Presumptive Eligibility and the New Requirement for Verification of U.S. Citizenship

With the new requirements for verification of citizenship beginning July 1st, 2006, many perinatal stakeholders across Oklahoma have wondered- Does the new requirement include women who are applying for Presumptive eligibility (PE)? The answer coming out of the Oklahoma Health Care Authority is no. Women will not need to provide proof of citizenship when applying for PE benefits, but, PE benefits are temporary and the benefits it provides are limited.

The PE program is designed to allow pregnant women to apply for benefits and begin receiving prenatal care while her Traditional SoonerCare application is being reviewed. The time period for PE benefits can be up to 45 days, but may end sooner if the Department of Human Services determines the woman to be ineligible for benefits. If, after review of the application, receipt of any requested documentation by DHS and if they determine that the pregnant woman qualifies for the full scope of benefits, the woman would then transition into Traditional SoonerCare. As of now, proof of citizenship will need to take place during this time in order to transition into Traditional SoonerCare.

Details about how Oklahoma will institute the new citizenship requirement have not been released yet, but a joint statement issued June 23rd by the Oklahoma Health Care Authority and the Department of Human Services states "Regarding proof of citizenship for Medicaid eligibility, the Oklahoma Health Care Authority and the Oklahoma Department of Human Services are creating procedures to comply with federal law. Once a process is prepared, the agencies will inform current and potential SoonerCare (Medicaid) members regarding the new requirements for eligibility determination. We will not take any action that creates unnecessary delays or denials of access to care for U.S. citizens or other legal persons."