Age and Identity 510-03-35-40

(New 7/1/2014 ML #3404)

View Archives

 

 

(N.D.A.C. Section 75-02-02.1-12)

 

1. An individual who is eligible upon reaching age twenty-one remains eligible for Medicaid through the month in which the individual reaches that age. An exception to this general rule permits eligibility to continue for a person who attains age twenty-one while receiving treatment and continues to receive treatment as an inpatient in a Psychiatric Residential Treatment Facility (PRTF), the state hospital, the Prairie at St. John's center, or the Stadter Psychiatric Center. Eligibility may continue through the month the individual attains the age of twenty-two.

2. Caretaker relatives, are not subject to any age requirements for purposes of Medicaid eligibility

3. In instances where only the year and not the exact date of birth can be established, use July 1 to designate the date of birth; or if the year and month can be established, use the year and first day of the month for purposes of Medicaid eligibility.

4. Identity must be established and documented as provided in this section.
   1. The following individuals are exempt from the identity verification requirements:
   1. SSI recipients who claim that they are US Citizens and that claim is not questionable (can prove using the SDX or NDVerify SSI match);
   2. Medicare beneficiaries who claim that they are US Citizens and that claim is not questionable (can prove using the NDVerify SSA match);
   3. Individuals receiving SSA disability insurance benefits based on their own disability;
   4. Individuals receiving Foster Care maintenance payments;
   5. Individuals receiving Subsidized Guardianship payments.
   2. Newborn children: A child, born to a woman who has applied for and been determined Medicaid eligible and is in receipt of Medicaid when the child is born, may be eligible without verifying identity. This provision also applies in instances where labor and delivery services were furnished prior to the date of the Medicaid application and covered based on retroactive eligibility.

This provision applies to all children whose Mother is eligible for Medicaid at the time of their birth, including those under the emergency services only provisions.

Children who are born to a woman who is here on a temporary basis and who is not eligible for Medicaid or emergency medical services must comply with the verification requirements if Medicaid is requested.

3. Reasonable Opportunity Period. Applicants who claim they are U.S. citizens or qualified aliens are entitled to a reasonable opportunity period to provide verification of citizenship, qualified alien status, and identity. Medicaid is not permitted to deny, delay, reduce, or terminate eligibility while documentation is being gathered during the reasonable opportunity period. A reasonable opportunity period applies when all other information necessary to determine eligibility is available. If an individual is eligible for Medicaid and has met all other criteria except for citizenship or identity verification, that individual’s eligibility may not be pended for verification of either citizenship or identity, but must be approved. If the individual does not provide satisfactory documentation of citizenship and identity by the end of the reasonable opportunity period, the individual’s eligibility must be terminated with advance (10-day) notice and without regard to continuous eligibility provisions.

A ‘reasonable opportunity period’ is defined as 90 days from the date the application is submitted and for the remaining days of the month in which the 90th day falls. An extension of an additional 60 days from the 90th day may be granted if the individual has verifiable documented evidence they have been making a good faith effort to obtain the verifications, but still have not received them.

An example of a good faith effort would be a letter from another state’s vital statistics office that the documentation was requested timely (no later than 10 days after the latter of the application date or the earliest date the verification was requested by the county or state agency), but there will be a delay in providing the documentation.

Example: Mr. Brown applies for Medicaid on May 11, 2010. He has verification of citizenship; however he has nothing to prove identity. He does not meet any of the exemptions from the verification requirements that are listed in the manual. Mr. Brown is determined to be eligible for Medicaid and the application approved for the prior months of March and April, the application month of May, and the future month of June. Mr. Brown claims he is a member of a federally-recognized Indian tribe in California. The worker has assisted him in requesting identifying tribal documents from the tribe in California. The worker sets an alert to follow up in early August. The worker does not receive a response by August 20, so sends an advance notice to close. On August 23, Mr. Brown brings in a recent letter from the tribal enrollment office in California, acknowledging receipt of his request for his tribal enrollment verification, and stating that it will take another 6 weeks for them to process it. In this case, an additional 2 month period may be granted. The worker would set an alert for a secondary follow up for October 2010. If not received by October 20, 2010, advance notice to close must be sent.

A reasonable opportunity can only be allowed once for any individual. If granted a reasonable opportunity period but the requested verifications are not received and eligibility is terminated, a second reasonable opportunity period is not allowed at a later application.

4. Primary and preferred verification of identity. Verification documents must be presented in their official and original form as received from the issuing agencies. Photocopies or notarized copies are not acceptable. Once an original document is presented, a photocopy must be made and maintained in the casefile.

 

These Documents Verify Both Citizenship and Identity:	Explanatory Information
US Passport or US Passport Card Issued since 2007	• Issued by the Department of State • Does not have to be currently valid, as long as it was issued without limitation; (any passport issued with a limitation cannot be used to verify citizenship, but CAN be used to verify identity). • Through 1980, spouses and children were often included on one passport; after that each person is issued his own passport. • The passport card is for frequent travelers by land or sea between the US and Canada, Mexico, the Caribbean and Bermuda.
Certificate of Naturalization (DHS/INS Forms N-550 or N-570)	• Department of Homeland Security or Immigration and Naturalization Service (INS) issues for naturalization.
Certificate of US Citizenship (DHS/INS Forms N-560 or N-561)	• Department of Homeland Security or INS issues certificates of citizenship to individuals who derive citizenship through a parent.
Tribal Enrollment Card Certificate of Degree of Indian Blood OR other documents issued by a federally recognized Indian tribe that evidences membership or enrollment with such tribe	• A Document issued by a federally recognized Indian tribe evidencing membership or enrollment or affiliation with, such tribe. See following table for acceptable verification from ND tribes.
Citizenship verification received from using the “Other Benefits” inquiry in the NDVerify system or from the citizenship verification system available through the Federally Facilitated Marketplace (FFM) – as automated through the Streamlined application process.	• Acceptable codes are: "Citizenship Verified" or "Verified with positive citizenship; Deceased."

 

Documents Issued by Recognized ND Tribes

Sisseton-Wahpeton (Wahpeton—SE corner of ND)	• Certificate of Degree of Indian Blood: Name, DOB, enrollment #, and degree of Indian blood; Issued to any enrolled member who requests it; Issued by tribal enrollment office; • Tribal ID cards: Name, DOB, enrollment #, degree of Indian blood, SSN, photo and individual’s signature; Issued to enrolled members age 16 and older who request it; Issued by tribal enrollment office;
Spirit Lake (Devils Lake)	• Certificate of Degree of Indian Blood: Name, DOB, enrollment #, and degree of Indian blood (may have more information); Issued to any enrolled member who requests it; Issued by tribal enrollment office; • Tribal Photo ID: Photo ID including name, DOB, tribal enrollment #, and degree of Indian blood (may have more information); Issued by tribal motor vehicle office; Issued to enrolled members;
Standing Rock Sioux Tribe (Fort Yates)	• Certificate of Degree of Indian Blood: Name, DOB, enrollment #, and degree of Indian blood, (may have more information); Issued to any enrolled member who requests it; Issued by tribal enrollment office; • Tribal ID cards: Name, DOB, enrollment #, and degree of Indian blood, last 4 digits of SSN (may have more information); Issued to enrolled members age 14 and older who request it; Issued by tribal enrollment office;
Three Affiliated Tribes (T. A. T.) (New Town)	• Certificate of Degree of Indian Blood: Name, DOB, enrollment #, and degree of Indian blood, mailing address, physical address, photo); Issued to any enrolled member who requests it; Issued by tribal enrollment office; • Tribal ID cards: Name, DOB, enrollment #, and degree of Indian blood, mailing address, physical address, photo ( plastic card with hologram on back) (will enter SSN (non-verified) at individual’s request); Issued to any enrolled member who requests it; Issued by tribal enrollment office (Cost = $10; free to seniors); Expire every 4 years;
Turtle Mountain Chippewa (Belcourt, Trenton)	• Certificate of Degree of Indian Blood: Name, DOB, enrollment #, and degree of Indian blood, (may have more information); Issued to any enrolled member who requests it; Issued by tribal enrollment office; • Tribal Enrollment cards: Name, DOB, enrollment #, and degree of Indian blood (may have more information); Issued to enrolled members age 18 and older who request it; Issued by tribal enrollment office.

 

 

5. Secondary verifications of identity may be accepted if primary verifications are not provided. Verification documents must be presented in their official and original form as received from the issuing agencies. Photocopies or notarized copies are not acceptable. Once an original document is presented, a photocopy must be made and maintained in the case file.

Secondary Verifications of Identity

(Level 2)

 

Acceptable Verifications:	Explanatory Information
Driver's license issued by a state or territory (DO NOT accept Canadian driver's license)	• Must include a photograph of the applicant or recipient: or • Have other personal identifying information for the individual such as name, age, sex, race, height, weight, or eye color.
Identification card issued by a US Federal, State or local government with the same information as a driver's license.	• DO NOT accept a voter's registration card.
School ID card	• Must include a photograph of the applicant or recipient.
U. S. military ID card or draft record
Military dependent's identification card
U. S. Coast Guard Merchant Mariner card

6. Third level verification of identity. These documents should only be used when documentation from levels one and two are unavailable.

 

Third Level Verifications of Identity

(Level 3)

Acceptable Verifications:	Explanatory Information
3 or more documents that together reasonably corroborate the identity of an individual, provided such documents have not been used to establish the individual's citizenship AND the individual has submitted at least second or third level citizenship verification	• Only to be used if no other evidence of identity is available. • Must contain the individual's name plus additional identifying information (employer ID cards, high school and college diplomas from accredited institutions, marriage certificates, death certificates, divorce decrees and property deeds/titles.).

7. Identity verifications for minor children. Exceptions identified in this section are allowed when a child does not have or cannot get any of the identity documents from the first three levels.

Identity Verifications for Children

(Level 4)

Acceptable Verifications:	Explanatory Information
School record	• Must show child's date and place of birth and parents' name.
Clinic, doctor, or hospital record	• Must show child's date and place of birth and parent's name.
Daycare or nursery school record showing date and place of birth	• Eligibility worker must call and verify with the school that issued the record.
An affidavit, signed under penalty of perjury, by the parent, guardian, or caretaker relative which states the date and place of birth of the child	• Only one affidavit may be used to establish either citizenship or identity. If an affidavit is used to establish citizenship, then identity must be established using a different document from the identity list. • The affidavit is not required to be notarized. • May be used for a child aged 16 to 18 only when school identity cards and driver's licenses are not available to the individual in that area until that age. • SFN 691, "Affidavit of Identity for Children," has been created for convenience.

 

8. Identity verifications for disabled individuals in institutional care facilities. Exceptions identified in this section are allowed when a disabled individual in an institutional care facility does not have or cannot get any of the identity documents from the first three levels.