Revision 24-4; Effective Dec. 1, 2024

A person applying for or receiving Medicaid and declaring to be a U.S. citizen or national must provide evidence of citizenship. Documentation must establish both citizenship and identity.

The following primary evidence documents are acceptable as verification of both citizenship and identity:

  • U.S. passport
  • Certificate of Naturalization (N-550 or N-570)
  • Certificate of U.S. Citizenship (N-560 or N-561)

If a person does not provide one of these primary evidence documents to establish both U.S. citizenship and identity, the person must provide two separate documents, one document each to verify:

  • U.S. citizenship; and
  • identity.

Refer to Appendix V, Levels of Evidence of Citizenship and Acceptable Evidence of Identity Reference Guide, for other verification sources based on the reliability level of the document as proof of citizenship when primary evidence of citizenship is not available. Begin with the second level of evidence and continue through the levels to explore the most reliable source of documentation available. If a document from the second level is not used, include in the case record the reason why a more reliable source of documentation of citizenship is not available.

Example: If a hospital record of birth is used to verify citizenship, document why a second-level source was not used.

Note: If citizenship verification is not a primary-level source, that verification cannot also be used to verify identity.

Example: If a person provides a birth certificate to verify citizenship, the person must provide a different document to verify identity.

Note: Affidavits are a last resort if the person is unable to provide any other documentary evidence of citizenship.

Criteria for acceptable affidavits:

  • The person or their authorized representative must provide an affidavit explaining why documentary evidence does not exist or cannot be readily obtained.
  • Two adults, regardless of the blood relationship to the person, must each complete an affidavit.
  • The two adults must attest that they have proof of their own citizenship and identity. These adults are not required to submit proof of citizenship and identity.
  • The two adults must provide any available information explaining why documentary evidence establishing the person's claim of citizenship does not exist or cannot be readily obtained.
  • Affidavits must be signed under penalty of perjury.

Form H1097, Affidavit for Citizenship/Identity, meets the required criteria.

Verification of citizenship and identity is a one-time requirement. Once citizenship is verified and documented in the case record, do not re-verify even after a break in eligibility.

If the person has a Social Security number (SSN), use all available electronic data sources (ELDS) to verify citizenship before requesting verification. 

Follow the instructions in the table below if the person has not been issued an SSN yet: If the person has applied for an SSN but has not been issued one, and:Then:
more information is required to determine eligibilityrequest the additional information and verification of citizenship. Allow the person 10 days to provide proof.
no other information is required to determine eligibilityallow the person a period of reasonable opportunity to provide the verification. If a reasonable opportunity period has been provided, citizenship must be verified before certifying for Medicaid.

If the person refuses or fails to provide proof of citizenship during the reasonable opportunity period, deny the person.

Note: If a person declares U.S. citizenship but cannot provide documentation, do not certify the person for ME – A&D Emergency.

Related Policy

Reasonable Opportunity to Provide, D-5500

D-5310 Exceptions to Documentation of Citizenship and Identity Requirement

Revision 13-1; Effective March 1, 2013

The following individuals are not required to provide evidence of identity and citizenship when they claim to be U.S. citizens or U.S. nationals and are:

  • active SSI recipients.
  • denied SSI recipients. If the State Data Exchange (SDX) contains the needed information to verify U.S. citizenship. Use SDX as a valid documentation source of both citizenship and identity when the denial is for any reason other than citizenship. SDX action code N13 is the denial code for citizenship.
  • determined to be entitled to or enrolled in Medicare Part A or B. This includes persons determined disabled for Social Security benefits who are in the 24-month period before receiving Medicare.
  • receiving Social Security Disability Insurance (SSDI) benefits based on their own disability.
  • in foster care and assisted under Title IV-B of the Social Security Act, and are beneficiaries of foster care maintenance or adoption assistance payments under Title IV-E of the Social Security Act.

Note: Neither the ineligible spouse of a person applying for Medicaid nor a parent applying for a child are required to provide evidence of citizenship and identity.

D-5320 Reserved for Future Use

Revision 24-4; Effective Dec. 1, 2024