5005-3        OTHER FORMS NEEDED

In addition to an application form, Medicaid and Denali KidCare also require the following:

• A citizenship status declaration (GEN 49), if a declaration was not already made on an application form.  See Section 5011;
   

• Verification of alien status done through the Systematic Alien Verification for Entitlements ( SAVE Systematic Alien Verification for Entitlements Program ) Program.  See Administrative Procedures Manual Section 105-14;
   

• An SSN Social Security Number or application for an SSN Social Security Number .  See Section 5014;
   

• A CSSD Child Support Services Division 1603 child support information form, if applicable.  See Section 5016;
   

• Cooperation in identifying any medical insurance or other third party resources that may be available.  See Section 5065;
   

•  Medical verification of pregnancy, if applicable.  See Section 5104-9 (C).