.
h. 51 shows Lawful Permanent Resident (LPR) status other than Afghan/Iraqi Special Immigrants. See 6. below.
i. 97 is used for individuals with an inconsistent C/I SSA match, and who are allowed 90 days to provide verification of citizenship/identity.
j. 98 is used for individuals who were receiving or applied for NCHC prior to 1/1/10. Individuals with a C/I code 98 and special review code Z must provide citizenship/identity verification by the next redetermination.
k. 99 is used for children in county custody at application if verification is unavailable.
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Note: Children in the custody of a private adoption agency are required to provide documentation of US citizenship and identity. Follow the charts below for acceptable documentation. For example, CID code 35 can be used if an extract of hospital record on hospital letterhead is provided documenting US citizenship (3), and an affidavit attesting to child’s identity is provided from the private adoption agency (5).
6. For Citizenship/Identity codes for Refugees or other Immigrants refer to, EIS 4000, Codes Appendix.
Note: The only individuals who are not required to have a C/I code are undocumented aliens and case heads who do not receive benefits.
B. Procedures When No Documentation or Information is Provided or Obtained
1. Individuals who meet this criteria are not automatically issued proof of citizenship by USCIS. The parent may apply for a certificate of citizenship for his child with the USCIS and/or for a passport for his child with the Department of State.
2. If documentation confirming citizenship and/or proof of identity is not provided at the end of the 6 month pending period for an application, evaluate for coverage under emergency Medicaid. Open an administrative application using the first of the month of the date of emergency services as the application date.
3. If an applicant is a naturalized citizen and cannot provide evidence or documentation of citizenship, refer the applicant to the address below:
United States Citizenship and Immigration Services
Charlotte Sub Office
6130 Tyvola Centre Dr.
Charlotte, NC 28217
Telephone (800) 375-5283
Treat this individual as a non-qualified alien until verification is provided. See MA-3330, Alien Requirements.
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