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Medicaid Policy Home > Health Care > Hoosier Healthwise > How to prove citizenship Proof of Citizenship

Beginning August 15, 2006 all individuals applying for or receiving Hoosier Healthwise are required by federal law to provide proof that they are U.S. citizens. *

Acceptable Documents to Prove Citizenship

One document from LIST 1 is proof.

LIST 1

  • United States passport, issued without limitation, even if it is expired; or

  • Certificate of Naturalization – N-550 or N-570; or

  • Certificate of Citizenship – N-560 or N-561.


OR

One document from LIST 2 and one document from LIST 3 are proof.

LIST 2
  • U.S. public birth certificate showing birth in one of the 50 States, District of Columbia, Puerto Rico (if born on or after January 1, 1941), Guam, the U.S. Virgin Islands, American Samoa, Swain’s Island, or the Northern Mariana Islands.
  • Certification of Report of Birth (DS1350)
  • Consular Report of Birth Abroad of a Citizen of the United States (FS-240)
  • Certification of Birth Abroad (FS 454)
  • United States Citizen Identification Card (I-197)
  • American Indian Card (I-873)
  • Final Adoption Decree that shows the child’s name and place of birth in the U.S.
  • Evidence of civil service employment by the U.S. government before June 1, 1976.
  • Official military record of service that shows a U.S. place of birth (example: DD-214)

If none of the documents above are available, contact your caseworker for possible alternatives.
LIST 3
  • Current state driver’s license with the individual’s picture.
  • Identification card issued by the State, Federal, or Local government with the individual’s picture and identifying information, such as Indiana’s State ID card issued for voting purposes.
  • School identification card with the individual’s picture.
  • Nursery or day care records for children not yet in school.
  • U.S. military card or draft record.
  • Military dependent’s identification card.
  • Certificate of Indian Blood, or other U.S. American Indian/Alaska Native tribal document with picture of the individual or other personal identifying information.
  • U.S. Coast Guard Merchant mariner card.

If none of the documents above are available for a child under age 16, contact your caseworker for a special affidavit to sign.

* Applicants who declare they are U.S. citizens and are receiving SSI or Medicare are not required to prove citizenship status.