Verification of U.S. Citizenship and Identity and Immigration Status

(A) U.S. Citizenship and Immigration Status. MassHealth requires verification of U.S. citizenship or immigration status for all MassHealth applicants, except other noncitizens. (1) The MassHealth agency will initiate electronic data matches as described in 130 CMR 502.004: Matching Information to attempt to verify U.S. citizenship or immigration status. If electronic data sources are unable to verify U.S. citizenship or immigration status, additional documentation will be required from the individual. (2) Acceptable proof of U.S. citizenship is described in 130 CMR 504.005(A)(1) and (2). Individuals who fail to submit proof of U.S. citizenship within 90 days of the MassHealth agency’s request will subsequently only be (a) eligible for Children’s Medical Security Plan (CMSP) if they meet the categorical requirements for CMSP described in 130 CMR 522.000: MassHealth: Other Division Programs; or (b) eligible for MassHealth Standard for those who are pregnant if they meet the categorical requirements and financial standards described in 130 CMR 505.002(D): Eligibility Requirements for Pregnant Women. (3) Acceptable proof of immigration status is described in 130 CMR 504.005(B). Individuals who fail to submit proof of immigration status within 90 days of the MassHealth agency’s request will subsequently be (a) eligible only for MassHealth Limited, if they meet the categorical requirements and financial standards of MassHealth Standard; (b) eligible for Children’s Medical Security Plan (CMSP) if they meet the categorical requirements for CMSP described in 130 CMR 522.000: MassHealth: Other Division Programs; or (c) eligible for MassHealth Standard for those who are pregnant if they meet the categorical requirements and financial standards described in 130 CMR 505.002(D): Eligibility Requirements for Pregnant Women. (B) Identity. MassHealth requires verification of identity for U.S. citizens. (1) The MassHealth agency will initiate electronic data matches as described in 130 CMR 502.003: Verification of Eligibility Factors to attempt to verify identity. If electronic data sources are unable to verify identity, additional documentation will be required from the individual. (2) Acceptable proof of identity is described in 130 CMR 504.005(A)(3). (3) U.S. citizens as described in 130 CMR 504.002 who fail to verify identity within 90 days of the MassHealth agency’s request will subsequently only be (a) eligible for Children’s Medical Security Plan (CMSP) if they meet the categorical requirements for CMSP described in 130 CMR 522.000: MassHealth: Other Division Programs; or (b) eligible for MassHealth Standard for those who are pregnant if they meet the categorical requirements and financial standards as described in 130 CMR 505.002(D): Eligibility Requirements for Pregnant Women. (C) Reasonable Opportunity to Verify Citizenship and Identity or Immigration Status. The MassHealth agency provides applicants and members a reasonable opportunity period to provide satisfactory documentary evidence of citizenship and identity or immigration status in accordance with 130 CMR 502.003(F): Reasonable Opportunity to Verify Citizenship and Identity or Immigration Status. (D) Reasonable Opportunity Extension. Applicants or members who have made a good-faith effort to resolve inconsistencies or obtain verification of citizenship and identity or immigration status may receive a 90-day extension in accordance with 130 CMR 502.003(G): Reasonable Opportunity Extension. (E) Child Born to a MassHealth-eligible Individual. Regardless of the mother’s immigration status, a child born to an individual who is eligible for MassHealth on the date of the child’s birth will be deemed eligible for MassHealth from birth until the child’s first birthday and is exempt from providing citizenship and identity verification for eligibility.