County of San Diego Health and Human Services Agency HHSAMediCal Program Guide Number Page Verification of California Residence 070501 1 of 2 Revision Date 02012021 Background To establish eligibility for MediCal a customer must have residence in the state of California This section is being updated due to reformatting and to incorporate the changes implemented by the Affordable Care Act ACA regarding California residence Purpose This section defines residence requirements explains how a customer may establish residence in California and specifies required actions by staff when a customer uses a Post Office PO Box or a Commercial Mail Receiving Agency CMRA address Policy 070501A Establishing California Residence California residence is a requirement for MediCal and may be established if the customer provides verbal attestation or entry of a California physical address on the application as verification to meet the residence requirement unless questionable Once California residence is established it continues until residence is established in another state or country In cases where a Human Services Specialist HSS becomes aware of information that contradicts the customers claim of California residence verification to support the customers claim of California residence must be requested Initiate a fraud referral due to inconsistent or questionable information which cannot be resolved if after reviewing all the available evidence the HSS is still unable to determine the customers claim of California residence The HSS must clearly narrate all facts in case comments if a determination is made that the customer is not a resident of the state 070501B Use of PO Box CMRA or Alternate Address to Establish California Residence Customers are required to meet residence requirements to be eligible to MediCal benefits however they are not required to have a fixed address A PO Box or CMRA address does not meet the residence requirement if it is listed as the physical address however a PO Box or CMRA can be used as a mailing address Once California residence is established it continues until residence is established in another state or country as defined in MPG 070503D 070501C Job Commitment or Seeking Employment A customer may establish California residence even if they plan to return to a residence in another state provided they reside in California during the period of employment or while seeking employment A person who commutes to California for employment while living in another state or country is not a resident of California 070501D Households with Separate Residences Household members may establish separate residences with no break in marital or familial ties In these situations only household members who meet the California residence requirements are eligible for MediCal County of San Diego Health and Human Services Agency HHSAMediCal Program Guide Number Page Verification of California Residence 070501 2 of 2 070501E Children Living with Their Parents Children living with their parents will have their residence determined as that of their parents Parents who do not meet the California residence requirements may establish California residence for their children if both of the following circumstances apply The parents o Intend for their children to remain in California on a permanent basis o Have arranged for the children to remain in California independent of the parents 070501F Miscellaneous Provisions The following are miscellaneous provisions regarding establishing of California residence for MediCal A customer on parole from a correctional or other institution may establish California residence A customer who is living within the boundaries of California on land owned or leased by the Federal Government is considered a California resident A customer may receive Public Assistance from another state or country if it can be shown that the issuing agency knows that the customer is a resident of California and if those benefits are sent directly to an address in California in the customers name or in the name of a bona fide caretaker Procedures None Program Impacts None References ACWDL 9627 9547 9329 MEDIL I 1420 I 1429 I 1444 Sunset Date This policy will be reviewed for continuance by 02282023 Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Number Page Verification Requirements 070502 1 of 3 Revision Date 02012020 Background Verification of California residence is required prior to the approval of a MediCal application The introduction of the Affordable Care Act ACA suspended the requirement for paper verification of California residence for customers and continues to be suspended Purpose This section is revised to incorporate changes to the verification of California residence and align with updates made to section 040705B Verification of California Residence Policy 070502A Verification Requirements for Residence MediCal applicants must verify California Residence prior to the approval of their application Residence must also be verified whenever one of the following conditions exists The customer is absent from the state for less than 60 days and claims to be a resident of California and the County has evidence to the contrary The customer is absent from the state for more than 60 days The following are acceptable verifications of California residence Verbal attestation Entry of a California physical address on the application unless questionable For Verification and Documentation Procedures please refer to MediCal Program Guide MPG 040705 Verification of California Residence 070502B Individuals who Must Provide Verification of Residence Every MediCal applicant must verify their California residence except Children whose parents are also applying for MediCal o In these cases the parents residence will also establish their childrens residence The spouse of a person who has verified their California residence unless the spouse lives at another address and is requesting MediCal Adults or children in the care of a government agency in California provided that the Human Services Specialist HSS has verified that the person is the responsibility of such an agency Minor Consent customers Customers transitioning to MediCal directly from a cashbased public assistance program with no break in aid for example those coming from Transitional MediCal TMC Edwards or Craig v Bonta aid codes unless there is evidence that contradicts the residence determination of the cash program o The case comments must document that the customer is transitioning directly to MediCal from a cashbased public assistance program County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Number Page Verification Requirements 070502 2 of 3 070502C Evidence to the Contrary Evidence to the contrary refers to any information available to the HSS that contradicts a customers claim that they are a resident of California This evidence may include but is not limited to information or documents which show the customer Entered the state for a visit or other temporary purposes At the time of application has plans to leave California to return to another state or country o For example a customer that has a return airline ticket and has not previously established nor continuously maintained residence in California Has a spouse andor minor children remaining in another state or country that lived with the customer immediately prior to their arrival in California Entered the state solely to obtain medical care and does not intend on establishing California residence Possesses a Border Crossing Card or visa of a temporary nature such as a B1 or B2 visa Operates a business or keeps a home outside of California Has motor vehicles registered in another state or country Has children attending school in another state or country Receives public assistance from another state or country 070502D Statement of Residence An applicant must sign the MediCal Statement of Facts SOF or an MC 212 MediCal Residence Declaration that both of the following conditions are met The applicant does not keep a principal residence outside of California The applicant is not receiving Public Assistance outside of California If a customer is unable to make this declaration because they claim an outofstate principal residence as defined per MPG 0904 then request verification supporting that the customer is a California resident Make an eligibility determination based on all the information available and narrate the determination in case comments The exception to this is in cases with an unmarried couple living together with a common child only the person completing the application must make the required residence declarations Procedures None Program Impacts None References ACWDL 9627 9547 9329 MEPM 4V 4S MEDIL I 1420 I 1429 I 1444 Sunset Date This policy will be reviewed for continuance by 02282023 County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Verification Requirements Number Page 070502 3 of 3 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Applicants with a Border Crossing Card BCC or Non Number Page Immigrant Visa 070503 1 of 2 Revision Date 02012021 Background A Border Crossing Card BCC is issued by the United Stated Citizenship and Immigration Service USCIS to noncitizens who state that they reside in another country A nonimmigrant visa is issued to noncitizens with permanent residence outside of the country but who want to come to the United States for a specific and temporary period Before USCIS issues a BCC or nonimmigrant visa a noncitizen must affirm and provide documentation to USCIS that they intend to enter the United States for only a temporary period and intend to return to their residence in the other country Purpose This section is intended to provide staff with guidance when processing a MediCal case with a noncitizen who possesses a BCC or nonimmigrant visa Policy 070503A Border Crossing Cards Due the requirements for receipt of a BCC possession of a valid and current card is compelling evidence that the holder is not a resident of the state of California However it is possible that a BCC holder may overstay the visit limitation and take steps to establish residence in California A noncitizen with a BCC may establish residence by presenting persuasive evidence that they are a resident of California The evidence must clearly show that the noncitizen has taken steps consistent with their stated intent to live in California permanently or indefinitely or has entered the state for employment reasons The claim of California residence must be evaluated in the context of all available information If after considering all available information the Human Services Specialist HSS is unable to determine the customers claim of California residence then initiate a fraud referral due to inconsistent or questionable information that cannot be resolved Please note that providing evidence to support residence does not necessarily support a finding that the customer has met the California residence requirement Clearly narrate all facts in case comments if it is determined that the customer is not a resident of the state 070503B NonImmigrant Visas A valid and current nonimmigrant visa including but not limited to B1 and B2 visas which allows entry for a period of less than one year constitutes strong evidence that the bearer is not a resident of California and is not eligible for any MediCal benefits unless they present persuasive evidence to the contrary People with nonimmigrant visas are permitted entry into the United States for personal or business purposes At the port of entry USCIS frequently stamps the I94 with permission for the person to stay for a period of six month or less County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Applicants with a Border Crossing Card BCC or Non Number Page Immigrant Visa 070503 2 of 2 If after considering all available information the HSS is unable to determine the customers claim of California residence then initiate a fraud referral due to inconsistent or questionable information that cannot be resolved Clearly narrate all facts in case comments if it is determined that the customer is not a resident of the state Procedures None Program Impacts None References ACWDL 9627 9547 Sunset Date This policy will be reviewed for continuance by 02282023 Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Number Page Temporary Absence and Loss of California Residence 070504 1 of 2 Revision Date 02012021 Background Individuals may be temporarily absent from the state of California and depending on the duration of absence may potentially be absent from the state without affecting their residence status Purpose Included with the reformatting this section has incorporated Temporary Absence and Loss of California Residence as a singular section Policy 070504A Absence for 60 Days or Less Individuals who are temporarily absent from the state of California for a period of 60 days or less will not have their residence status affected Presume an absence of 60 days or less to be a temporary absence unless there is evidence to the contrary Accept applications reapplications restorations or redeterminations from customers who are temporarily absent from the state for 60 days or less 070504B Absence for More than 60 Days If a customer is absent from the state for more than 60 days then presume that the customer intends to establish residence outside of California unless they provide a written statement which states both An intent to return to California The existence of one of the following circumstances o Illness or emergency prohibits the customers return to California o Family members with whom the customer lives are California residents and are physically present in the state o The customer keeps California housing arrangements When a customer is absent from the state for more than 60 days request verification of residence 070504C Loss of California Residence A customer is considered to have loss of California residence when they leave the state and take any of the following actions in another state Purchases leases or rents a residence Becomes employed Obtains an outofstate drivers license Applies for aid in another state The loss of residence will be considered unless there is evidence to the contrary If a customer has loss of residence then discontinue the case accordingly If 10day notice can then discontinue the case effective the month be given in which the customer lost their residence County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Number Page Temporary Absence and Loss of California Residence 070504 2 of 2 070504D Death During Absence from the State A customer who dies during an absence from the state will be considered a resident of California if there is evidence that the customer met the residence requirements at the time of death Procedures None Program Impacts None References ACWDL 9547 9329 Sunset Date This policy will be reviewed for continuance by 02282023 Approval for Release Rick Wanne Director Eligibility Operations County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Number Page Residence for OutofState Students 070505 1 of 2 Revision Date 02012021 Background Individuals residing in California for purposes of attending school can meet MediCal residence requirements Similarly beneficiaries can remain MediCal eligible if they leave California temporarily to attend school in another state Purpose This section is to provide guidance when determining California residence for customers who are living in California to attend school as well as beneficiaries who attend school outofstate Policy 070505A Individuals Who Come to California to Attend School Individuals residing in California to attend school from another state or country can apply for MediCal while residing in California These students can meet the residence requirement for MediCal if they are residents of California even if they plan to return to their prior state or country Students who commute into California to attend school from another state or country do not meet the California residence requirement If a student applies for MediCal and is receiving Medicaid in another state then Medicaid in their previous state must be discontinued as soon as administratively possible The previous state of coverage must confirm that they are discontinuing benefits as soon as administratively possible An eligible student can receive Medicaid in two states during this transition period from one state to coverage in a new state All other MediCal eligibility rules and requirements apply in cases with individuals who come to California to attend school 070505B California Residents Attending School in Another State MediCal beneficiaries who leave California to attend school temporarily in another state must report their temporary leave to the County These individuals may remain eligible to MediCal while temporarily attending school in another state Keep these individuals addresses in the MediCal Eligibility Data System MEDS as the California address to which they plan to return Temporary absence from California does not have a specific timeframe requirement however a 60day absence may lead to a presumption that the customer is no longer a California resident A MediCal beneficiary attending school in another state can choose to discontinue benefits in California and apply for Medicaid in the state where they are attending school If this occurs then MediCal must be discontinued as soon as administratively possible County of San Diego Health and Human Services Agency HHSAEligibility Operations Program Guide Number Page Residence for OutofState Students 070505 2 of 2 070505C Impact to ParentCaretaker Relatives of OutofState Students Students who move outofstate to attend school have no impact on the family MediCal case if the student is still claimed as a tax dependent by their parent If a student is claimed as a tax dependent they must provide the applicable tax household and income information when they apply for MediCal If the student who temporarily moves out of state is the only child on the case then their parents maintain their parentcaretaker linkage if the student meets the requirements to be considered a dependent child These requirements are The child meets the age requirements The parents remain the primary caregivers and isare financially responsible for the child The child is still considered to be residing with their parents This would therefore indicate that the outofstate student would maintain MediCal coverage while they are temporarily absent from California and would be ineligible for Medicaid in another state 070505D OutofState Coverage MediCal covers emergency services for individuals who are temporarily absent from the state When emergency services are received outofstate then the provider must agree to accept MediCal and must meet the requirements for becoming a MediCal provider Emergency services are provided in the United States and only emergency services requiring hospitalization are provided in Canada and Mexico Procedures None Program Impacts None References ACWDL 1523 Sunset Date This policy will be reviewed for continuance by 02282023 Rick Wanne Director Eligibility Operations