Eligibility Criteria

Eligibility for major coverage groups within Medicaid

The following guidelines provide general income criteria that are used in part to determine a person’s eligibility for Medicaid programs and services. To become eligible, please visit your local county Department of Family and Children Services Office.

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Proof of Citizenship Requirements

In the past, if you had Medicaid or applied for Medicaid, you had to declare that you were a U.S. citizen or national, or that you were a “Qualified Alien.” All States have required that you be able to document Qualified Alien status, and some States have required you to document citizenship status.

What is changing?

Congress passed a new law. Beginning on July 1, 2006, all people who get Medicaid or people who apply for Medicaid must be able to document that they are U.S. citizens or nationals. If you are enrolled in Medicare or receive Supplemental Security Income (SSI), or are a “Qualified Alien,” you will not be affected by this new law.

What kind of documentation do you need?

The best way to document that you are a citizen is with one of these:
• A U.S. Passport
• A Certificate of Naturalization (DHS Forms N-550 or N-570)
• A Certificate of U.S. Citizenship (DHS Forms N-560 or N-561)
(If you do not have any of these items, you will need two documents, one document to show you are a citizen and one document to show who you are.)

Document you are a citizen with:
• Your birth certificate, or
• A Report or Certification of Birth Abroad of a U.S. Citizen (Form FS-240 or FS-545), or
• U.S. Citizen I.D. card (DHS Form I-197), or
• Adoption Papers, or
• Military Record if it shows where you were born
Show who you are with:
• Your picture on your current State driver’s license or State identity card, or
• School identification card, or
• A Federal, State or Local government identification card, or
• A U.S. Military identification card
What should you do if you don’t have any of these things?
• Check with Medicaid about other ways to document you are a citizen and to show who you are
• Tell Medicaid why you can’t get documents, and
• Give Medicaid any documents you have
(Each document you provide must be an original or a copy certified by the Agency that has the original. You cannot use a photocopy or a notarized copy of your document.)

How much time do you have to show this documentation to Medicaid?

Medicaid must give you a reasonable amount of time to get your documents. Check with Medicaid
to see exactly how much time you have to get your documents.
What if you still have questions?
If you still have questions, contact Medicaid, or call 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048. Information is also available on the cms.hhs.gov web site.