Age and Identity 510-05-35-40

(Revised 7/1/09 ML #3183)

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

An eligible categorically or medically needy aged applicant or recipient is eligible for Medicaid for the entire calendar month in which that individual reaches age sixty-five.
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), or 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.
Blind individuals, disabled individuals, and caretaker relatives, are not subject to any age requirements for purposes of Medicaid eligibility.
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.
Identity must be established and documented as provided in this section.

The following individuals are exempt from the identity verification requirements:

SSI recipients who claim that they are US Citizens and that claim is not questionable (can prove using the SDX or TPQY SSI match);
Medicare beneficiaries who claim that they are US Citizens and that claim is not questionable (can prove using the TPQY SSA match);
Individuals receiving SSA disability insurance benefits based on their own disability;
Individuals receiving Foster Care maintenance payments;
Individuals receiving Subsidized Adoption payments; and
Individuals receiving Subsidized Guardianship payments.

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 for up to one year as long as the Mother is eligible or would remain eligible if she were pregnant and as long as the child remains in the Mother's household. Identity verification for the child must be supplied at the next redetermination of eligibility. 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 exception applies to all children whose birth is covered by Medicaid, including those under the emergency services only provisions as long as the child remains in the Mother's household.

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.

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.

Primary Verifications of Identity

(Level One)


These Documents Verify Both Citizenship and Identity:	Explanatory Information:
US Passport	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.
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.

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:
Certificate of Degree of Indian Blood, or other U. S. American Indian / Alaska Native tribal document	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
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

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.)

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

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.

Identity Verifications for Disabled Individuals in

Institutional Care Facilities

(Level 4)


Acceptable Verification:	Explanatory Information:
An affidavit signed under penalty of perjury by a residential care facility director or administrator	Is not required to be notarized Should be used only as a last resort SFN 690, "Affidavit of Identity for Disabled Individual in Facility," has been created for convenience.