Potential government shutdown

In the event of a federal government shutdown, individuals enrolled in Apple Health (Medicaid), Public Employees Benefits Board, and School Employees Benefits Board coverage—and those accessing behavioral health services—will not experience a disruption in care. In addition, health care providers will continue to be paid for the services they provide.

If a shutdown occurs, we will share more information at that time.

Apple Health public health emergency (PHE)

Important: Stay covered! Are you enrolled in Apple Health (Medicaid) coverage? It may be time to complete your renewal. Make sure your address and phone number are up to date so you can stay enrolled. Report a change.

100 Series reason codes

Revised date
Purpose statement

100 Series Reason Code Protocols

Go to the Reason Code Link chart to link directly to a specific reason code or scroll through the list below.

For ACES Procedures go to ACES Letters in the ACES User Manual.

Reason Code Reason Code Description WAC References - Classic Medicaid Free Form Text - Classic Medicaid WAC References - MAGI-Based Medicaid Free Form Text - MAGI-Based Medicaid


ABD Cash/HEN Referral Spouse Ineligible

You can't receive Aged, Blind, & Disabled (ABD) Cash or Housing and Essential Needs (HEN) Referral when your spouse receives Supplemental Security Income (SSI).




None Required



WASHCAP Application Month Denied - For Administrative Use Only


None Required



WASHCAP Terminates - Individual Has Had Earned Income For More Than Three Months

You can't receive WASHCAP food assistance because you've been working more than 3 months.


None Required



SSA Terminates WASHCAP Food Assistance

Social Security asked us to stop your food benefits See WAC rule (Washington Administrative Code)


None Required



WASHCAP Terminates - Individual's Living Situation Has Changed

You can't receive Washington State Combined Application Project (WASHCAP) food benefits because your living arrangement changed.


None Required



WASHCAP Terminates - Individual Getting $1.00 Or Less SSI Money

You stopped receiving SSI cash.


None Required



WASHCAP Terminates - Individual Not Eligible For SSI Money Or Medical

SSA decided that you cannot get SSI. See WAC rule (Washington Administrative Code):


None Required



Not SSP Eligible - Individual's SSI Terminated

You can't receive a state supplemental payment if you're not receiving a SSI payment


None Required



Not SSP Eligible - SSI Eligibility Category Change

You can only receive a State Supplemental Payment (SSP) if you receive SSI and one of the following is true:

  • You live with your SSI ineligible spouse.
  • You are blind.
  • You are age 65 or older.


None Required



Receiving Tribal TANF Benefits

We believe you are eligible for cash benefits from the tribe


If you are an individual in a household which is eligible for a tribal TANF program, you cannot receive state and tribal TANF in the same month.



Failed to Provide Proof of Citizenship/Identity

You did not provide proof of citizenship for a member or members of your household. Proof of citizenship is required before a person can receive medical.


Specify the persons who are ineligible due to lack of proof of citizenship

182-503-0535 None Required

Ineligible Spouse of an SSI Recipient – Medical

Because your spouse receives SSI, you aren’t eligible for Community First Choice services. See WAC rule (Washington Administrative Code):

    182-512-0100 None Required


Not TFA Eligible – Not Recipient of BF in Prior Month

The people listed above will not get Transitional Food benefits with you because they did not get Basic Food benefits with you during the last month you got TANF. If you want to find out if you would get more food benefits by including others in your household, please apply for Basic Food. You can choose the program that gives you the most benefits, Basic Food or Transitional Food.



None Required



A Member of the Household is now receiving TANF

Someone who gets Transitional Food with you is approved for Temporary Assistance for Needy Families (TANF) or Tribal TANF. We will see if you can get Basic Food. You may need to turn in an eligibility review for us to see if you can get Basic Food.


Specify the person who is receiving TANF or Tribal TANF.



Mid-Certification Review Not Returned

We did not get your change report form. If you get us what we need before the end of the month, we will reconsider our decision.

You must either:

  • Turn in the form; or
  • Call us to report your current circumstances.


None Required



Incomplete Mid-Certification Review

We got your change report form. Some information is still missing. We sent you a letter telling you what you need to give to us. We did not get it.


None Required


TSOA - Invalid Waiver

You need an approved plan before we can help you and your caregiver. See WAC rule (Washington Administrative Code):

    182-513-1610 None Required

TSOA – Client Active in a Different AU

You can’t receive services under this program when you are eligible for certain Medicaid programs. 

    182-513-1615 None Required


Individual Already Received CN Medicaid In Another AU For This Benefit Month - For Administrative Use Only


None Required

182-503-0510 None Required


Medical Review Not Completed

Your medical disability review was not completed in time. This is because: We did not get updated medical information; or We got your medical information but it is still being reviewed.


Specify person who is being terminated.


Non-Federally Qualified Individual Becomes Federally Qualified

You are now eligible to receive health care coverage under a federally-funded program.

    182-503-0535 None Required

Federally Qualified Individual Changed to Non-Federally Qualified

You are no longer eligible to receive health care coverage

    182-503-0535 None Required

Alien Emergency Medical Requirement

You don't meet the requirements to receive Washington Apple Health Alien Emergency Medical coverage.

    182-507-0110 None Required