Section R9-22-305. Eligibility Requirements

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 appli- cant 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 cooperat- ing 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 individ- ual 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 num- ber), or

b.        Other documents that the Administration or its des- ignee 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 Eligi- bility 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 immi- gration status from the USCIS.

Arizona Health Care Cost Containment System - Administration

6.        If a person for whom eligibility is being sought, states that they are an alien, that person is not required to com- ply with subsections (4) and (5); however, if they do not comply with those sections, and if they meet all other eli- gibility criteria, benefits will be limited to those neces- sary to treat an emergency medical condition.

Historical Note

Adopted effective August 30, 1982 (Supp. 82-4). Former Section R9-22-305 repealed, new Section R9-22-305 adopted effective November 20, 1984 (Supp. 84-6). Amended subsection (A) effective January 1, 1987, filed December 31, 1986 (Supp. 86-6). Amended subsection

(A) effective February 26, 1988 (Supp. 88-1). Section repealed by final rulemaking at 5 A.A.R. 294, effective January 8, 1999 (Supp. 99-1). New Section R9-22-305 made by final rulemaking at 20 A.A.R. 192, effective Jan-

uary 7, 2014 (Supp. 14-1).