CRITERION | SUMMARY OF THE POLICY | VERIFICATION REQUIREMENTS |
|
Age | Children must be under 19. | Accept A/R statement. | |
Application
for Other Benefits |
In RSM children cases the A/R must apply
for and accept all monetary benefits any AU member is entitled to receive
(except TANF and SSI).
This policy is not applicable in RSM pregnant women cases. |
Accept A/R statement. | If the potential benefits are for a child and application is not made, then the child is ineligible for Medicaid |
Citizenship/
Alienage |
Must be a US Citizen or qualified alien; Does not have to be established for Newborn COA. |
Third party verification of both citizenship and alienage is required. Section 2215 of the policy manual lists acceptable forms of verification. |
The individual for whom verification is not obtained is not eligible for RSM. |
Enumeration | Each person in the AU must provide an
SSN or proof of application for a number. Good cause may apply for
failure to provide.
Individuals who are in the budget group only should be asked to provide their SSN, but no penalty is imposed if they fail to do so. |
Accept A/R statement of SSN
if the number is known.
Can also accept AU statement for application for an SSN in order to process the application, but verification is required in the third month following the month of approval. |
Exclude the non-enumerated individual if the SSN or application for an SSN is not verified. |
Residency | Must live or intend to live in Georgia. A permanent dwelling or fixed address is not required. | Accept A/R statement. | |
Third Party Resources (TPR) | AU members must assign rights to Third Party Resources to the Department of Medical Assistance. | Accept A/R statement as to whether anyone in the AU has insurance. Form DMA-285 must be completed and routed to DMA on each AU regardless of whether the AU has insurance. Complete the HIPP referral form if AU or absent parent has access to health insurance, but cannot afford the premium. | The adult in the AU is not eligible if the AU does not cooperate with the TPR process. |
Pregnancy
and EDD |
Pregnancy must be verified
from a medical source, verbally or in writing.
A/R statement of the expected delivery date (EDD) is acceptable. |
Application for RSM Pregnant woman is denied if pregnancy is not verified. |