300 Series reason codes

Revised Date: 
December 1, 2014

Purpose: 300 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

300

Nonpayment of Premium

According to our records, you have not paid all required premiums. See WAC rule (Washington Administrative Code):

 

None Required

   

301

Exceeds Income Standard

Your income is over the limit that is allowed for this program. See WAC rule (Washington Administrative Code):

388-478-0060

388-478-0055

388-450-0165

388-450-0162

388-450-0015

388-478-0090

The limit for your household size is $ __ .

182-519-0050

182-505-0100

182-512-0010

182-517-0100

182-509-0001

 

306

Change In Unearned Income

The amount of unearned income you get has changed. See WAC rule (Washington Administrative Code):

388-418-0020

388-450-0025

388-450-0162

182-512-0010

388-492-0020

388-492-0030

Your income from (source) has changed from $ __ to $ __ .

   

307

Change In Gross Earned Income

The amount of money that you earn has changed. See WAC rule (Washington Administrative Code):

388-450-0030

182-512-0010

388-418-0020

Your gross earned income has changed from $ __ to $ __ .

   
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

320

Exceeds Gross Income Limit

Your income is higher than the income limit for this program. See WAC rule (Washington Administrative Code):

388-450-0015

388-450-0165

388-478-0060

388-478-0090

The limit for your household size is $ __ .

   

321

Change In Net Deemed Income

The amount of income we consider available to you from an outside source has changed. See WAC rule (Washington Administrative Code):

388-450-0100

388-450-0105

388-450-0115

388-450-0120

388-450-0135

388-450-0155

388-450-0130

388-450-0150

388-450-0140

388-450-0160

388-450-0125

We are counting $ __ of (Name)'s income.

   

323

Change In Home Maintenance Exemption

The income amount that you are allowed to keep to pay for home expenses is called a home maintenance allowance. Yours is changing because:

  • You have been getting it for 6 months;
  • Your doctor says you have to stay longer; or
  • The amount of your home expense has changed.

See WAC rule (Washington Administrative Code):

388-513-1380

Your home maintenance amount has changed because __ . (add specific details, e.g. "Your rent has changed from $ __ to $ __ ." Or "On __ (date) __ , Dr. __ told us you can't return home before __ .")

   

327

Change In Recoupment

We are taking a different amount from your benefits to repay an overpayment. See WAC rule (Washington Administrative Code):

388-410-0005

388-410-0010

388-410-0015

388-410-0030

None Required

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

330

Lump Sum

Your resources are over the limit for this month because of your lump sum payment. See WAC rule (Washington Administrative Code):

388-450-0245

388-470-0005

You got $ __ from __ on 00/00/00. Your countable resources are now $ __ . Your resources cannot be more than $ __ (specify resource limit for household size).

If the grant is suspended:

We will be subtracting $ __ from next month's grant. This reduction is for one month only.

If the grant is terminated:

Your lump sum payment is more than the need standard for two months. You can reapply for a cash grant in (month).

   

332

Change In CPI Allowance

Your Personal Needs Allowance (PNA) changed. See WAC rule (Washington Administrative Code):

388-513-1380

     

334

Your earned income is over the limit for this program

388-478-0035

The limit for your household size is $ __ .

   

335

Change In Uncovered Medical Expense Allocation

The amount you can use to pay medical expenses has changed. See WAC rule (Washington Administrative Code):

388-513-1380

The amount you can use to pay for the following medical expenses has changed: (Type of expense) from $ __ to $ __ .

   

336

Change In CSMA / FMMA Allocation

The amount we can allow for the maintenance of your family members at home has changed. See WAC rule (Washington Administrative Code):

388-513-1380

Your allocation changed from $ __ to $ __ because __ .

   

337

Change In Extra Hardship Allocation

The amount that we can allow for your special needs has changed. See WAC rule (Washington Administrative Code):

388-513-1380

Your allocation changed from $ __ to $ __ because __ .

   

339

Medical Extension Ends

Your medical extension expired and we did not get your review form. If we get it before the end of the month, we will reconsider our decision. If you have already sent it, let me know. If your medical benefits stop and you decide that you still want them, you need to reapply. See WAC rule (Washington Administrative Code):

388-400-0035

182-523-0100

182-505-0115

None Required

   
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

340

QMB Ineligible - Client Is Not Institutional Related

You are no longer eligible for assistance that pays for all or part of your Medicare costs and premiums. The department must count your income differently when you are no longer eligible for Long-Term Care Services, such as Nursing Facility Care, COPES or CAP/OBRA Services. See WAC rule (Washington Administrative Code):

388-450-0005

None Required

   

341

The state supplemental payment rate for all SSI recipients has changed. See WAC rule (Washington Administrative Code):

388-478-0055

None Required

   

342

Medical coverage stopped for the children listed above because you are 3 months behind in premium payments. Medical can't start again until the premiums are paid.

Premiums aren't required for a child who is pregnant, an American Indian or Alaska Native. If your family income decreases, medical coverage without a premium may be available.

HPF

Health care coverage stopped for the children listed above because you are three months behind in premium payments. Washington Apple Health with premiums coverage can't start again until the premiums are paid.

182-505-0225

None Required

182-505-0225

None Required

343

The amount of Third Party Resources you get has changed. See WAC rule (Washington Administrative Code):

388-501-0200

The amount of your third party resource has changed from $ __ to $ __ .

   
388

WA Fund CAP For ESLMB Already Reached

Washington gets a limited amount of money for the Qualified Individual (QI-1) Program. There are no more funds available for this year. You can reapply in December for next year. See WAC rule (Washington Administrative Code):

182-517-0300 None Required