On July 1, 2006, the U.S. government added new rules (regulations) for U.S. citizens who apply for or already receive Medicaid. Before this time, anybody applying for Medicaid who claimed he or she was a U.S. citizen simply had to state in writing, under oath, that he or she was a U.S. citizen. Under the new rules, many people receiving or applying for Medicaid who state that they are citizens will have to submit specific documents to prove that they are citizens.

Can immigrants still receive Medicaid?

Yes. These new rules only apply to some citizens. Immigrants remain eligible for Medicaid under the same rules that applied before July 1, 2006. Most immigrants who are lawful permanent residents of the U.S. (or have “green cards”) can receive Medicaid. But some immigrants may have to wait five years. Many immigrants, even undocumented immigrants, can receive Medicaid for treatment of emergencies. Before July 1, 2006, immigrants who applied for non-emergency Medicaid were required to show written proof of their immigrant status. The new rules do not change this requirement for immigrants. The new rules only change the proof requirement for citizens.

Do all citizens now have to supply written proof?

No. The new rules do not apply to some citizens who receive Medicaid and also receive another government benefit. For example, in New Jersey, Medicaid beneficiaries who also receive SSI (Supplemental Security Income), or who also receive Medicare, do not have to supply any documents to Medicaid to prove they are citizens.

Also, people who receive New Jersey FamilyCare, which is not part of the Medicaid program, are not subject to this new requirement. For example, these new Medicaid rules do not apply to children receiving NJ FamilyCare Plans B, C, or D. Also, single adults who receive New Jersey FamilyCare Plans G and H do not have to follow these new Medicaid rules.

If these new rules for proving citizenship apply to me, what documents do I need?

If you stated that you (or your child) were a citizen when you applied for Medicaid, the government office where you applied will let you know if they believe that the new rules require you to supply written proof. They will ask for one or more documents to prove both citizenship and identity. For citizenship, a document must show that you (or your child) are a U.S. citizen. For identity, a document must show that you (or your child) are who you say you are. If you have a U.S. passport, you do not need any other document. This is because a passport shows both citizenship and identity.

If you do not have a passport, a birth certificate is the easiest way to prove citizenship. Anyone born in the United States (including Puerto Rico after 1941, Guam, and the U.S. Virgin Islands) is a U.S. citizen. If the new rules apply to you, and you do not have a passport, the Medicaid office will next ask if you have a birth certificate. The birth certificate must be an original or a certified copy.

If I do not have an original or certified copy of a birth certificate, what do I do?

If you do not have an original or certified copy, you can ask for one from the state vital statistics agency in the state where you were born. New Jersey Bureau of Vital Statistics; the phone number is 609-292-4087. If you were born in New Jersey after 1965, you may ask the Medicaid office to get your birth records electronically. If you also receive TANF (cash assistance), you may also ask the Medicaid office to get proof of citizenship from your TANF file.

If you are still unable to show citizenship, you have a right to show specific documents other than a birth certificate to the Medicaid office. That office should give you a chart that lists other documents they will accept to show citizenship. If you have none of these other documents, you may “in rare circumstances” provide a written affidavit (sworn statement) from two people who know you are a citizen.

What do I need to prove identity?

You may prove identity (that you are the person named on the birth certificate or other document showing citizenship) with many different documents. For example, you can prove identity with a driver’s license, a school identification card with a photo, or with another government identification card. If you have a child under 16, you may prove identity with school records, or with an affidavit (sworn statement) from a parent or guardian (if you did not use an affidavit to prove citizenship). You may also not need to prove identity because the New Jersey Medicaid agency has stated that it may use computer information from other federal or state governmental agencies to show your identity.

Can the State stop my Medicaid if I don’t have these documents right now?

No. If you (or your child) are currently receiving Medicaid, and the State asks you to get documents to support your previous statement that you (or your child) are a citizen, they must give you some time. The government must continue your Medicaid for a period of time while you are getting those documents. While the new rules do not state the exact amount of time, they do state that you must have a “reasonable opportunity” to gather these documents.

If you (or your child) don’t have Medicaid now, but are applying for it, the State may treat you differently. As of right now, if you apply for Medicaid and declare that you are a citizen, the State may delay approval while you gather documents to prove you are a citizen.

What can I do if I have problems with these new rules?

Many people believe that some of these new rules are not what Congress (the lawmakers in Washington, D.C.) wanted when it passed the new Medicaid law earlier this year. Legal Services attorneys have asked that some of the rules be changed, and a lawsuit has been filed. Some of the rules may change soon. Also, because all of these rules are new, the Medicaid office may make some mistakes when requesting documents. If your Medicaid is stopped, delayed, or denied because of these new rules, or if you have questions about the rules, please contact the Health Care Access Project at Legal Services of New Jersey by calling LSNJ-LAW™, New Jersey’s statewide, toll-free legal hotline, at 1-888-LSNJ-LAW (1-888-576-5529). The hotline is open Monday through Friday between 8:00 a.m. and 5:30 p.m. You may also contact your regional Legal Services office.

This article originally appeared in the September 2006 issue of Looking Out for Your Legal Rights^®.