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State of Wisconsin |
HISTORY |
The policy on this page is from a previous version of the handbook.
Persons applying for or receiving Medicaid (MA), BadgerCare Plus, or FPOS benefits, who have declared that they are a U.S. citizen, must provide documentation of their U.S. citizenship unless they are exempt from this requirement (See 4.2.2) or their citizenship is verified by the Social Security Administration through a data exchange.
Certain documents, such as a passport, are considered verification of citizenship by themselves. These are called “stand-alone documents.” Those who are not exempt from the requirement, have not had their citizenship verified by the Social Security Administration, and do not provide a stand-alone document must provide documentation of citizenship and of identity. Any document used to establish U.S. citizenship must show either a birthplace in the U.S., or that the person is otherwise a U.S. citizen. In addition, any document used to establish identity must show identifying information that relates to the person named on the document. For a list of all the allowable documentation, see Process Help, Section 68.3 Acceptable Citizenship and Identity Documentation.
If an individual has provided proof of citizenship in a state other than WI, the IM worker can either request that the individual resubmit the documentation or request and obtain a copy or electronic copy of the original documentation reviewed by the other state to keep on file in WI.
Agencies may accept citizenship and identity documents from a woman whose last name has changed due to marriage or divorce if the documentation matches in every way with the exception of the last name. If there is any doubt, the agency may request that the individual provide an official document verifying the change such as a marriage license or divorce decree. If an individual has changed his or her first and last name, he or she must produce documentation from a court or governing agency documenting the change.
Applicants who are otherwise eligible and are only pending for verification of citizenship (and identity when needed) must be certified for health care benefits within the normal application processing timeframe (30 days from the filing date). Applicants are not eligible for backdated health care benefits while pending for citizenship and/or identity. Once verification is provided, the applicant’s eligibility must then be determined for backdated health care benefits if they have been requested.
The applicant will have 95 days after the request for verification to provide the requested documentation. If the requested verification is not provided by the end of the 95 days, the eligibility will be terminated with Adverse Action notice, unless the eligibility worker believes a good-faith effort is being made by the applicant/member and the worker chooses to extend the good-faith period. This 95-day period applies to applications, reviews and person adds. An individual can only receive one 95 day good-faith effort period in his or her lifetime.
Once the citizenship (and identity when needed) requirement is met, it need not be applied again, even if the person loses Medicaid at some point and later re-applies. A person should ordinarily be required to submit evidence of citizenship (and identification when needed) only once, unless other information is received causing the evidence to be questionable.
Note: Do not re-verify identity for a person who has had his or her identity verified through the signing of a Statement of Identity for Children Under 18 Years of Age, F-10154.
An electronic copy of documentation submitted by the applicant or member to satisfy the requirement must be maintained in the case record.
See Process Help, Section 68.1 Citizenship and Identity Verification, for tools that IM workers can use to assist clients and applicants in meeting this requirement.
The citizenship and identity documentation requirement covers all non-exempt applicants and members of:
BadgerCare Plus
Medicaid
Katie Becket
Note: Eligibility for Katie Becket is determined by Division of Long Term Care staff, therefore they will be ensuring citizenship and identity verification.
Tuberculosis (TB)-related Medicaid
Wisconsin Well Woman Medicaid
Note: TB and Wisconsin Well Woman Medicaid eligibility is not determined in CWW; therefore, it is important to ensure that citizenship and identity verification is done only once.
The following populations are exempt from the citizenship and identity documentation requirement:
Former SSI and Medicare Recipients
States cannot consider individuals who received Medicare or SSI in the past to be exempt. An individual is not required to be a citizen to receive these benefits. Since SSA does not share information regarding the reason benefits were lost, it is not possible to determine if the termination was due to citizenship status or not.
Note: Confirm the receipt of SSI, SSDI, and Medicare through SOLQ or DXSA.
Note: Qualified providers who conduct BadgerCare Plus express enrollment determinations must not apply the citizenship and identification documentation requirement to persons seeking eligibility through express enrollment. Persons determined eligible for BadgerCare Plus through express enrollment are not subject to the documentation requirement until they file a formal application with the local Income Maintenance Agency.
For individuals who meet the selection criteria below, CARES will automatically submit a request to the Social Security Administration (SSA), with the person’s name, verified Social Security Number (SSN), and date of birth for comparison to SSA’s data. If SSA is able to verify the person’s U.S. citizenship, no additional verification of citizenship is required.
Only persons meeting all of the following criteria will be selected for this data exchange:
Requesting Medicaid, BadgerCare Plus, or Family Planning Only Services
Declaring to be a US citizen or national
Provides an SSN
Is not a member of an exempt population listed in 4.2.2
Citizenship/nationality has not already been verified through other means
Non-exempt BCP applicants/members who do not provide an SSN or whose SSN cannot be verified, must meet the citizenship/identity verification requirement by providing verification as defined in 4.2.4.
If an individual applying for BadgerCare Plus is not exempt from documenting citizenship and the Social Security Administration is unable to verify his or her citizenship through the data exchange, he or she needs to provide documents that verify citizenship (and identity when needed). If an applicant/member contacts the agency, work with him or her to determine if anything on the document list in Process Help, Section 68.3 Acceptable Citizenship and Identity Documentation is readily available to the applicant/member.
In certain circumstances the agency can authorize payment of documentation for an applicant/member. See 4.2.5, Agencies Paying for Documentation.
Stand-alone Documentation of Citizenship
Stand-alone documentation is a single document that verifies citizenship, such as a United States passport. Stand-alone documentation of citizenship is the most reliable way to establish that the person is a U.S. citizen. If an individual presents a stand-alone document, no other information is required. See Process Help, Section 68.3 Acceptable Citizenship and Identity Documentation, for a list of stand-alone documents.
An applicant or member who does not provide a stand-alone document must provide documentation of citizenship and identity.
Evidence of Citizenship
If an applicant is unable to provide stand-alone documentation of citizenship, the first thing he or she must provide is evidence or other documentation proving citizenship. (See Process Help, Section 68.3 Acceptable Citizenship and Identity Documentation, for a list of acceptable Documentation of Citizenship Only.) If an applicant is unable to provide any of the acceptable documents of citizenship found in Process Help, he or she may submit an affidavit signed by another individual under penalty of perjury who can reasonably attest to the applicant’s citizenship, and that contains the applicant’s name, date of birth, and place of U.S. birth. The affidavit does not have to be notarized. Provide the applicant with the Statement of Citizenship and/or Identity form, F-10161.
Note, however, that a citizenship document is evidence of U.S. citizenship only and must be accompanied by evidence of identity.
Note: Completing an on-line birth query can be done for all persons born in Wisconsin.
Evidence of Identity
If an applicant is unable to provide stand-alone documentation of citizenship, in addition to providing evidence of citizenship, they must also provide evidence of identity. (See Process Help, Section 68.3 Acceptable Citizenship and Identity Documentation, for a list of acceptable Documentation of Identity Only.) The applicant may provide any documentation of identity listed in PH 68.3 Acceptable Citizenship and Identity Documentation to prove identity, provided such document has a photograph or other identifying information sufficient to establish identity, including, but not limited to, name, age, sex, race, height, weight, eye color, or address..
In addition, you may accept as proof of identity a finding of identity from a Federal agency or another State agency, including but not limited to a law enforcement, revenue, or corrections agency, if the agency has verified and certified the identity of the individual. If the applicant does not have any documentation of identity and identity is not verified by another Federal or State agency, he or she may submit an affidavit signed, under penalty of perjury, by a person other than the applicant who can reasonably attest to the applicant’s identity. Such affidavit must contain the applicant’s name and other identifying information establishing identity, as described above. The affidavit does not have to be notarized. Provide the applicant with the Statement of Citizenship and/or Identity form, F-10161.
The worker can authorize payment for a birth certificate from the state where the applicant was born and/or a WI State ID if an applicant/member:
Has no documentation of citizenship or identity;
Needs either an out of state birth certificate and/or has no identity documentation; and
Requests financial assistance.
Note: If a member has obtained and already paid for his or her own documentation and later asks the IM agency for reimbursement of those costs, the IM agency should not provide reimbursement.
If an individual was born in Wisconsin and not found in the Wisconsin online birth query, agencies may authorize payment for a WI birth certificate to verify citizenship.
IM agencies should pay for a birth certificate or state ID card before relying on a written affidavit. If there is an opportunity to obtain a document that meets the guidelines then that should be pursued.
However, when an applicant/member lacks any identity documentation needed to apply for a birth certificate or lacks any citizenship documentation to be able to apply for an ID card, it is appropriate to consider using a written affidavit for citizenship and/or identity.
In order to obtain birth certificates or state ID cards for applicants/members, agencies need to follow the process outlined in Process Help, Section 68.2.5 Agency Documentation Requests.
A person being added to a case is subject to the verification requirement at the time of his or her request for benefits. If not exempt and citizenship is not verified by SSA, inform the applicant of the documentation requirement and give him or her the 95-day reasonable opportunity period to comply. Grant eligibility if the person is otherwise eligible. If documentation is not received timely, terminate BadgerCare Plus for that person only.
Qualified providers who conduct BadgerCare Plus presumptive eligibility/express enrollment determinations must not apply the citizenship and identification documentation requirement to persons seeking presumptive eligibility. Persons determined presumptively eligible for BadgerCare Plus are not subject to the documentation requirement until they file a formal application with the local Income Maintenance agency.
IM workers should not delay an individual household member’s eligibility when awaiting another household members’ citizenship or identity verification. The individual pending for citizenship/identity should be counted as part of the group when determining eligibility for other group members. See Process Help, Section 68.1 Citizenship and Identity Verification, for processing instructions.
Certain foreign-born individuals have derivative U.S. citizenship as a result of the Child Citizenship Act (CCA). Within the context of the BadgerCare Plus citizenship verification requirement, this means that for any applicant or member claiming citizenship through the CCA, IM workers should not request documentation for that person. In these cases, IM workers need to acquire documentation proving the citizenship and identity of at least one U.S. citizen parent. The parent’s U.S. citizenship is the basis for the child receiving derivative citizenship.
For persons who meet the citizenship verification requirement through the means allowed in the CCA, this is considered evidence of citizenship. Therefore this counts for citizenship only and the individual needs to provide another document to verify identity.
See 4.1.1 Child Citizenship Act of 2000
As a reminder, do not request or require citizenship and identity documentation from individuals who have not declared that they are citizens. Non-citizens who apply for IM programs are not subject to this policy. Legal non-citizens are subject to the verification process through FDSH and SAVE, and undocumented non-citizens do not have any status that can be verified. (See Process Help, Section 44.2.2.11 Immigrant/Refugee Verification, for instructions on using FDSH and Process Help, Chapter 82 SAVE, for instructions on using SAVE.) Undocumented non-citizens can apply for Emergency Medicaid or BadgerCare Plus Prenatal Program and should not be subject to the citizenship and identification verification policy.
When an individual who had legal non-citizen status subsequently gains U.S. citizenship, this is recorded in SAVE. Therefore SAVE can be used to verify these individuals' citizenship. The verification result from SAVE will be used to verify these individuals' citizenship. The verification result from SAVE will be "individual is a US Citizen." These individuals still need to provide proof of identity.
Disabled individuals in institutional care facilities may have their identity attested to by the facility director or administrator when nothing else is available. Use the Statement of Identity for Persons In Institutional Care Facilities, F-10175, for this purpose. A medical institution can be, but is not limited to, skilled nursing facilities (SNF), intermediate care facilities, IMDs, and hospitals.
This page last updated in Release Number: 18-02
Release Date: 08/10/2018
Effective Date: 07/01/2018
The information concerning the BadgerCare Plus program provided in this handbook release is published in accordance with: Titles XI, XIX and XXI of the Social Security Act; Parts 430 through 481 of Title 42 of the Code of Federal Regulations; Chapter 49 of the Wisconsin Statutes; and Chapters HA 3, DHS 2 and 101 through 109 of the Wisconsin Administrative Code.
Publication Number: P-10171