Social Security Number

Revised July 25, 2014

Purpose: To explain the social security number (SSN) requirements and instructions for obtaining SSNs for applicants and recipients for Apple Health.

WAC 182-503-0515 Washington apple health -- Social Security number requirements.

Effective May 24, 2018.

  1. To be eligible for Washington apple health (medicaid), or tailored supports for older adults (TSOA) described in WAC 182-513-1610, you (the applicant or recipient) must provide your valid Social Security number (SSN) or proof of application for an SSN to the medicaid agency or the agency's designee, except as provided in subsections (2) and (6) of this section.
  2. An SSN is not required if you are:
    1. Not eligible to receive an SSN or may only be issued or may only be issued an SSN for a valid nonwork reason described in 20 C.F.R. 422.104;
    2. A household member who is not applying for apple health coverage, unless verification of that household member's resources is required to determine the eligibility of the client;
    3. Refusing to obtain an SSN for well-established religious objections as defined in 42 C.F.R. 435.910 (h) (3); or 
    4. Not able to obtain or provide an SSN because you are a victim of domestic violence.
  3. If you are receiving coverage because you meet an exception under either subsection (2) (c) or (d) of this section, we (the agency) will confirm with you at your apple health renewal, consistent with WAC 182-503-0050, that you still meet the exception.
  4. If we ask for confirmation that you continue to meet an exception in subsection (2) of this section and you do not respond in accordance with subsection (3) of this section, or if you no longer meet an exception and do not provide your SSN, we will terminate your apple health coverage according to WAC 182-518-0025.
  5. If you are not able to provide your SSN, either because you do not know it or it has not been issued, you must provide:
    1. Proof from the Social Security Administration (SSA) that you turned in an application for an SSN; and
    2. The SSN when you receive it.
      1. Your apple health coverage will not be delayed, denied, or terminated while waiting for SSA to send you your SSN. If you need help applying for an SSN, assistance will be provided to you.
      2. We will ask you every ninety days if your SSN has been issued.
  6. An SSN is not required for the following apple health programs:
    1. Refugee medical assistance program described in WAC 182-507-0120, and 182-507-0125;
    2. Alien medical programs described in WAC 182-507-0115, 182-507-0120, and 182-507-0125;
    3. Newborn medical program described in WAC 182-505-0210 (2)(a);
    4. Foster care program for a child age eighteen and younger as described in WAC 182-505-0211(1); or
    5. Medical programs for children and pregnant women who do not meet citizenship or immigration status described in WAC 182-503-0535 (2)(e)(ii) and (iii).
  7. If you are required to provide an SSN under this section, and you do not meet an exception under subsection (2) of this section, failure to provide an SSN may result in:
    1. Denial of your application or termination of your coverage because we cannot determine your household's eligibility; or 
    2. Inability to apply the community spouse resource allocation (CSRA) or monthly maintenance needs allowance (MMNA) for a client of long-term services and supports (LTSS).

This is a reprint of the official rule as published by the Office of the Code Reviser. If there are previous versions of this rule, they can be found using the Legislative Search page.

Clarifying Information

  1. A valid Social Security Number (SSN) or proof that an individual has submitted an application for a SSN is required for all Apple Health programs except for the following:
    1. Apple Health for Refugees
    2. Apple Health Alien Emergency Medical
    3. Apple Health for Pregnant Women, Apple Health for Kids, and Apple Health Medical Care Services, for individuals who entered the U.S. under a non-immigrant visa (e.g., individuals with a student, business or visitor visa)
      Note: Those who have entered the U.S. on a non-immigrant visa should not be referred to the Social Security Administration (SSA) to obtain a non-work SSN. These individuals are exempt from the requirement to provide a SSN.
  2. Household members who are not applying for coverage are not required to provide their SSN.
  3. An individual claiming religious reasons for not providing a SSN must provide proof of membership in a recognized sect or division that is conscientiously opposed to applying for a SSN.
    Personal, cultural, or political beliefs do not qualify as a religious objection to providing a SSN.
  4. If a current and valid SSN is not available and the individual needs to pay an agency for a copy of his or her birth certificate, the agency must help the individual obtain the birth certificate and pay for any applicable fees. During this process, the agency may grant "Good Cause" to extend the eligibility of individuals who are demonstrating a reasonable effort to comply with the SSN requirement.
  5. ACES and Healthplanfinder automatically submit every SSN to the SSA for validation.

Worker Responsibilities

  1. Document all actions taken to comply with SSN requirements for Apple Health programs.
  2. For applications in ACES:
    1. If the applicant provides a SSN:
      1. Validation (when entering the SSN in ACES)
        1. Enter the SSN on the ACES DEM1 Screen
        2. Hit Shift-F3 to validate the SSN through SOL
          1. If the SSN is validated, no additional verification is needed.
      2. Verification
        1. If SOLQ shows that the SSN does not belong to the individual or otherwise does not validate, send a request for verification of the SSN.
        2. If the individual sends verification, update the SSN and try to revalidate through SOLQ.
          1. If SOLQ does not validate the SSN, deny or close coverage.
        3. If the individual does not send verification or otherwise refuses to cooperate, deny or close coverage.
    2. If the applicant does not provide a SSN that is required:
      1. Pend the application and send ACES Letter 023-08 (SSN Referral) to refer the applicant to the Social Security Administration District Office (SSADO) for:
        1. Application for a SSN;
        2. Application for a replacement card; or
        3. Determination of a previously issued number.
  3. For applications in Healthplanfinder (note that Healthplanfinder automatically tries to validate every SSN):
    1. Verification
      1. If Healthplanfinder has not validated the SSN:
        1. Manually access SOLQ; and
        2. Recheck and re-verify the SSN.
      2. If SOLQ shows that the SSN does not belong to the individual or otherwise does not validate, send a request for verification of the SSN.
        1. If the individual sends verification, update the SSN and try to revalidate through SOLQ.
        2. If SOLQ does not validate the SSN, deny or close coverage.
        3. If the individual does not send verification or otherwise refuses to cooperate, deny or close coverage.
    2. If the applicant does not provide a SSN that is required:
      1. Pend the application and send ACES Letter 023-08 (SSN Referral) to refer the applicant to the Social Security Administration District Office (SSADO) for:
        1. Application for a SSN;
        2. Application for a replacement card; or
        3. Determination of a previously issued number.
  4. “Qualified aliens” not authorized to work in the U.S.:
    1. “Qualified aliens” as defined in WAC 388-424-0001 (e.g. abused spouses and children who received a USCIS notice of “prima facie” case established (BA), persons who have been granted parole for at least one year (PL)), who are applying for benefits but are not authorized to work in the U.S. must still apply for a non-work SSN.
      1. Assist with the application as described in Citizenship and Alien Status Chapter- Social Security Number (SSN) Requirements for Legal Immigrants.
      2. Use this Sample SSN Request Letter to refer them to SSA.
      3. Consider using Good Cause if a victim of domestic violence not able to apply or provide proof that they have previously received an SSN.
  5. Adoption Cases:
    1. Domestic adoption
      1. When a child is being adopted, or given adoption support through Children’s Administration, the child’s SSN is not always entered into ACES for confidentiality reasons. It is verified as valid by the Foster Care unit through FamLink and SOLQ. Actions are documented in the case narrative and in Remarks behind DEM1 screen and the child’s SSA/SSN Referral field is coded with “E” (Exception to Policy).
      2. Do not request an SSN until adoption is finalized.
    2. International adoption
      1. Effective February 27, 2001 adopted children born outside of the U.S. are granted “automatic” citizenship upon their arrival. Code “P” (Generate Referral Letter to be Printed) in SSA/SSN Referral field on DEM1 screen to print the ACES letter 023-08 (SSN Referral) to refer the household to SSA to apply for SSN for the child.
      2. Valid value “S” (Referral Letter Generated) will automatically appear in the SSA/SSN Referral field on the child’s DEM1 screen after the SSN Referral letter is printed.
      3. After 60 days, if no SSN is provided, request proof of the SSN application status and process case as usual.
  6. Good Cause:
    1. Any individual who provides written proof has "Good Cause", if they are:
      1. Making substantial and reasonable efforts to supply the Social Security Administration with the necessary information; or
      2. A victim of domestic violence and are unable to supply an SSN.
    2. Existence of Good Cause must be clearly documented in the case narrative and in Remarks behind the DEM1 screen.
    3. Code “G” (Good Cause) in the SSA/SSN Referral field on the individual’s DEM1 screen.
    4. If “Good Cause” has been used to extend a person’s eligibility, after an initial grace period of 2 months, which includes the month of application, proof of good cause must be provided for every month that the SSN application is delayed (WAC 182-503-0515).
    5. Good Cause doesn't include delays due to illness, lack of transportation, temporary absence, or failure to respond to the SSN request.
    6. Children remain eligible through their current medical certification period even if an SSN is not provided. Do not recertify as eligible children without a valid SSN or “Good Cause” documentation.
    7. Battered Aliens who meet the definition of Abused spouses or children provided in WAC 182-503-0530 (Citizenship and alien status – Definitions), "Qualified Aliens, (1), (a - e) are qualified aliens with 5 year bar on federal benefits. Every effort should be made to help them to obtain or validate their SSN as they might not be able to apply or provide proof that they have previously received an SSN.
    8. If proof of Good Cause is not provided monthly, as required, consider an individual as "Failing to Provide an SSN" and terminate all coverage for which SSN is an eligibility factor.
  7. Refusing to Provide an SSN for Religious Reasons:
    1. If the individual claims religious grounds for refusing to provide or apply for an SSN:
      1. Obtain verification from the individual and confirm that the religion is a recognized sect or division that is conscientiously opposed to applying for a SSN.
        1. If verified, no negative action should be taken.
        2. If not verified, deny or close coverage.

ACES Procedures

See "SSN"

See "Interview - (DEM1) screen"

See "Interfaces - Numident"

Please report broken links or content problems.