With the implementation of the Affordable Care Act, U.S. citizenship verification is completed in real-time through the SSA Composite service with the Hub when applications are processed through Application Processing (AP) or new individuals are added to a case in Case Processing (CP). Citizenship verification results display on the Demographics screen in CP.
If citizenship is verified electronically, the U.S. Citizenship verification field will populate with “V - Electronic Verification.”
If citizenship verification is not able to be verified electronically (i.e. the SSA match is not successful), and the individual is not exempt from the DRA citizenship verification requirements (See Section 322.11 Citizen/Non-Citizen Declaration), the CAO will take the following steps:
When the CAO frontloads an application in CP, they will request citizenship verification from the individual on the Pending Verification Checklist (PA 253), if verification for other factors is required.
If verification for other factors of eligibility is on file or verified electronically except for the citizenship verification and the individual is otherwise eligible, the CAO will process the application and enter “P - Verification Pending” in the U.S. Citizenship field on the Demographics screen and process the application.
If the individual provides verification for other factors of eligibility requested on the PA 253 but verification of citizenship is not provided and the individual is otherwise eligible, the CAO will enter “P - Verification Pending” in the U.S. citizenship verification field on the Demographics screen and process the application.
NOTE: The CAO will make an effort to obtain verification of citizenship by using procedures outlined in MAEH 378 Verification, Appendix G for individuals born in Pennsylvania and MAEH 378 Verification, Appendix E for individuals born outside of Pennsylvania.
If the CAO's attempt to verify citizenship is not successful:
The CAO will request citizenship verification from the individual in writing, regardless of whether or not citizenship verification was previously requested, and allow a reasonable opportunity period of 90 days for the individual to provide citizenship verification. The worker must allow five days for mailing the request and set an alert for 95 days from the day the request is mailed.
If the individual fails to provide citizenship verification and the inconsistency is not resolved by the end of the 90-day period, the CAO will close MA for that individual with a 15-day advance notice. The CAO must close MA within 30 days from the date the 90-day reasonable opportunity period ends, if the individual has not made a good faith effort to provide necessary verification. If the individual is making a good faith effort to provide necessary documentation and there is a reasonable expectation that verification is pending from a third party or the CAO needs additional time to complete the verification process, the CAO may extend the reasonable opportunity period beyond 90 days.
If an individual verifies his or her citizenship by providing paper documentation, the CAO will scan and attach the document to the individual’s electronic record and update the case in CP with the appropriate verification code. Once the individual’s citizenship is verified, the CAO may not require the individual to verify citizenship again.
If the individual fails to provide verification of citizenship during the reasonable opportunity period and MA is closed for failure to provide this verification, the individual’s MA cannot be reopened until the CAO verifies citizenship electronically or the individual provides required verification.
Public Law 111-3 sec 211 42 CFR § 435.407(k)
An eligible US citizen or national is an individual who was:
55 Pa. Code § 150.1 (a) 55 Pa. Code § 150.1(b) (1)
NOTE: This includes children born in the U.S. to non-citizen parents who are living in the U.S. either lawfully or unlawfully.
NOTE: The Child Citizenship Act of 2000 allows a child who was born outside of the U.S. to get a certificate of naturalization Pub Law 106-395 if the following conditions are met:
At least one parent (a) is a U.S. citizen who has been present in the United States for at least five years, at least two of which were when the parent was age 14 or older or (b) has a citizen parent meeting such requirements.
The child is under 18 years old.
The child is living outside the United States in the legal and physical custody of the citizen parent, in lawful status. This rule also applies to an adopted child meeting certain definitional requirements who is adopted by a U.S. citizen parent.
The following documents may be used as primary-level proof of citizenship and identity.
42 USC § 1320b-7(d) 42 CFR § 435.407(a) Public Law 109-171 Sec 6036 Public Law 111-3 sec 211
U.S. Citizenship verification through the SSA Composite service with the Hub.
A U.S. passport.
A Certificate of Naturalization (Department of Homeland Security [DHS] Form N-550 or N-570).
NOTE: A Memorandum of Understanding between the Department of Homeland Security and the Department of Human Services has been revised to grant permission to verify the status of naturalized citizens through the Systematic Alien Verification for Entitlements (SAVE) program.
The CAO must have the Alien Registration Number (A#) of the naturalized citizen to confirm the individual’s status. However, Form G-845S, Document Verification Request, cannot be used as proof of U.S. citizenship. The individual must cooperate in getting a copy of the Naturalization Certificate or in submitting other proof of U.S. citizenship along with identity documentation. With confirmation of the individual’s naturalized citizenship status through SAVE, the individual may be authorized for MA if he or she meets all other criteria for eligibility. (See Supplemental Handbook, Chapter 740, SAVE Procedures.)
A Certificate of United States Citizenship (DHS Form N-560 or N-561)
Tribal enrollment or membership documents issued by a Federally recognized Indian Tribe showing membership, enrollment in or affiliation with such Tribe must be accepted as verification of citizenship. No additional identity documents are required. The document must identify the Federally recognized tribe which issued it and identify the individual by name. Examples may include: Tribal enrollment/membership cards, a certificate of degree of Indian blood issued by the Bureau of Indian Affairs, a Tribal census document or a document issued by a Tribe indicating an individual’s affiliation with the Tribe. Tribal documents are considered to be as reliable as a passport.
The following documents may be used as secondary-level proof of citizenship (but not identity):
A U.S. birth certificate from one of the fifty states or the District of Columbia (see Chapter 378, Verification, Appendix E).
NOTE: The applicant or recipient must present an original document to be copied. The copy must be kept in the case record
NOTE: A child’s birth certificate may not be used as proof of citizenship for a parent whose name, date of birth and place of birth are listed on the birth certificate
.
A Certification of Report of Birth (Department of State Form DS-1350).
A Consular Report of Birth (Department of State Form FS-240).
A Certification of Birth Abroad (Department of State Form FS-545).
NOTE: A Certification of Birth (Form FS-545 or DS-1350) or replacement of a Consular Report of Birth (FS-240) may be obtained by writing to:
Department of State
Passport Vital Records Section
44132 Mercure Cir.
PO Box 1213
Sterling, VA 20166-1213
A written request must be notarized and include a copy of a valid photo ID of the individual requesting it. The written request must include the following:
The full name of the child at birth (plus any adoptive names).
The date and place of birth.
The names of the parents.
The serial number, if it is known, of the FS-240 (on those issued after November 1, 1990).
Any available passport information.
The signature of the requestor.
A notarized affidavit, for a replacement FS-240 (if applicable).
A U.S. Citizen Identification card (DHS Form I-197 or I-179).
NOTE: Neither card is issued at this time, but either form that used to be issued is still valid.
An American Indian Card (DHS I-872) with the classification code “KIC”
NOTE: This card is issued by the DHS to identify U.S. citizen members of the Texas Band of Kickapoos living near the U.S./Mexican border.
A Northern Mariana Identification Card (DHS I-873).
NOTE: This card was issued to individuals who were born in the Northern Mariana Islands before November 4, 1986 and were collectively naturalized as U.S. citizens. This card is no longer issued, but those that were previously issued are still valid.
A final adoption decree
NOTE: The adoption decree must show the child’s name and U.S. place of birth. When an adoption is not finalized and the state in which the child was born will not release a birth certificate before the final adoption, a statement from a state-approved adoption agency that shows the child’s name and U.S. place of birth is acceptable. The adoption agency must state that the source of the place of birth information is an original birth certificate.
Proof of Civil Service employment by the U.S. government before June 1976
An official military record of service showing a U.S. place of birth (DD-214 or similar official record)
Proof of meeting the automatic criteria for U.S. citizenship in the Child Citizenship Act of 2000, for a biological or adopted child born outside the United States
The following papers can be used as third-level proof of citizenship: 42 CFR § 435.407(c)
Extract of a hospital birth record on hospital letterhead established at the time of the individual’s birth and from at least five years before the MA application. The birth record must show that the individual was born in the U.S. For children under 16, the document must have been created near the time of birth or five years before the date of application.
NOTE: The CAO will not accept souvenir birth certificates issued by the hospital.
A life, health or other insurance record showing a U.S. place of birth from at least five years before the MA application (or near the time of birth for children under age 16).
A religious record that was recorded in the U.S. within three months of birth. It must show that the birth took place in the U.S. and show either the date of the birth or the individual’s age when the record was made. The record must be an official record recorded with the religious organization, such as a baptismal certificate.
NOTE: Entries in a family Bible are not considered religious records.
Caution: In questionable cases (for example, where the child’s religious record was recorded near a U.S. international border and the child may have been born outside the U.S.), the state must confirm the religious record or have proof that the mother was in the U.S. at the time of birth.
An 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 names and places of birth of the applicant’s parents.
NOTE: Persons over 65 years of age may have this type of early school record showing a U.S. place of birth and the parents’ information.
Fourth level evidence of citizenship is the least reliable proof and must be used only rarely (such as when no higher-level documents are available).
The following papers can be used as fourth-level proof of citizenship:
A federal or state census record showing U.S. citizenship or a U.S. place of birth (generally for people born from 1900 to 1950).
A U.S. State Vital Statistics official notice of birth registration from at least five years before the MA application date (or near the time of birth for children under age 16).
An amended U.S. public birth record that was amended more than five years after the individual’s date of birth and at least five years before the MA application date (or near the time of birth for children under age 16).
A statement signed by the physician or midwife who was present at the individual’s birth and created at least five years before the MA application date (or near the time of birth for children under age 16).
Admission papers from an institution such as a nursing home or skilled nursing facility showing a U.S. place of birth. The papers must be from at least five years before the MA application date.
A medical (clinic, doctor or hospital) record that indicates a U.S. place of birth. The record must be from at least five years before the MA application date (or near the time of birth for children under age 16).
NOTE: An immunization record cannot be used as proof of U.S. citizenship.
Affidavits
Affidavits may be used only when the state is unable to get proof of citizenship from other documents. When affidavits are used as proof of citizenship, the following rules apply:
The affidavits must come from the applicant or recipient or from an individual who knows him or her (for example, a guardian or representative). The affidavits must explain why other proof of citizenship does not exist or why it cannot be obtained.
There must be two affidavits by two individuals who have individual knowledge of how the applicant or recipient became a citizen.
At least one of the individuals making the affidavit must not be related to the applicant or recipient and must not be the applicant or recipient.
Each individual signing an affidavit must be able to provide proof of his or her own citizenship and identity.
If the individuals signing the affidavits have information that explains why there is no existing written proof of the applicant or recipient’s claim of citizenship or why it cannot be obtained, the information must be included in the affidavit.
The affidavits must be signed under penalty of perjury.
NOTE: Naturalized citizens may use affidavits.
NOTE: An individual may not use affidavits to prove both citizenship and identity. He or she must choose one or the other.
The following documents are accepted as primary-level proof of nationality (but not identity):
42 CFR § 435.407 (b) (1)(i)(ii)(iii)
For Puerto Rico:
Proof of the applicant or recipient’s birth in Puerto Rico on or after April 11, 1899, and the applicant or recipient’s statement that he or she was residing in the U.S., a U.S. possession, or Puerto Rico on January 13, 1941
Proof that the applicant or recipient was a Puerto Rican citizen and the applicant or recipient’s statement that he or she was residing in Puerto Rico on March 1, 1917, and that he or she did not take an oath of allegiance to Spain.
As of October 31, 2010, a birth certificate issued by Puerto Rico is only acceptable for new applicants if it was issued on or after July 1, 2010. Birth certificates issued by Puerto Rico prior to July 1, 2010 became invalid as of October 30, 2010 by Puerto Rico’s enactment of Law 191 of 2009. This law strengthened the issuance and usage of birth certificates in order to combat fraud and to protect the identity of people born in Puerto Rico. If a birth certificate was valid at the time it was first presented, no new or additional documentation is needed to establish nationality.
Individuals born in Puerto Rico will need to request their own birth certificate unless they are a veteran or the age of 60; these do not have a fee. If these individuals would like to request a birth certificate they may obtain additional information at: http://www2.pr.gov/prgovEN/Pages/BirthCertifcateInfo.aspx
For the U.S. Virgin Islands:
Proof of the applicant or recipient’s birth in the U.S. Virgin Islands and the applicant or recipient’s statement that he or she was residing in the U.S., a U.S. possession or the U.S. Virgin Islands on February 25, 1927
The applicant or recipient’s statement that he or she was residing in the U.S. Virgin Islands as a Danish citizen on January 17, 1917, and in the U.S., a U.S. possession or the U.S. Virgin Islands on February 25, 1927, and that he or she did not maintain Danish citizenship.
Proof of the applicant or recipient’s birth in the U.S. Virgin Islands and the applicant or recipient’s statement that he or she was residing in the U.S., a U.S. possession or territory, or the Canal Zone on June 28, 1932.
For the Northern Mariana Islands (NMI) (formerly part of the Trust Territory of the Pacific Islands, or TTPI)
Proof that the applicant or recipient was born in the NMI, is a TTPI citizen and was residing in the NMI, the U.S or a U.S. territory or possession on November 3, 1986 (NMI local time) and the applicant or recipient’s statement that he or she did not owe allegiance to a foreign state on November 4, 1986 (NMI local time).
Proof of TTPI citizenship, continuous residence in the NMI since before November 3, 1981 (NMI local time), voter registration before January 1, 1975 and the applicant or recipient’s statement that he or she did not owe allegiance to a foreign State on November 4, 1986 (NMI local time).
Proof that the applicant or recipient has been residing in the NMI since before January 1, 1974, and the applicant or recipient’s statement that he or she did not owe allegiance to a foreign state on November 4, 1986 (NMI local time).
For Guam:
Proof of the applicant or recipient’s birth in Guam on or after April 10, 1899.
For Swain’s Island and American Samoa:
Proof of the applicant or recipient’s birth in Swain’s Island or American Samoa. People born in American Samoa or Swain’s Island are generally U.S. noncitizen nationals.
The CAO will scan any documents used to prove citizenship and attach them into Imaging as a permanent part of the applicant's/recipient's record.
NOTE: See Appendix B for sample citizenship identification cards.
Updated July 5, 2016 Replacing February 14, 2012