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Proof of Citizenship and Identity

New Requirements for Medi-Cal and CMSP Beneficiaries

Who Are U.S. Citizens or Nationals

A new law says most Medi-Cal and CMSP beneficiaries who are U.S. citizens or nationals must show proof of citizenship and proof of identity.  Read below to see if this law applies to you.

If you are not a U.S. citizen, this law does not apply to you.

The new law does not apply to U.S. citizens or nationals in any of these categories:

Anyone with:

        Supplemental Security Income (SSI)

        Medicare

        Social Security Disability Insurance (SSDI)

        Social Security Retirement and Survivors Insurance (RSI – Title II) based on their own disability

        Anyone under 21 asking for Minor Consent Services

        Babies born to women on Medi-Cal

        Children in Foster Care, Adoption Assistance, or Kin-GAP

        Babies in the Abandoned Baby Program

        CalWORKs Beneficiaries

 

What if I am not one of the above people?

        If you are a U.S. citizen or national, you must provide proof of citizenship and identity to continue to be eligible for Medi-Cal. (See page 3 for a list of acceptable proof of citizenship and identity.)  U.S. nationals include people born in American Samoa (including Swains Island) and certain people from the Commonwealth of the Northern Mariana Islands.

 

What if I am NOT a U.S. citizen?

       If you are not a U.S. citizen or national, you will need to provide the same documents that were required before. Nothing has changed.

 

How long will my coverage continue?

       Your Medi-Cal benefits will continue if you meet all other eligibility requirements and make a reasonable effort to provide the proof of citizenship and identity. You must tell your eligibility worker you are trying to get the proof.

 

How can I get proof of citizenship?

       If you were born in California, the county may be able to get your birth record. (A birth record is proof of citizenship.) Fill out a Request for California Birth Record to ask the county to request your birth record. Then mail or take this form to your local social services office.

       If a birth record cannot be found, you will need to provide another proof of citizenship. See page 3 for list of acceptable documents.

       Ask the county about getting proof of citizenship if you were not born in California.

       Contact the county to see if they have found a birth record match for you before you pay for a birth certificate.

 

State of California – Health and Human Services Agency Department of Health Care Services  DHCS 0002 (01/08) Page 1 of 4


 

What if I cannot provide proof of citizenship and identity?

       You will have a reasonable amount of time to provide your proof. If you cannot provide your proof but you continue to meet all other eligibility requirements, you will be changed to limited benefits.

       Limited benefits cover emergency, pregnancy-related, and long-term care services.

       If you provide proof within one year of the redetermination month, your Medi-Cal benefits will be changed to full-scope starting from the month that your limited benefits began.

       If you incurred health costs while getting your citizenship and identity documents, Medi-Cal may pay for your bills. Call the Beneficiary Services at the Department of Health Care Services for answers to your questions: (916) 403-2007.

 

Do children have to provide proof of citizenship and identity, too?

       Yes. If your child was born in California, ask your county to request the birth record as proof of citizenship. You will still need to provide proof of identity. See page 3.

       If your child is under 16 and you have filled out and signed the Medi-Cal application or the Healthy Families/Medi-Cal joint application with your child’s date and place of birth, you do not need to provide proof of identity. (This signed application is proof of your child’s identity.)

       You will still have to provide proof of citizenship. If your child is 16 or over, you will need to provide proof of identity for your child. See page 3.

 

Do I have to provide proof of citizenship and identity each time I renew?

        No. You only have to provide this information once – either when you first apply or on your next annual eligibility review.

 

Does this law affect my Food Stamps, CalWORKs, or Healthy Families benefits?

        No. The new citizenship and identity requirements apply to Medi-Cal only.

 

Do you need original citizenship and identity documents?

        Yes. We need the original citizenship and identity documents, or copies that have been certified by the issuing agency.

 

Can I mail my proof?

        Yes. The county will make copies and mail them back to you.

        Or, you can take your documents to your local social services office.

        Ask them to make copies and give them back right away.

       You must provide the county with original documents- not copies

 

State of California – Health and Human Services Agency Department of Health Care Services  DHCS 0002 (01/08) Page 2 of 4


 

Acceptable Citizenship and Identity Documents

The easiest way for U.S. citizens or nationals to prove citizenship and identity is with one of these documents:

        U.S. Passport issued without limitation (expired ones are acceptable)

        Certificate of Naturalization (N-550 or N-570)

        Certificate of U.S. Citizenship (N-560 or N-561)

– OR –

If you do not have one of the documents above provide…

 

One citizenship document listed below:

 

        U.S. Birth Certificate

        Certification of Report of Birth (DS-1350)

        Report of Birth Abroad of a U.S. Citizen (FS-240)

        State Department Certification of Birth (FS-545 or DS-1350)

        U.S. Citizen Identification Card (I-197 or I-179)

        American Indian Card (I-872)

        Northern Marianas Card (I-873)

        Final adoption decree showing a U.S. place of birth

        Proof of adoption of a child born outside U.S. and in the legal/physical custody of the U.S. citizen parent (IR-3 or IR-4)

        Proof of U.S. civil service employment before June 1, 1976

        U.S. military service record showing a U.S. place of birth

        U.S. hospital record made at the time of birth * †

        Life, health, or other insurance record * †

        Religious record recorded in the U.S. within 3 months of birth showing U.S. place of birth and birth date or age

        Early school record showing a U.S. place of birth, date of admission, birth date, names and places of birth of parents

        Federal or State census record that shows the applicant’s age and U.S. citizenship or place of birth

        Seneca Indian tribal census record * †

        Bureau of Indian Affairs Navajo Indians tribal census record * †

        U.S. State Vital Statistics birth registration notification * †

        A delayed U.S. public birth record that was recorded more than 5 years after the person’s birth * †

        Statement signed by doctor or midwife present at the birth * †

        Roll of Alaska Natives from the Bureau of Indian Affairs * †

        Admission papers from a nursing or skilled care facility, or other institution that shows a U.S. place of birth *

        Medical record (not an immunization record) * †

1.       * Must be dated at least 5 years before your 1st Medi-Cal application and show a U.S. place of birth)

2.       For children under 16, must be created near the time of birth.

You must provide a document as high up on the list as you can. If you cannot provide any of these citizenship documents… Ask two adults to fill out and sign an Affidavit of Citizenship. Both adults must have proof of their own identity and U.S. citizenship, and only one of them may be related to you.

 

– AND –

One identity document listed below:

 

        Driver's license issued by a U.S. State or Territory with a photograph or other identifying information

        School Identification card with a photograph

        U.S. Military I.D. card or draft record

        Federal, state or local government I.D. card with same identifying information as a driver’s license

        U.S. Military dependent identification card

        A U.S. passport (issued with limitation)

        Certificate of Degree of Indian Blood or other U.S. American Indian/Alaska Native Tribal document

        U.S. Coast Guard Merchant Mariner Card

        Three or more confirming documents, such as employee ID cards, high school or college diplomas, marriage licenses, divorce decrees, and property deeds/titles

        Clinic, doctor, or hospital records for a child under 16

        School, nursery school, or daycare records, including report cards, for a child under 16. The county will verify with the school.

        For people with disabilities who live in a residential care facility, an Affidavit signed by the facility’s director or administrator. 

 

State of California – Health and Human Services Agency Department of Health Care Services  DHCS 0002 (01/08) Page 3 of 4


 

For a child under 16 who did not provide an Affidavit of Citizenship, you may submit:

        An Affidavit of the child’s identity signed by the child’s parent, guardian, or caretaker relative with date and place of birth

        A Medi-Cal application or the Healthy Families/Medi-Cal joint application that shows the child’s date and place of birth, and is signed by the child’s parent, guardian, or caretaker relative.

 

For a child under 18 you may submit:

        An Affidavit of the child’s identity signed by the child’s parent, guardian, or caretaker relative may be used if school ID cards or driver licenses are not available.

        Note: Expired identity documents are acceptable proof of identity.


State of California – Health and Human Services Agency Department of Health Care Services  DHCS 0002 (01/08) Page 4 of 4

This site is intended as a resource to provide Sutter Coast Hospital Patients better access to free or low cost medical coverage. For more help and information contact:

 

Debbie Youtsey - Patient Services - Sutter Coast Hospital

800 E. Washington Blvd. PO Box 2009 Crescent City CA 95531

Phone: (707)464-8960      Fax: (707)464-8839

  E-mail: YoutseD@sutterhealth.org

 

Official Sutter Web Sites:  Sutter Coast Hospital   Sutter Health   Find a Doctor

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