Citizens Must Prove Status/Identity to Qualify for Medicaid
By Michael Campbell, Esq., Executive Director, PA Health Law Project
Congress has placed the "burden of proof" on many Medicaid applicants and recipients.
Beginning July 1, the "Deficit Reduction Act" passed by Congress requires people claiming to be U.S. citizens or nationals to document both their citizenship and identity in order to qualify for Medicaid. Medicaid is the federal name for Pennsylvania's Medical Assistance (MA) Program.
A person does not have to be a U.S. citizen in order to qualify for Medicaid. However, those claiming citizenship must prove their status, either at the time of application or at their first re-determination.
Those who don't have a preferred document (such as a passport) will need to separately prove both citizenship and identity, or risk being denied or terminated from Medical Assistance.
Past and present Supplemental Security Income (SSI) and Medicare recipients are exempt from the new guidelines.
Acceptable Proofs
Federal regulations identify a complex list of documents that may be used to satisfy the new requirements.
Some documents, such as a U.S. Passport, a Certificate of Naturalization, or a Certificate of US Citizenship, prove both citizenship and identity. A birth certificate (or other documents such as a Certification of Birth Abroad), can be used for citizenship. A driver's license with picture can be used for identity.
For individuals who lack a birth certificate and/or driver's license, a number of other documents can be used to meet the new guidelines. It is even possible to present affidavits from two individuals who attended your birth in the United States, only one of whom can be a relative.
Assistance from DPW
It is expected that the heaviest burden of these regulations will fall on persons born out of state, and adopted children.
In Pennsylvania, the Department of Public Welfare (DPW) intends to assist all individuals applying for or currently receiving MA to obtain the necessary proof of citizenship (or nationality) and identity.
The department has also established a special verification unit to help track down birth certificates and driver's licenses in Pennsylvania and in other states.
If all other conditions of eligibility are met, except the documentation of citizenship and identity, DPW has announced that eligibility for MA will not be denied or terminated, so long as the individual is cooperating.
What To Do If . . .
If you, or someone you know, is denied Medical Assistance in Pennsylvania because of the new requirements for documentation, it is important to get help from legal aid.
The Pennsylvania Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call their helpline at 1-800-274-3258 or 1-866-236-6310 TTY.
Northwestern Legal Services provides civil legal aid to low-income residents, including issues with Medical Assistance. In Erie, call NWLS at 452-6957. For individuals outside of Erie, you can use their toll free number at (800) 665-6957.
Congress has placed the "burden of proof" on many Medicaid applicants and recipients.
Beginning July 1, the "Deficit Reduction Act" passed by Congress requires people claiming to be U.S. citizens or nationals to document both their citizenship and identity in order to qualify for Medicaid. Medicaid is the federal name for Pennsylvania's Medical Assistance (MA) Program.
A person does not have to be a U.S. citizen in order to qualify for Medicaid. However, those claiming citizenship must prove their status, either at the time of application or at their first re-determination.
Those who don't have a preferred document (such as a passport) will need to separately prove both citizenship and identity, or risk being denied or terminated from Medical Assistance.
Past and present Supplemental Security Income (SSI) and Medicare recipients are exempt from the new guidelines.
Acceptable Proofs
Federal regulations identify a complex list of documents that may be used to satisfy the new requirements.
Some documents, such as a U.S. Passport, a Certificate of Naturalization, or a Certificate of US Citizenship, prove both citizenship and identity. A birth certificate (or other documents such as a Certification of Birth Abroad), can be used for citizenship. A driver's license with picture can be used for identity.
For individuals who lack a birth certificate and/or driver's license, a number of other documents can be used to meet the new guidelines. It is even possible to present affidavits from two individuals who attended your birth in the United States, only one of whom can be a relative.
Assistance from DPW
It is expected that the heaviest burden of these regulations will fall on persons born out of state, and adopted children.
In Pennsylvania, the Department of Public Welfare (DPW) intends to assist all individuals applying for or currently receiving MA to obtain the necessary proof of citizenship (or nationality) and identity.
The department has also established a special verification unit to help track down birth certificates and driver's licenses in Pennsylvania and in other states.
If all other conditions of eligibility are met, except the documentation of citizenship and identity, DPW has announced that eligibility for MA will not be denied or terminated, so long as the individual is cooperating.
What To Do If . . .
If you, or someone you know, is denied Medical Assistance in Pennsylvania because of the new requirements for documentation, it is important to get help from legal aid.
The Pennsylvania Health Law Project provides free legal services and advocacy to Pennsylvanians having trouble accessing publicly funded health care coverage or services. For assistance, call their helpline at 1-800-274-3258 or 1-866-236-6310 TTY.
Northwestern Legal Services provides civil legal aid to low-income residents, including issues with Medical Assistance. In Erie, call NWLS at 452-6957. For individuals outside of Erie, you can use their toll free number at (800) 665-6957.
posted by Access to Justice at 10:13 AM
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