State Medicaid and CHIP Eligibility Verification Plans

*Chart updated May 8, 2014

Due to the ACA’s new eligibility verification rules,states have developed plans outlining Medicaid and CHIP eligibility verification procedures. This chart highlights key elements from states’ verification plans, such as which eligibility factors are verified through electronic data and the specific data sources states are using, as well as whether self-attestation is accepted for some eligibility factors. The chart also contains information about how states will determine reasonable compatibility, which is how they will resolve issues if there are discrepancies between electronic data sources and information provided by applicants.
Certain eligibility factors are not included in the chart, such as pregnancy,¹ Social Security Numbers,² citizenship and immigration status³ because the ACA requires states to use the same verification processes for these factors. State CHIP programs also have unique eligibility factors that must be verified in addition to those listed below. Click here for a chart on CHIP-specific eligibility verification plans.
This chart is based on information contained in publicly available state Medicaid/CHIP eligibility verification plans; each state abbreviation links to each state’s plan. Please note that not all state verification plans have been approved and information from them will be added to this chart as they become available.
Like all State Refor(u)m research, this chart is a collaborative effort with you, the user. State Refor(u)m captures the health reform comments, documents, and links submitted by health policy thinkers and doers all over the country. And our team periodically supplements, analyzes, and compiles this key content. Do you know of information that should be added to this chart? Your feedback is central to our ongoing, real-time process, so tell us in a comment below.

State	Self-Attestation Accepted without Additional Verification	Self-Attestation Accepted with Post-Eligibility Verification	Electronic Data Source Used for Verification	Reasonable Compatibility Resolution Process (Reasonable explanation required)	Reasonable Compatibility Resolution Process (Paper documentation required)	Financial Verification Data Sources [4]	Non-Financial Verification Data Sources [5]
AL	Income, Residency, Age, Household, Caretaker Relative, Application for Other Benefits	Medicare	Income, Medicare	Income, Medicare	Income, Medicare	IRS, SSA, SNAP, TANF, TALX/Work Number, PARIS	SSA, DHS, Vital Statistics, TANF, SNAP, TALX, PARIS
AK	Income, Residency, Age, Household, Caretaker Relative	Medicare	Income, Medicare, Application for Other Benefits	Income, Medicare, Application for Other Benefits	Income, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, State General Assistance Programs, SNAP, TANF, OCSE, The Work Number, PARIS, Department of Revenue Permanent Fund	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS, Department of Revenue, Permanent Fund Dividend, Department of Labor, State Administered Supplementary Payment Program
AZ	Household, Caretaker Relative	N/A	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment, SNAP, TANF, Work Number, State New Hire Database, State Eligibility System Database, PARIS	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, State Eligibility System Database, PARIS
AR	Residency, Household, Caretaker Relative	Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	Income, Age	Income, Age, Medicare, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment, SNAP, Work Number	SSA, DHS, Vital Statistics, DMV, SNAP, PARIS, Corrections
CA	Household, Caretaker Relative, Application for Other Benefits, American Indian/Alaska Native Exemptions,	Former Foster Care and Medicaid Enrollment	Income, Residency, Age, Medicare, Deceased, Former Foster Care and Medicaid Enrollment	Deceased	Income, Residency, Age, Medicare, Former Foster Care and Medicaid Enrollment	IRS, SSA, SWICA, State Unemployment, State Income Tax, PARIS	SSA, DHS, DMV, TANF, SNAP, State General Assistance Programs, State Income Tax, PARIS
CO	Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income	Income	Income	Income	SSA, SNAP, TANF, Income Eligibility and Verification System from Colorado Department of Labor and Employment	SSA, DHS, DMV, TANF, SNAP, PARIS
CT
DE	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	Income, Medicare	Income, Medicare	Income, Medicare	Income, Medicare	SSA, SWICA, State Unemployment, State General Assistance Programs, SNAP, TANF, TALX/Work Number, Child Care Subsidy	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, OCSE, State General Assistance Programs, PARIS, Child Care Subsidy
DC
FL	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Medicare	Income, Medicare	Income, Medicare	SSA, SWICA, State Unemployment, Work Number, Florida Retirement, Out of State Unemployment	SSA, DHS, Vital Statistics, DMV, PARIS
GA	Residency, Age, Household, Caretaker Relative	Medicare, Application for Other Benefits	Income, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income, Household	Income, Household, Caretaker Relative, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, TALX/Work Number	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, WIC, PARIS
HI	Residency, Household, Caretaker Relative, Application for Other Benefits	Income	Income, Age, Medicare, Incarceration status, Other Insurance Coverage	Income, Age, Household, Caretaker Relative, Medicare, Incarceration status, Other Insurance Coverage	Income, Age, Medicare, Other Insurance Coverage	SSA, SWICA, State Unemployment, OCSE	SSA, DHS, Vital Statistics, OCSE, Third Party Coverage, PARIS, State Workers Compensation, Department of Defense Enrollment Eligibility Reporting, State Dept. of Public Safety, Hawaii Youth Correctional Facility
ID	Residency, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Age, Medicare	Income, Medicare	Income, Medicare	SSA, State Unemployment, SNAP, TANF, OCSE, Work Number, Department of Labor Quarterly Wage, Department of Labor New Hire	SSA, DHS, Vital Statistics, PARIS
IL
IN	Caretaker Relative	N/A	Income, Residency, Age, Household, Medicare, Application for Other Benefits	Household, Application for Other Benefits	Income, Residency, Age, Household, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, Work Number (Equifax)	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS
IA	Residency, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Age, Medicare	Income, Age, Medicare	Income, Age, Medicare	IRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TALX/ Work Number	SSA, DHS, PARIS, Death Matches, Prisoner Matches
KS
KY	Age, Household, Caretaker Relative, Application for Other Benefits	Residency	Income, Residency, Medicare, Incarceration	Income, Residency, Medicare, Incarceration	Income, Residency, Medicare, Incarceration	IRS, SSA, SWICA, State Unemployment, Work Number	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS
LA	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	Medicare, Third Party Liability	Income, Medicare, Third Party Liability	Medicare, Third Party Liability	Income, Medicare, Third Party Liability	SSA, SWICA, State Unemployment, SNAP, TANF, TALX/Work Number, PARIS, State Income and Eligibility Verification System	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE,HMS Coordination of Benefits, PARIS
ME	Residency, Household, Caretaker Relative, Incarceration	Age, Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	SSA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, Work Number, Verify Direct	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, PARIS, Maine Department of Corrections
MD	Residency, Household, Caretaker Relative, American Indian/Alaska Native	Medicare, Application for other Benefits, Public Institution Status	Income, Age, Medicare, Application for other Benefits, Public Institution Status	Income, Application for other Benefits, Public Institution Status	Income, Age, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, Equifax Work Number	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, Jail Match, PARIS
MA	Household, Caretaker Relative, Application for Other Benefits, Access to ESI	Income, Residency, Age, Identity, Access to ESI, Third Party Recovery	Income, Residency, Age, Medicare, Identity, Access to ESI, Incarceration, Third party Recovery	Age, Incarceration	Income, Residency, Age, Medicare, Identity, Third Party Recovery	IRS, SSI, SWICA, State Unemployment Compensation, SNAP	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, State General Assistance Programs, Third Party Liability Data Matching, PARIS, Experian/LexisNexis
MI
MN	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Medicare	Income	Income	IRS, SSA, SWICA, State Unemployment, OCSE, TALX/ Work Number	SSA, DHS, PARIS
MS	Residency, Household, Application for Other Benefits, Third Party Liability	IV-D Child Support Agency	Income, Age, Caretaker Relative, Medicare, IV-D Child Support Agency, Title II 40 Work Quarters	Income, Age	Income, Age, Caretaker Relative, Medicare, Title II 40 Work Quarters	IRS, SSA, SWICA, State Unemployment, Work Number Equifax	SSA, DHS, Vital Statistics, OCSE, PARIS
MO	Residency, Age, Household, Caretaker Relative	Application for Other Benefits	Income, Medicare, Application for Other Benefits	Income, Medicare, Application for Other Benefits	Income, Medicare, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, PARIS, TALX/ Work Number, Quarterly Wage Match, Directory of New Hire Matches	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, PARIS, MMIS
MT	Residency, Household, Caretaker Relative, Application for Other Benefits, Third Party Liability, Child Support Enforcement Division, Premium cost-effectiveness for the Health Insurance Premium Payment Program	Income, Household, Caretaker Relative	Income, Age, Household, Caretaker Relative, Medicare	Income, Age, Household, Caretaker Relative	Income, Age, Household, Caretaker Relative	SSA, SWICA, State Unemployment, SNAP, TANF, Work Number, National Directory of New Hires	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS
NE	Residency, Household	N/A	Income, Age, Caretaker Relative, Medicare, Application for other Benefits	Income	Income, Age, Cartaker Relative, Medicare, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment Compensation, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, TALX/The Work Number, Provider Alerts, National Directory of New Hires, IRS 1099 information,	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, Office of Child Support Enforcement, PARIS, CMS: Medicare Part D Interface,
NV	Residency, Household, Caretaker Relative	Household, Caretaker Relative, Medicare, Application for Other Benefits	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment, SNAP, TANF, Work Number, State New Hire	SSA, DHS, Vital Statistics, TANF, SNAP, OCSE, PARIS, Third Party Liability vendor Emdeon
NH	Residency, Household, Caretaker Relative, Application for Other Benefits	Income, Age, Medicare	Income, Age, Medicare	Income, Age	Income, Age	SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, Work Number, Verify Direct, PARIS	SSA, DHS, Vital Statistics, TANF, SNAP, PARIS
NJ	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Medicare	Income	Income, Medicare	SSA, SWICA, State Unemployment, State Income Tax	SSA, DHS, Vital Statistics, OCSE, State Income Tax, Health Management Systems, PARIS
NM	Residency, Household Composition, Caretaker Relative, Application for Other Benefits	N/A	Income, Age, Household Composition, Medicare	Income, Age, Medicare	Income, Age, Medicare	IRS, SSA, SWICA, State Unemployment Compensation, State Administered Supplementary Payment Program, State General Assistance Programs, SNAP, TANF, OCSE, TALX, PARIS	SSA, DHS, DMV, TANF, SNAP, OCSE, State General Assistance Programs, PARIS
NY	Residency, Household, Caretaker Relative	Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits, Federal public MEC beyond Medicare (e.g. Peace Corps) ESI known to Medicaid	Income, Medicare	Income, Age, Medicare, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment	SSA, DHS, Experian, PARIS, Medicaid/CHIP active coverage
NC	Age, Household Composition, Caretaker Relative	Medicare	Income, Residency, Medicare, Application for Other Benefits	Income	Income, Residency, Medicare, Application to Other Benefits	SSA, SWICA, State Unemployment Compensation, SNAP, TANF, OCSE, State Income Tax, The Work Number, Address Verification System, PARIS	SSA, DHS, DMV, TANF, SNAP, OCSE, The Work Number, PARIS, North Carolina Department of Corrections, MMIS
ND	Residency, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Age, Medicare	Income, Age, Medicare	Income, Age, Household, Medicare	IRS, SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, PARIS, TALX/Work Number	SSA, DHS, Vital Statistics, DMV, OCSE, PARIS
OH	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Medicare, Application for Other Benefits, Former foster care status	Household, Caretaker Relative	Income, Household, Caretaker Relative, Medicare, Application for Other Benefits, Former foster care status	IRS, SSA, SWICA, State Unemployment, OCSE, TALX/Work Number, PARIS,	SSA, DHS, PARIS, Incarceration
OK	Age, Household, Caretaker Relative, Application for Other Benefits	Income, Residency, Medicare	Income, Residency, Household, Caretaker Relative, Medicare	Income, Residency, Household, Medicare	Income, Residency, Household, Medicare	SSA, SWICA, State Unemployment	SSA, DHS, Vital Statistics, OCSE, PARIS
OR	Residency, Household, Caretaker Relative	Income, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits, Oregon Medicaid/CHIP beneficiary	Income, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Income, Age, Household, Caretaker Relative, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, SNAP, TANF, OCSE, Work Number	SSA, DHS, Vital Statistics, DMV, OCSE, APPRISS Incarceration Match, PARIS, Department of Corrections, State of Oregon Medicaid/CHIP eligibility data
PA	Residency, Household, Caretaker Relative	Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment, State Administered Supplementary Payment Program, State General Assistance Programs, SNAP, TANF, OCSE, Work Number, OnBase	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, OCSE, State General Assistance Programs, Health Management Systems, PARIS
RI	Residency, Household, Caretaker Relative	Age, Application for Other Benefits	Income, Age, Medicare, Application for Other Benefits	Income	Income, Age, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment	SSA, DHS, Vital Statistics, OCSE, PARIS
SC	Income, Residency, Household, Caretaker Relative,	N/A	Income, Age, Medicare, Application for Other Benefits	Income, Medicare	Income, Age, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment, SNAP, TANF, Work Number and Verify Direct	SSA, DHS, Vital Statistics, TANF, SNAP, PARIS, State Wage Collection Agency/Unemployment
SD	Residency, Age, Household, Caretaker Relative, Application for Other Benefits	Medicare	Income, Residency, Age, Household, Caretaker Relative, Medicare	Income, Residency, Age, Household, Caretaker Relative, Medicare	Income, Residency, Age, Household, Caretaker Relative, Medicare	IRS, SSA, SWICA, State Unemployment, SNAP, TANF, TALX/Work Number	SSA, DHS, Vital Statistics, TANF, SNAP, PARIS, HMS (ORFI)
TN	Caretaker Relative, Application for Other Benefits	Household, Incarceration	Income, Residency, Age, Household, Medicare, Incarceration	N/A	Income, Residency, Age, Household, Incarceration	IRS, SSA, SWICA, State Unemployment, Work Number, Defense Enrollment Eligibility Reporting System, IRS Computer Matching Program	SSA, DHS, Vital Statistics, PARIS, TN Department of Corrections, Unemployment Data, Quarterly Wage Data
TX	Residency, Age, Household Composition,	Application for Other Benefits	Income, Residency, Age, Caretaker Relative, Medicare, Application for Other Benefits	N/A	Income, Residency, Age, Caretaker Relative, Medicare, Application for Other Benefits	SSA, SWICA, State Unemployment Compensation, SNAP, TANF, The Work Number System, Office of Attorney General Employee New Hire Data, Choices Information Transmittal, State Employee Benefits Data from the Employees Retirement System and Teacher Retirement System	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, PARIS
UT
VT	Residency, Household, Caretaker Relative, Application for Other Benefits	N/A	Income, Age, Medicare	Income, Age, Medicare	Income, Age, Medicare	SSA, SNAP, TANF	SSA, DHS, Vital Statistics, TANF, SNAP, PARIS
VA	Residency, Age, Household, Caretaker Relative	N/A	Income, Medicare, Application for Other Benefits	Income	Income, Medicare, Application for Other Benefits	IRS, SSA, SWICA, State Unemployment, SNAP, TANF, Work Number, PARIS	SSA, DHS, Vital Statistics, DMV, PARIS
WA
WV	Residency, Household, Caretaker Relative, Application for Other Benefits	Other insurance coverage	Income, Residency, Age, Household, Caretaker Relative, Medicare, Other insurance coverage	Income, Residency, Age, Household, Caretaker Relative, Medicare, Other insurance coverage	Income, Residency, Age, Household, Caretaker Relative, Medicare, Other insurance coverage	IRS, SSA, SWICA, State Unemployment, SNAP, TANF, OCSE, Work Number, Work Force West Virginia, Families and Children Tracking System	SSA, DHS, Vital Statistics, DMV, TANF, SNAP, Health Management System, PARIS, Third Party Administrator, Public Employees Insurance Agency, Families and Children Tracking System
WI
WY	Household, Caretaker Relative	Residency,Application for Other Benefits	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	Household, Caretaker Relative	Income, Residency, Age, Household, Caretaker Relative, Medicare, Application for Other Benefits	IRS, SSA, State Unemployment, TALX/Work Number, PARIS	SSA, DHS, Vital Statistics, DMV, OCSE, PARIS, Electronic Verification of Vital Events, WYCAPS, SWICA, IRS

Notes:

[1] Self-attestation of pregnancy is a requirement for states regardless of the benefit package provided by the State; however under § 435.956(e) if a state has information that is not reasonably compatible with the attestation, the State may verify pregnancy in a manner consistent with § 435.952.
[2] Per §435.956(d)(1), the agency must verify Social Security numbers (SSNs) in accordance with §435.910.
[3] States will be required to verify citizenship and immigration status through the federal data services hub if available (§435.956(a)(1)).
[4] Financial Verification Data Source acronym definitions: SSA = Social Security Administration; SWICA= State Wage Information Collection Agency; SNAP = Supplemental Nutrition Assistance Program; TANF = Temporary Assistance for Needy Families; OCSE = Office of Child Support Enforcement; PARIS = Public Assistance Reporting Information System; IRS= Internal Revenue Service.
[5] Non-Financial Verification Data Source acronym definitions: SSA = Social Security Administration; DHS = Department of Homeland Security; TANF = Temporary Assistance for Needy Families; SNAP = Supplemental Nutrition Assistance Program; OCSE = Office of Child Support Enforcement; PARIS = Public Assistance Reporting Information System; DMV = Department of Motor Vehicles; MMIS = Medicaid Management Information Systems; HMS ORFI = HMS is used to identify enrollment in private health insurance for Targeted Low Income Children; WYCAPS = Wyoming Child Assistance and Protection System.
Produced by Anita Cardwell and Kaitlin Sheedy.

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