Medical Assistance Eligibility Handbook
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Appendix B: Sample Citizen/Non-Citizen Documents

United States Citizens

Those born in the U.S., naturalized through court proceedings or born abroad to U.S. citizens are citizens. A citizen is not required to carry proof of U.S. citizenship.

 

CERTIFICATE OF BIRTH ABROAD, I-197, I-179

Certification of Birth issued by the Department of State
FS-545

Certification of Birth issued by the Department of State
DS-1350

Issued by U.S. embassies and consulates overseas to United States citizens born abroad.

Issued by the U.S. Department of State to United States citizens born abroad.
  

United States Citizen Identification Card I-197
Issued by INS to United States citizens. The USCIS no longer issues this card.

Identification Card for use of Resident Citizen in the United States I-179
Issued by the USCIS to U.S. citizens who are residents of the United States. The USCIS no longer issues this card.
   

I-197

FEDERAL IDENTIFICATION CARDS

CITIZEN IDENTIFICATION

U.S. Citizen’s Identification Card

Form I-197

Laminated

Residency status:

U.S. citizen

Employment:

Allowed

Other: Form I-197 has not been issued since April 1983 and there is no replacement card. The card was issued to naturalized U.S. citizens. The cards are still in circulation and still valid.

Non-Citizens

Immigrants, also known as Lawful Permanent Residents (or Green Card holders) usually plan to remain in the U.S., are authorized to work and have basically the same rights and responsibilities as U.S. citizens, except they do not have the right to vote or to hold a U.S. passport.

Some non-immigrants are non-citizens who come to the U.S. for a specific purpose to be accomplished during a temporary stay. (Examples include, but are not limited to students, business persons, tourists and exchange visitors.) Some may have documentation for employment authorization. The nonimmigrant is granted a specific time to remain in the U.S.

A refugee is one granted entry to the U.S. because of persecution or well-founded fear of persecution in one's home country because of race, religion, nationality, membership in a particular social group or political opinion.

Also known as a person seeking “political asylum,” the status granted by the immigration service to an non-citizen residing in the U.S. because of a well-founded fear of persecution in the person’s country because of race, religion, ethnic group or social group. This status is similar to refugee status, but the difference is that refugees are granted their status abroad, while people seeking asylum apply after they enter the U.S.

A person who has been released from prison on certain conditions, or an immigration status granted to certain non-citizens admitted to the U.S. for humanitarian or public interest reasons. Non-Citizens with parolee status are eligible to receive cash assistance.

The status given to Cubans  and to Haitians entrants as defined by Section 501(e)P.L. 96-422  of the Refugee Education Assistance Act of 1980.

An non-citizen who has resided in the U.S. and performed agricultural labor for at least 90 person-days during the one-year period before May 1, 1986. This non-citizen may be granted temporary lawful resident non-citizen status. The SAW status is limited to the first 350,000 non-citizen  who apply. This status is covered by Section 210(b)(6) of the Immigration Reform and Control Act of 1986 (IRCA).

Non-citizens that do not have  temporary nor permanent stay documents or documents that have expired.

Refers to people who are known to the government and are allowed to remain in the U.S. at the administrative discretion of the USCIS.

NOTE:  Certain victims of severe forms of trafficking are eligible to receive refugee benefits. Forms of trafficking include coercive or deceptive recruitment and transportation of people into conditions of slavery, forced labor, and servitude for prostitution, domestic, agricultural and factory labor.

 USCIS Field Offices

I-551

FEDERAL IDENTIFICATION CARDS

PERMANENT RESIDENTS

Permanent Resident Card

Form I-551

Holographic Laminate

 

Residency status: Permanent

 

Employment: Allowed

 

Other: This form replaced older issues of the I-151. The photo is part of the form and has no raised edges.

MEDICAL ASSISTANCE BENEFIT STATUS: QUALIFIED Non-Citizens, determine if the five year bar applies.


I-551

FEDERAL IDENTIFICATION CARDS

PERMANENT RESIDENTS

Permanent Resident Card

Form I-551

Laminated

Residency status: Permanent

 

Employment: Allowed

 

Other: This form replaced older issues of the I-151. The photo is part of the form and has no raised edges.

MEDICAL ASSISTANCE BENEFIT STATUS: QUALIFIED Non-Citizens, determine if the five year bar applies.
     


I-151

 

 

FEDERAL IDENTIFICATION CARDS

PERMANENT RESIDENTS

Permanent Resident  Card


Form I-151

Laminated

Residency status: Permanent

 

Employment: Allowed

 

Other: This form is no longer issued but is still in circulation and still valid. Photo may be either color or black and white.

MEDICAL ASSISTANCE BENEFIT STATUS: QUALIFIED Non-Citizens, determine if the five year bar applies.
     


I-151

 

 

FEDERAL IDENTIFICATION CARDS

PERMANENT RESIDENTS

Permanent Resident Card

Form I-151

Laminated

Residency status: Permanent

 

Employment: Allowed

 

Other: This form is no longer issued but is still in circulation and still valid. The form is bluish-green.

MEDICAL ASSISTANCE BENEFIT STATUS: QUALIFIED, Non-Citizens determine if the five year bar applies.


I-151

 

 

FEDERAL IDENTIFICATION CARDS

PERMANENT RESIDENTS

Permanent Resident Card

Form I-151

Laminated

Residency status: Permanent

 

Employment: Allowed

 

Other: This form is no longer issued but is still in circulation and still valid. The form is bluish-green. Photo may be either color or black and white.

MEDICAL ASSISTANCE BENEFIT STATUS: QUALIFIED Non-Citizens, determine if the five year bar applies.


I-94

REFUGEE DOCUMENTATION

SAMPLE FORM I-94

This version was issued between 1/1/83 and 9/30/85.

MEDICAL ASSISTANCE BENEFIT STATUS: ELIGIBLE REFUGEE


I-94

REFUGEE DOCUMENTATION

SAMPLE FORM I-94

Issued prior to January 1, 1983.

MEDICAL ASSISTANCE BENEFIT STATUS: ELIGIBLE REFUGEE


I-94

REFUGEE DOCUMENTATION

CUBAN/HAITIAN ENTRANT DOCUMENTATION

SAMPLE FORM I-94

NOTE: All Cubans and Haitians have been granted extended employment authorization by an act of Congress.

MEDICAL ASSISTANCE BENEFIT STATUS: ELIGIBLE REFUGEE.


I-94

REFUGEE DOCUMENTATION

SAMPLE FORM I-94

Issued after October 1, 1985.

MEDICAL ASSISTANCE BENEFIT STATUS: ELIGIBLE REFUGEE.


I-94

 

 

FEDERAL IDENTIFICATION CARDS

NON-IMMIGRANTS

Departure Record

Form I-94 is issued to visitors to the U.S. and will show the date of issue and date by which visitor must depart. Employment is not allowed unless specifically noted on the form. I-94 is carried in conjunction with a passport.

 

MEDICAL ASSISTANCE BENEFIT STATUS: ELIGIBLE IF STAMPED REFUGEE, PAROLED AS A REFUGEE, OR PAROLEE. INS SECTION NUMBER MUST ALSO BE VERIFIED.

NOTE: Refugees may be parolees, but not all parolees are refugees.


PASSPORT

THIS IS A PASSPORT WHICH HAS BEEN STAMPED INSIDE BY INS

MEDICAL ASSISTANCE BENEFIT STATUS: ELIGIBLE PERMANENT RESIDENT.


I-688A

 

 

FEDERAL IDENTIFICATION CARDS

TEMPORARY RESIDENTS

LEGALIZATION PROGRAM APPLICANTS

Non-citizens who apply and go through a preliminary interview for residency under the Immigration Reform and Control Act (legalization program) are first issued the I-688A. The card gives them the right to work in the U.S. When they are granted temporary residency, they are issued the I-688.

Form I-688A

Employment Authorization Card

Laminated

 

Residency status: Holder has applied for temporary residency

Employment: Allowed

Other: Photo is part of the form and has no raised edges. Gold Department of Justice seal in laminate is superimposed over the middle of the card front.

MEDICAL ASSISTANCE BENEFIT STATUS: Children under age 21 and pregnant women through the postpartum period may be eligible for federally-funded MA. All other individuals may be eligible for state-funded MA (GA-related).


I-688B

 

 

FEDERAL IDENTIFICATION CARDS

TEMPORARY RESIDENTS

Form I-688B is issued to applicants in the legalization program who are granted temporary residency.

Employment Authorization Card



Form I-688B

Laminated

Residency status: Temporary

 

Employment: Allowed

 

Other: Photo is part of the form and has no raised edges. Gold Department of Justice seal in laminate is superimposed over the middle of the card front.

MEDICAL ASSISTANCE BENEFIT STATUS: Children under age 21 and pregnant women through the postpartum period may be eligible for federally-funded MA. All other individuals may be eligible for state-funded MA (GA-related).

I-688

 

 

FEDERAL IDENTIFICATION CARDS

TEMPORARY RESIDENTS

Form I-688 is issued to applicants in the legalization program who are granted temporary residency.

Temporary Resident Identification Card

Form I-688

Laminated

Residency status: Temporary

 

Employment: Allowed

 

Other: Photo is part of the form and has no raised edges. Gold Department of Justice seal in laminate is superimposed over the middle of the card front.

MEDICAL ASSISTANCE BENEFIT STATUS: Children under age 21 and pregnant women through the postpartum period may be eligible for federally-funded MA. All other individuals may be eligible for state-funded MA (GA-related).

Updated July 8, 2016   Replacing February 14, 2012