Code of Maine Rules › 10 - DEPARTMENT OF HEALTH AND HUMAN SERVICES › 144 - DEPARTMENT OF HEALTH AND HUMAN SERVICES - GENERAL › Chapter 332 - MAINECARE ELIGIBILITY MANUAL › Part 2 - BASIC ELIGIBILITY CRITERIA › Section 144-332-2-3 - CITIZENSHIP AND IDENTITY

Current through 2024-29, July 17, 2024
MaineCare and CHIP applicants must declare their United
					 States citizenship or qualifying noncitizen status and have their status
					 verified to receive MaineCare benefits. An individual who is not a citizen of
					 the United States may be eligible for full MaineCare benefits, or they may be
					 eligible for emergency services only.
Section
				  3.1
Verification of Citizenship and Identity
I. Unless exempted below in Paragraph II(A)
				  through (F), all members of a household applying for Medicaid and CHIP must
				  verify citizenship and identity. The Department will attempt to verify
				  citizenship or qualifying noncitizen status through electronic services before
				  requiring verification from the applicant or member.
II. The requirement to verify U.S.
				  citizenship and identity does not apply to:
A.
				  Current recipients of Supplemental Security Income (SSI).
B. Current recipients of Social Security
				  benefits, based on the individual's disability.
C. Individuals entitled to or enrolled in
				  Medicare.
D. Children who receive
				  child welfare assistance under IV-B of the Social Security Act or foster care
				  assistance under IV-E of the Social Security Act. This exemption is for the
				  child only, not the family providing the care.
E. A newborn whose mother receives Medicaid
				  at the time of birth.
F.
				  Individuals while covered under Presumptive Eligibility.
G. Individuals whose citizenship or eligible
				  noncitizen status has been verified by the Department and for whom no change in
				  status has been reported to the Department.
III. Applicants and household members who
				  declare United States citizenship or a qualifying noncitizen status, who are
				  otherwise eligible and only pending for verification of citizenship or
				  noncitizen status, will be granted a reasonable opportunity period of 90 days
				  from the date of request for verification to provide documentation necessary to
				  prove citizenship or qualifying noncitizen status. MaineCare or CHIP coverage
				  will be provided during the reasonable opportunity period, starting with the
				  first day of the month of application.
A reasonable opportunity period is not provided if an
					 individual does not declare U.S. citizenship or a qualifying noncitizen
					 status.
The reasonable opportunity period is defined as
					 follows:
A. It begins the date after
				  the member receives notice informing them they need to provide documentation of
				  citizenship or qualifying noncitizen status. The date the notice is received is
				  5 days after the date on the notice.
B. It ends on the earlier of the date the
				  Department verified the individual's citizenship or immigration status or at
				  the end of the 90-day period if verification of citizenship or satisfactory
				  noncitizen status was not obtained.
The Department may extend the reasonable opportunity period
					 if the individual is making a good faith effort to obtain any necessary
					 documentation, or if the Department needs more time to complete the
					 verification process.
If the applicant does not provide documentation necessary
					 to verify citizenship or qualifying noncitizen status of the applicant and
					 household members within 90 days, benefits for unverified household members
					 will end. A reasonable opportunity period will not be provided on subsequent
					 applications submitted by or on behalf of the applicant or household
					 members.
IV.
				  Failure to declare or prove citizenship or qualifying noncitizen status may
				  result in ineligibility for Medicaid or CHIP. Emergency Services may be
				  provided to an applicant who does not declare or is unable to prove declared
				  qualifying noncitizen status within the reasonable opportunity period.
If an individual within a household is not eligible due to
					 inability to prove citizenship, identity or noncitizen status, the individual
					 will still be counted as part of the household and that person's income and
					 assets will be included in determining eligibility for the rest of the
					 household.