New Citizenship Requirements

AHCCCS is working to provide the community with accurate and detailed answers to all frequently asked questions about the new additional citizenship requirements. AHCCCS compiled this list from meetings held with community members, providers, and hospital staff around Arizona. If your question is not yet on this list, please email Community Relations at: community@azahcccs.gov.

Frequently Asked Questions

1. How will the AHCCCS eligibility requirements change due to this new Federal law?
2. What type of documentation do U.S. citizens provide during the eligibility process before implementation of the additional citizenship and identity requirements?
3. What will members and applicants have to provide under the new requirements?
4. How are AHCCCS and DES informing members and applicants about the new additional requirement for AHCCCS health insurance?
5. How are AHCCCS and DES informing the community, including providers and hospitals?
6. How does this additional requirement affect the Federal Emergency Services (FES) program?
7. How does this additional requirement affect members or applicants who are non-citizens?
8. Can an applicant submit an AHCCCS application if he/she does not have all the additional documentation to prove citizenship and identity?
9. What if an AHCCCS member cannot produce the required proof of U.S. citizenship and identity?
10. Will AHCCCS and DES provide assistance to members and applicants who do not have a copy of their birth certificates?
11. How much time will an AHCCCS member be given to provide the required additional documentation?
12. Who will decide if an affidavit proving U.S. citizenship can be used, and where can members/applicants obtain the affidavit?
13. If AHCCCS and/or DES allow use of an affidavit, does it need to be notarized?
14. Do any programs under AHCCCS not have to provide citizenship and identity documentation?
15. What is the expected impact for this new Federal law on the health care system?

1. How will the AHCCCS eligibility requirements change due to this new Federal law?

As a result of a new federal law, effective July 1, 2006, AHCCCS members and applicants declaring U.S. citizenship must provide additional documentation of their U.S. citizenship and identity. This includes all AHCCCS health insurance programs (Medicaid), including ALTCS, and KidsCare.

2. What type of documentation do U.S. citizens provide during the eligibility process before implementation of the additional citizenship and identity requirements?

Before July 1, 2006, AHCCCS (Medicaid) recipients and new applicants declaring U.S. Citizenship must certify their citizenship statement under penalty of perjury and provide Social Security numbers. The Social Security number and other data provided to AHCCCS is verified with the Social Security Administration. If any conflicting citizenship information arises, documentation is required.

3. What will members and applicants have to provide under the new requirements?

Under the new Federal requirements, in addition to a verified Social Security number, members and applicants declaring U.S. Citizenship must provide additional documentation of U.S. Citizenship and identity – such as a U.S. passport, Certificate of Citizenship or Certificate of Naturalization, Driver’s license and birth certificate, etc (see Fact Sheet for AHCCCS & Kidscare Families for detailed list of acceptable proof).

4. How are AHCCCS and DES informing members and applicants about the new additional requirement for AHCCCS health insurance?

Information about additional documentation requirements is being mailed by AHCCCS to all affected members approximately 90 days before their review.

The first member letters were sent in May, 2006 for members with reviews scheduled in July and August. AHCCCS and DES will continue to notify members throughout 2006 and 2007 until all members have been notified 90 days prior to their review. (Visit Provider Resources to view letters).

Members will also receive review notices 30 days prior to the review date as they normally would, and each reminder notice will include information about the additional requirements.

Posters and informational fliers will be in all AHCCCS and DES offices to help our members understand the additional requirement and acceptable proof of citizenship and identity, as well as where they can go for help.

5. How are AHCCCS and DES informing the community, including providers and hospitals?

Both agencies are working together to educate the community about how the additional requirement will be managed in Arizona during the eligibility and review processes.

Informational Briefings continue to occur throughout the state in Phoenix, Tucson, Flagstaff, Casa Grande, Yuma, Sierra Vista, Page, Lake Havasu, and Nogales with advocacy organizations, community-based groups, health plans, hospitals and others who may provide information or assist individuals with the application process. For more information about these Briefings, visit http://www.azahcccs.gov/community.

AHCCCS and DES will work to inform the community of changes and work with the community to avoid denial or loss of health insurance for eligible Arizonans.

6. How does this additional requirement affect the Federal Emergency Services (FES) program?

This new additional requirement does not affect the Federal Emergency Services program. Eligibility rules have not changed for persons who are not U.S. citizens. The FES program continues to operate under its existing rules.

7. How does this additional requirement affect members or applicants who are non-citizens?

The new additional requirement does not affect eligibility rules for non-citizen qualified immigrants. Members and applicants who are qualified immigrants are already required to provide documentation. For more information about the eligibility polices for non-citizens, click here.

8. Can an applicant submit an AHCCCS application if he/she does not have all the additional documentation to prove citizenship and identity?

Yes. An application can be submitted without complete information and/or required documentation; however the application will NOT be approved until all required documentation is provided.

9. What if an AHCCCS member cannot produce the required proof of U.S. citizenship and identity?

AHCCCS and DES are prepared to work with difficult situations involving members who need assistance obtaining the additional documentation. Members must make a good faith effort in a timely manner to provide proof of U.S. Citizenship and identity. In those difficult circumstances where documentation cannot be obtained, the federal government has allowed for the acceptance of an affidavit. Both agencies are committed to working with members on a case-by-case basis.

10. Will AHCCCS and DES provide assistance to members and applicants who do not have a copy of their birth certificates?

AHCCCS and DES are working in partnership with the State Vital Records office to create an internal system to verify births for members/applicants born in Arizona.

The State will need additional information from the member/applicant to complete this verification of Arizona Birth, including:

• Full name at birth
• Date of Birth
• Gender
• County of Birth
• Medical Facility name
• Mother’s Full name (maiden)
• Mother Birth Date
• State or County of Mother's Birth

For members/applicants born outside Arizona, AHCCCS and DES can provide the contact information for vital records department in that state of birth; click here for that directory of state’s vital records office.

11. How much time will an AHCCCS member be given to provide the required additional documentation?

AHCCCS members will be notified of the new requirements approximately 90 days prior to their review. The eligibility process allows members/applicants 45 days to complete the review/application process. This rule will still apply after July 1, 2006, however, under the new law, members who make a good-faith effort to obtain and provide additional documentation to AHCCCS and DES will not lose health insurance coverage. Members must communicate to their eligibility specialist during the review process about their good-faith efforts to obtain their citizenship and identity documentation and they will remain a member until the requirements are met.

12. Who will decide if an affidavit proving U.S. citizenship can be used, and where can members/applicants obtain the affidavit?

AHCCCS and DES local office supervisors will determine if a member qualifies as what the Federal Government calls a "rare case" and therefore is able to use the affidavit for citizenship. The affidavits will only be available through the eligibility office that is reviewing the application for the member or applicant.

13. If AHCCCS and/or DES allow use of an affidavit, does it need to be notarized?

No. In those limited cases where an affidavit is used, they do NOT need to be notarized.

14. Do any programs under AHCCCS not have to provide citizenship and identity documentation?

Yes. Members receiving SSI-Cash and/or Medicare benefits are not required to provide additional documentation to AHCCCS or DES, as U.S. Citizenship is already verified through the Social Security Administration.

15. What is the expected impact for this new Federal law on the health care system?

If in fact U.S. Citizens lose health insurance coverage due to the inability to provide necessary documentation, studies show that individuals without health insurance are more likely neglect their routine preventive health care needs and more likely to use hospital emergency rooms for the care they need.

Studies have been conducted about the impact of disenrollment from AHCCCS. To view one of these studies, click here.

NOTE: These policies subject to change based on information AHCCCS receives from the federal government.