POL M301A:  FACTORS REQUIRING VERIFICATION  

1.    Citizenship And Identity Must Be Verified Within 90 Days

Medicaid applicants who declare U.S. Citizenship and identity, have 90 days to provide verification from the date of approval. Refer to Medicaid Table 5 for evidence of citizenship and identity except for the following programs that do not have this verification requirement:

• • • • • Emergency Services.

        • Basic Foster Care.

        • Institutional Foster Care.

2.    Citizenship And Identity Verification Not Required

Verification of citizenship and identity has already been documented by the Social Security Administration; for that reason, verification is not required for the following Individuals:

• • • • • Entitled to Supplemental Security Income (SSI).

        • Entitled to Social Security Disability.

        • Entitled to or enrolled in Medicare.

Verification of citizenship and identity is not required for a newborn of a Medicaid eligible mother.

Verification of citizenship and identity is not required when documentation has already been provided for a previous application or can be verified by reliable information available to the Department.

3.    Date Of Birth Must Be Verified 

Any electronic source or document that verifies citizenship and lists the applicant's date of birth can be used to verify date of birth.  Refer to Medicaid Table 5 for evidence of citizenship.

4.    Social Security Number Must Be Verified

SSN can be verified via the following electronic sources:

• SDX

• SOLQ-I

• SVES

A Social Security card can be used as hard copy verification of SSN.

5.    Eligibility Must Not Be Delayed

Eligibility determination must not be delayed while verification for other programs is pending.

6.    Age Must Be Verified

Age must be verified using primary or second level documents for the Aged, Blind or Disabled Programs. Refer to Medicaid Table 5B.

7.    Income Must Be Verified

Income must be verified using primary or secondary evidence sources. Refer to Medicaid Table 5B.

A report of zero income must be verified through electronic sources for any household member age 14 and over.

Verification of income is not required for the Medicare Savings Programs when an application is received from the Social Security Administration (SSA), referred to as the MIPPA file.  Post eligibility electronic verification is used when there is conflicting or incomplete information provided by SSA.

8.    Income Deductions Must Be Verified

Tax deductible adjustments to income for MAGI programs must be verified at application and renewal or when the deduction is added to the case.

Client can request the deduction not be included in the calculation if they cannot provide verification.

Deductions that do not make a difference in eligibility do not need to be entered into WES or verified.

9.    Resources Must Be Verified

Resources must be verified for the Aged, Blind or Disabled (except for the Employed Individuals with Disabilities (EID) and Medicare Savings Programs, using primary or secondary evidence sources. Refer to Medicaid Table 5B.

Verification of resources is not required for the Medicare Savings Programs when a MIPPA application is received from the Social Security Administration (SSA).  Post eligibility electronic verification is used when there is conflicting or incomplete information provided by SSA.