507 Citizen of the United States

Revised 05/29/2024

Policy

To qualify for AHCCCS Medical Assistance (MA), a U.S. citizen or national must declare his or her U.S. citizenship. To declare U.S. citizenship, the customer must be listed as a U.S. citizen on the application, and the application must be signed by the customer or other person listed in MA1301.

U.S. citizens or nationals must also provide proof of citizenship, except for customers who:

Receive Social Security Disability Insurance benefits (MA606DDD);
Receive SSI Cash (MA606III);
Qualify for Medicare (MA523);
Are Deemed Newborns (MA407); or
Receive Title IV-E foster care or adoption assistance payments (MA606A).

NOTE When a person claims U.S. citizenship, but additional proof is needed, the person must provide proof within 90 days from the date it is requested. During this time, when the person meets all other eligibility requirements, MA is approved.

There is no limit on the number of times a customer may receive a conditional approval.

Definitions

Term	Definition
U.S. Citizen	A person may be a U.S. citizen by: Birth in the U.S. or a U.S. territory; Having a U.S. citizen parent; Marriage to a U.S. citizen; or Naturalization. NOTE People born in some U.S. territories may have to meet other conditions (see Citizen by Birth below).
Citizen by Birth	A person is a U.S. citizen by birth when the person was born in the United States, or in the following U.S. territories: American Samoa; District of Columbia; Guam (on or after April 10, 1899); Northern Mariana Islands (on or after November 4, 1986); Panama Canal Zone (between February 26, 1904 and September 30, 1979, AND a parent was a U.S. citizen employed by the U.S. government or the Panama Railroad Company); Puerto Rico (on or after January 13, 1941); Swain’s Island; U.S. Virgin Islands (on or after January 17, 1917); and Wake Island. Exception: A person born to foreign diplomats living in the U.S. or one of the territories above is not a U.S. citizen.
Citizenship through a U.S. citizen parent – Customer was born on or before February 27, 1983	The person is a U.S. citizen when either of the following are met: Both parents are U.S. citizens and at least one parent lived in the U.S. or its territories before the person’s birth; or One parent is a U.S. citizen and lived in the U.S., its possessions, or its territories for a total of five years before the customer’s birth. At least two of the five years must be after the parent reached age 14. NOTE Count any period of time that the parent lived outside of the U.S as a U.S. government employee, serving in the U.S. military or working for an international organization as living in the U.S.
Citizenship through a U.S. citizen parent – Customer was born after February 27, 1983	The person is a U.S. citizen when ALL of the following are met before the person reached age 18: At least one biological or adoptive parent is a U.S. citizen by birth or naturalization; The child is admitted to the U.S. on an immigrant visa or as a lawful permanent resident; The child lives in the legal and physical custody of the U.S. citizen parent; and For an adopted child, the final adoption is completed.
Citizenship through Marriage	A woman who married a U.S. citizen before September 22, 1922 established U.S. citizenship. This does not apply to a man who married a U.S. citizen.
Citizenship by Naturalization	Persons who are not U.S. citizens by birth or adoption may go through the naturalization process to become U.S. citizens. A person born outside the U.S. to noncitizen parents is a U.S. citizen when both parents (or the sole custodial parent) were naturalized as U.S. citizens before: The person’s 21st birthday when naturalization was before October 14, 1940; or The person’s 18th birthday when naturalization was on or after October 14, 1940.
Dual Citizenship	A person may be a U.S. citizen and a citizen of another country. A person claiming dual citizenship can lose U.S. citizenship only when the person voluntarily abandons it. Dual citizenship status does not affect the individual's U.S. citizenship.
Enhanced Driver’s License	A driver’s license issued by a state that requires proof of citizenship and verification of Social Security Number before issuing the license. Enhanced driver’s licenses have the word “Enhanced” printed on the front.

Proof

Citizenship is verified electronically through matches with federal and state data sources when possible.

When US Citizenship is not verified automatically by the hubs, see Checking Electronic Sources for Citizenship. Proof may have been provided during earlier applications.

When citizenship cannot be verified electronically, the customer must provide proof of citizenship.

The following documents can be used by themselves as proof of citizenship:

U.S. passport or passport card, regardless of its expiration date, as long as it is not a limited-validity passport;

Certificate of Naturalization;
Certificate of U.S. Citizenship;
Enhanced drivers license;
Any of the following documents issued by a federally recognized Indian Tribe:
- Tribal enrollment card;
- A Certificate of Degree of Indian Blood;
- A Tribal census document; or
- Other document on tribal letterhead signed by a tribal official that includes the name of the Tribe issuing the document and confirms the customer’s membership, enrollment, or affiliation with the Tribe.

NOTE When another State Medicaid agency or a Federal agency has verified the customer’s U.S. citizenship on or after July 1, 2006, the other agency’s decision can be accepted as proof.

When the person does not have one of the documents in the list above, proof of citizenship must include one document from List A and a different document from List B below:

List A

List B

U.S. Birth Certificate showing birth in one of the 50 states, the District of Columbia, Guam, American Samoa, Swain's Island, or the U.S. Virgin Islands;
Certification of Report of Birth, issued to a citizen born outside the U.S.;
Report of Birth Abroad of a U.S. Citizen;
Certification of birth in the United States issued by the Department of State;
U.S. Citizen ID card;
Northern Marianas Identification Card issued by the U.S. Department of Homeland Security;
A U.S. birth certificate showing birth in Puerto Rico on or after January 13, 1941;
Proof of birth in Puerto Rico and the person’s statement that he or she was living in the U.S. or a U.S. possession, or Puerto Rico on January 13, 1941;
A U.S. birth certificate showing birth in the Northern Mariana Islands after November 4, 1986;
Final adoption papers listing the child’s name and a U.S. place of birth

NOTE When the adoption is not yet final, a statement from a State-approved adoption agency with the child's name and U.S. place of birth.

Evidence of U.S. Civil Service employment before June 1, 1976
U.S. Military Record showing a U.S. place of birth;
Proof of birth in the Northern Mariana Islands; Trust Territory of the Pacific Islands citizenship; and residence in the U.S. or a U.S. possession on November 3, 1986, AND the person’s statement that he or she did not owe allegiance to a foreign State on November 4, 1986
Proof of Trust Territory of the Pacific Islands citizenship; continuous residence in the Northern Mariana Islands since before November 3, 1981, voter registration before January 1, 1975 and the person’s statement that he or she did not owe allegiance to a foreign State on November 4, 1986
Proof of continuous residence in the Northern Mariana Islands since before January 1, 1974 AND the person’s statement that he or she did not owe allegiance to a foreign State on November 4, 1986
Proof of birth in the Republic of Panama between February 26, 1904 and September 30, 1979, AND proof that a parent was a U.S. citizen employed by the U.S. government or Panama Railroad Company at the time of birth
Proof that a woman was married to a U.S. citizen before September 22, 1922
U.S. consular official’s statement
Extract of U.S. hospital record of birth on hospital letterhead
One of the following documents if it was created at least 5 years before the person first applied and shows birth in the U.S. For children under 16 it must have been created near the time of birth or 5 years before the date of application
- Life, health or other insurance record
- Medical record
- Admission papers from a nursing home or other institution
- Bureau of Indian Affairs tribal census record of the Navajo Indians
- U.S State Vital Statistics official notification of birth registration
- A delayed U.S. public birth record
- Statement signed by the physician or midwife in attendance at the birth
- Roll of Alaska Natives maintained by the Bureau of Indian Affairs
Federal or State census records with the person’s name, U.S. citizenship, a U.S. place of birth, and date of birth or age
An official religious record recorded in the U.S. or its territories within three months of the birth with the birthplace and the person’s date of the birth, or age at the time the record was made
Early school records that show ALL of the following: name, date admitted to the school, date of birth, a U.S. place of birth, and the parent’s name and birthplace

A WTPY or SOLQI if it indicates that the social security number is verified.
Driver’s license or ID card with a photo or identifying information issued by a federal, state or local government
School ID card with photograph
U.S. military draft card or draft record
Military dependent’s ID card
Native American tribal document
U.S. Coast Guard Merchant Mariner Card
Court documents
Three or more documents that confirm the person’s identity, including:
- Employee ID card
- High school or college diploma
- Marriage license or divorce decree
- Property deed or title
For children under 16, medical, school or daycare records can be used if they were not already used for list A

Exception:

A person who became a citizen through the Child Citizenship Act (CCA) may not have the documents listed above. To determine the proof needed for customers who became citizens through the CCA, see the table below:

If...

Then proof is needed that:

The customer was under 18 or not yet born on February 27, 2001

Before the customer turned 18:
At least one parent was a U.S. citizen (by birth or naturalized); and
The customer was admitted to the U.S. as a Lawful Permanent Resident and was in the legal and physical custody of a U.S. citizen parent.

Both of the customer’s parents were U.S. Citizens

Both parents were U.S. citizens;
The parents were married at the time of the customer’s birth; and
At least one parent lived in the U.S. or its territories before the customer was born.

The customer was born to a U.S. citizen

AND

Was born on or after November 14, 1986

One parent was a U.S. citizen;
The parents were married at the time of the customer’s birth; and
The U.S. citizen parent lived in the U.S. or its territories for a total of at least five years before the customer’s birth. Two of the five years must have been after the customer’s parent turned 14.

NOTE Any time the parent was outside the U.S. serving in the U.S. Armed Forces, employed by the U.S. government or employed by certain international organizations is counted toward the five years. Also, count any time the U.S. citizen parent was abroad as the unmarried child of a person who meets any of these three conditions.

The customer was born to a U.S. citizen

AND

Was born before November 14, 1986 but after October 10, 1952

One parent was a U.S. citizen;
The parents were married at the time of the customer’s birth; and
The U.S. citizen parent lived in the U.S. or its territories for a total of at least ten years before the customer’s birth. Five of the ten years must have been after the customer’s parent turned 14.

NOTE Any time the parent was outside the U.S. serving in the U.S. Armed Forces, employed by the U.S. government or employed by certain international organizations is counted toward the ten years. Also, count any time the U.S. citizen parent was abroad as the unmarried child of a person who meets any of these three conditions.

Customer was not born to a U.S. citizen

AND

Was born on or after December 24, 1952

Before the customer turned 18, he or she was living in the U.S. as an Lawful Permanent Resident and met any one of the following:

Both parents naturalized;
When one parent died, the surviving parent naturalized;
When the parents legally separated, that the parent maintaining legal and physical custody naturalized before the child turned 18;
When the child was born out of wedlock and paternity has not been established by legitimation, the mother naturalized.

NOTE The order in which the customer meets the conditions does not matter so long they are met before his or her 18th birthday.

Customer was adopted by a U.S. citizen

AND

Was under age 18 on February 27, 2001 or was not born yet

Before the customer turned 18, he or she was living legally in the U.S. in the legal and physical custody of a U.S. citizen parent

AND

Met any one of the following:

The citizen parent adopted the child before his or her 16th birthday (or, in some cases, 18th birthday) and had legal custody of the child and resided with the child for at least two years;
The child was admitted to the U.S. as an orphan (IR-3) or Convention adoptee (IH-3) and the adoption was fully completed abroad; or
The child was admitted to the U.S as an orphan (IR-4) or Convention adoptee (IH-4) to be adopted and the adoption was completed before his or her 18th birthday.

When a customer cannot provide proof that meets any of the policies above, see Obtaining Proof of Citizenship when the Customer Has No Documentation.

NOTE If you encounter a situation where you believe the customer’s identity is not verified, please discuss with your supervisor. If your supervisor agrees identity is not verified and needs to be verified, please submit a policy clarification request (PCR) requesting help getting the proof.

Legal Authority

This requirement applies to the following programs:

Program	Legal Authorities
All programs	8 USC 1431 42 USC 1396b 42 CFR 435.406, 407 and 911 ARS 36-2903.03 AAC R9-22-305.4,5,6
SSI MAO	AAC R9-22-1505.A.1
Medicare Cost Sharing	AAC R9-29-204.3
KidsCare	42 CFR 457.320(b)(6) and (d) ARS 36-2983.E AAC R9-31-302