Arizona Administrative Code › Title 9 - HEALTH SERVICES › Chapter 22 - ARIZONA HEALTH CARE COST CONTAINMENT SYSTEM - ADMINISTRATION › Article 3 - GENERAL ELIGIBILITY REQUIREMENTS › Section R9-22-305 - Eligibility Requirements

Current through Register Vol. 30, No. 28, July 12, 2024
As a condition of eligibility, the Administration or its
				  designee must require applicants, and members to do the following:
1. Take all necessary steps to obtain any
				annuities, pensions, retirement, disability benefits to which they are
				entitled, unless they can show good cause for not doing so.
2. Furnish a SSN under
				42 CFR
				435.910 and
				435.920, or
				in the absence of an SSN, provide proof of a submitted application of SSN. The
				Administration or its designee will assist in obtaining or verifying the
				applicant's SSN under
				42 CFR
				435.910 if an applicant cannot recall the
				applicant's SSN or has not been issued a SSN. An applicant is not required to
				furnish an SSN if the applicant is not able to legally obtain a SSN. The
				Administration or its designee shall determine eligibility notwithstanding the
				applicant's lack of a SSN, if the applicant is cooperating with the
				Administration or its designee to obtain a SSN and obtain a SSN prior to the
				next scheduled review of eligibility.
3. Provide proof of residency of Arizona. An
				applicant or a member is not eligible unless the applicant or member is a
				resident of Arizona under
				42 CFR 435.403
				effective October 1, 2012, which is incorporated by reference and on file with
				the Administration, and available from the U.S. Government Printing Office,
				Mail Stop: IDCC, 732 N. Capitol Street, NW, Washington, DC, 20401. This
				incorporation by reference contains no future editions or amendments.
4. A written declaration, signed under
				penalty of perjury, must be provided for each person for whom benefits are
				being sought stating whether the individual is a citizen or national of the
				United States, and, if that individual is not a citizen or national of the
				United States, that the individual is a qualified alien. The declaration must
				be provided by the individual for whom eligibility is being sought or an adult
				member of the individual's family or household.
5. Each applicant who claims qualified alien
				status must provide either:
a. Alien
				registration documentation or other proof of immigration registration from the
				Immigration and Naturalization Service that contains the individual's alien
				admission number or alien file number (or numbers if the individual has more
				than one number), or
b. Other
				documents that the Administration or its designee accepts as evidence of
				immigration status, such as:
i. a Form I-94
				Departure Record issued by the USCIS,
ii. a Foreign Passport,
iii. a USCIS Parole Notice,
iv. a Victim of Trafficking Certification or
				Eligibility Letter issued by the US DHHS Office of Refugee
				Resettlement,
v. other
				documentation consistent with
				42 CFR
				435.406 or
				435.407.
c. Sufficient information for the
				Administration or its designee to obtain electronic verification of immigration
				status from the USCIS.