New ID Requirements for Medicaid How do they affect you?

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New ID Requirements for Medicaid How do they affect you? If you are a US citizen Starting July 1, 2006, Medicaid will require all recipients to show an ID that proves their Identity and US Citizenship o New applicants when you apply o Current recipients at your redetermination You can use your o US Passport (or Certificates of Naturalization or US Citizenship) OR If you do not have any of the above, you will have to show TWO forms of ID o One showing US Citizenship, such as Birth Certificate or other document showing a US place of birth, Certificate of Birth Abroad, or Citizen ID card AND o One showing your Identity, such as State issued Driver s License or ID card The new regulations do NOT apply to: - CHP+ or SSI recipients - Foster Children - Newborn children of eligible mothers - Non-citizens If you do not have the ID s you need, go apply NOW! See Attached For Details

HOW TO GET A COLORADO ID CARD Where to apply: Find the Driver s License/ID Card Office nearest you: Arapahoe County Aurora Broomfield Denver 5334 S Prince St, 80166 14391 E 4 th, 80011 5139 W 120 th Ave, 80020 1865 W Mississippi, 80223 Lakewood Littleton Northglenn Parker 1881 Pierce St, 80214 311 E County Line Rd, 80126 500 Malley Dr, 80233 17737 Cottonwood Dr, 80134 Offices are normally open Monday-Friday, 8:00 AM to 5:00 PM. Cost: $7.60 for everyone younger than 60. You must pay the exact amount by cash, check, or money order. Free for adults age 60 and older What to bring: 2 forms of ID, one from List A below, the second from either List A or List B. *For more details, see back* If your name is different from the document presented from List A or you are changing your name, you MUST bring a document from List B. The documents must be originals, an amended original document, or a true copy certified by the issuing agency. List A - Driver s license or state issued photo ID - Birth certificate - US passport - Foreign passport with I-94 form - I-94 with refugee/asylee status - Resident alien/permanent resident card - Photo temporary resident card - Valid US Military ID - US Military separation papers - Tribal identification card - Territory certified court order of adoption - Certificate of Naturalization List B - Marriage certificate - Divorce certificate - Court order of name change - Valid US military ID - Tribal identification card - Out of state driver s license or ID card *NOTE* You do NOT have to bring your Social Security card, but you will have to provide your social security number or documentation indicating you have been denied, are not eligible, or have never been issued a Social Security Number. ***Colorado law prohibits a person from holding both a valid driver's license and an*** identification card. You cannot be issued an ID card if you hold a valid driver's license. If you have any questions call the Department of Motor Vehicles at 303-205-5613 or visit http://www.revenue.state.co.us/mv_dir/wrap.asp?incl=faqdrli/faqdrli1

LIST A 1. Out of state issued photo driver license or photo identification card expired one year or less. (These require additional documentation from List A for proof of lawful presence.) 2. Any Colorado driver license, Colorado 7-day Affidavit and Notice of Revocation or Affidavit and Notice of Suspension, or Colorado ID card that matches the photograph on file with the department. (Colorado ID cards issued between June 6, 1997 and July 1, 1998 require additional documentation from List A for proof of lawful presence.) 3. Certified birth certificate (Birth certificates issued by the hospital are NOT acceptable). 4. US Passport (expired less than 10 years.) 5. Valid foreign passport with I-94 or valid Processed For I551 stamp; NO B1, B2, WT, WB, CP or NC status. (H1, H2, J1, J2, F1, F2 etc. requires verification of Colorado employment or education.) 6. I94 with refugee/asylee status. *Must provide either an Employment Authorization Card or an original letter, on agency letterhead, from the legal agency providing assistance. 7. Valid I551 Resident Alien/Permanent Resident card. NO border crosser or USA B1/B2 Visa/BCC cards. 8. Valid I688 (photo temporary resident card), I688B and I766 (photo employment authorization card) 9. Valid US military ID (active duty, dependent, retired, reserve and National Guard) 10. Original or certified copy of the DD214 (US military separation papers) from the Department of Defense or Veteran Affairs. Any DD214 with the disclaimer "Not to be used for identification" will NOT be accepted. 11. Bureau of Indian Affairs, Tribal Identification Card 12. United States or United States Territory Certified court order of adoption, (must include date of birth) 13. Certificate of Naturalization with intact photo LIST B 1. Certified marriage certificate, US, city, county, state or foreign issued (foreign language documents may require translation) NO church documents. 2. Certified divorce decree, US or foreign, with a case number and official signature (foreign language documents require translation) 3. Certified court order of name change, US or foreign, with case number and official signature (foreign language documents require translation) 4. Valid US Military ID (active duty, dependent, retired, reserve and National Guard) 5. Tribal Identification card 6. Out of state issued photo Driver's License or photo identification card expired one year or less.

HOW TO GET A COLORADO BIRTH CERTIFICATE You can order in person from: Colorado Department of Public Health and Environment - Vital Records Section 4300 Cherry Creek Drive South Denver, CO 80246-1530 Phone: 303-692-2200 Office hours are from 8:30 a.m. to 4:45 p.m., Monday through Friday. You can order online at: http://www.vitalchek.com/default.asp You can order by fax or mail: Fill out the application in English at http://www.cdphe.state.co.us/hs/bicert.pdf or Fill out the application in Spanish at http://www.cdphe.state.co.us/hs/bcrtspan.pdf Fax the completed form to 1-800-423-1108 OR Mail the completed form to: Colorado Department of Public Health and Environment - Vital Records Section 4300 Cherry Creek Drive South HSVRD-VS-A1 Denver, CO 80246-1530 Cost: The cost is $17 for first copy (or search of files when no record is found), $6 for each additional copy of the same record ordered at the same time. For phone, fax, or online orders, there is an extra $5 convenience charge. They accept checks, money orders and credit cards. Make checks or money orders payable to "Vital Records Section". Do NOT send cash. IDENTIFICATION: You will need to show an ID in order to obtain a birth certificate. You must have either: One Item from this list OR Two Items from this list (no expired documents accepted) - Photo driver license or ID card - School, university, or college ID card - US or foreign passport - Alien registration receipt card - Permanent resident card - Temporary Resident card - Employment authorization card - US Military ID card - Tribal ID card - US Certificate of naturalization - US citizenship ID card or Certificate (no documents expired more than 1 year accepted) - Work ID/ Paycheck stub/ W-2 - Voter registration card - Social Security card - Previously issued vital record - Motor vehicle registration/title - Probation documents - Marriage license - Social services card (Medicaid card) - Hospital birth worksheet - Acknowledgement of paternity document - Department of Corrections ID card If you have any questions call 303-692-2200 or E-mail vital.records@state.co.us or visit http://www.cdphe.state.co.us/hs/certs.asp For information about getting an out-of-state birth certificate, visit: http://www.cdc.gov/nchs/howto/w2w/w2welcom.htm or www.vitalchek.com

HOW TO GET A PASSPORT http://travel.state.gov/passport/passport_1738.html You must apply in person if: - You are applying for the first time - Your last passport was issued more than 15 years ago - You are 17 years old or younger - Your last passport was lost, stolen, or damaged - Your last passport was issued when you were under 16 Passport Application Stations are located in various post offices, city and county buildings, and federal offices. Find the location nearest to you at http://iafdb.travel.state.gov/ Step 1: Fill out Passport Application form DS-11 *DO NOT sign the form until told to do* Available either - Online http://foia.state.gov/forms/passport/ds0011.pdf OR - At the passport application station Step 2: Show proof of US Citizenship using any of these - Old US passport - Certified Birth Certificate - Letter of No Record (issued by the state saying there is no available record) AND Either another public record showing place of birth Or Form DS-10 - affidavit of birth by an older relative - If you were born abroad, your foreign birth certificate and proof of parent(s) US citizenship Step 3: Show proof of identity using any of these - Old US passport - Naturalization certificate - Current valid driver s license, government or military ID - Some documents with your signature (social security card, bank card, library card, etc.) AND a person to vouch for you who is a US citizen, has known you for at least 2 years, and has filled out Form DS-71) Step 4: Submit 2 identical passport photographs - 2 inches by 2 inches in size, full face, color, taken in the last 6 months - NO hats or sunglasses may be worn Step 5 Pay the fee - If you are 16 or older 1) $67 check, money order, or bank draft made out to US Department of state AND 2) $30 check, money order, bank draft, or credit card for the passport application station - If you are under 16 1) $52 check, money order, or bank draft made out to US Department of state AND 2) $30 check, money order, bank draft, or credit card for the passport application station You will receive your passport within about 6 weeks

If you are renewing your passport, you can apply by mail if: - You already have a passport AND - You received it in the last 15 years AND - You were older than 16 when you received it AND - You live in the US or Canada Step 1: Fill out Passport Application form DS-82 *DO sign and date the form* Available online at http://foia.state.gov/forms/passport/ds0082.pdf Step 2: Attach to the application - Your most recent passport - Two identical passport photographs 2 inch by 2 inch in size, full face, color, taken in the last 6 months, NO hats or sunglasses may be worn - $67 fee, payable to US Department of State, by check or money order *Note your previous passport will be returned to you Step 3: If your name has changed since your last passport: - Enclose a certified copy of the legal document specifying your name change (e.g. marriage certificate, divorce decree, adoption decree, or court order) *Note no photocopies will be accepted Step 4: Mail in a padded envelope to: National Passport Center P.O. Box 371971 Pittsburgh, PA 15250-7971 OR If you use an overnight delivery service that does not deliver to a post office, include a prepaid overnight return envelope and an extra $60, then mail it to: Passport Services - Lockbox Attn: Passport Supervisor 371971 500 Ross Street, Rm. 154-0670 Pittsburgh, PA 15250-9971 You will receive your passport within about 6 weeks for regular service, or in about 2 weeks for overnight service. If you have any questions call 1-877-487-2778 This communication is made available by Colorado Legal Services, Inc., (CLS), as a public service and is issued to inform not to advise. No person should attempt to interpret or apply any law without the assistance of an attorney. The opinions expressed in this communication are those of the authors and not those of CLS or its funding sources.