Revised on: November 29, 2022
Code |
Reason Code Title / Text |
WAC References |
Recommended Free Form Text |
---|---|---|---|
200 |
Non-Citizen Medicaid Ineligibility You do not meet the citizenship or alien status requirements to receive Washington Apple Health. |
Need to specify which persons in AU do not meet citizenship requirements. |
|
201 |
Living Arrangement - Cash / Medical Assistance |
|
Your living arrangement does not meet our requirements because (specify relevant requirement and how client's living situation does not meet that requirement) . (Note to Users: This reason code is based on the valid value entered in the living arrangement field on the DEM1 screen). |
202 |
Citizenship / Alien Status |
|
If client submitted verification of alien status: You do not meet the requirements because (specify relevant requirement and how client's alien status does not meet that requirement). . If client didn't submit verification of status: We can't determine if you meet our requirements because we do not have verification of your citizenship status. |
203 |
Receiving SSI |
None Required |
|
204 |
No Dependent Child |
If pending medical: We have not figured out if you are eligible for medical assistance because we are still waiting to hear if your condition meets our definition of a disability or emergency medical condition. |
|
205 |
Failed Age / School Attendance |
|
(Name) is # years old. S/he cannot get assistance because (specify requirement that client does not meet). . |
206 |
Living Arrangement - Food Assistance |
Your living arrangement does not meet our requirements because (specify requirement that client does not meet) . (Note to Users: This reason code is based on the valid value entered in the living arrangement field on the DEM1 screen). |
|
207 |
Failed Eligible Student Requirement - Food Assistance |
Specify requirements and why client doesn't meet them. |
|
208 |
Failed Social Security Number (SSN) Requirement We don't have one of the following:
|
Need to specify which person(s) in AU we require the SSN for. |
|
209 |
Failed Refugee Requirement |
For refugees: or For asylees: |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
210 |
Failed Residency Requirement |
You do not meet the residency requirements because (specify client facts showing why client is not considered a WA resident) . |
|
212 |
No Relationship To receive cash assistance for a child, you must be: A relative, A legal guardian, Acting as the child's parent, or A court ordered custodian. See WAC rule (Washington Administrative Code): |
|
(Caretaker's name) is not a relative of specified degree, legal guardian, acting as a parent or permanent custodian of (Child's Name). (Note to Users: This reason code is based on the valid value entered in the relationship field on the STAT screen). If pending medical: |
213 |
Failed Pregnancy Requirement - S Medical & Family Planning Medical |
You are not eligible for post-partum coverage because it has been more than 2 months since your pregnancy ended. or You are not eligible for family planning coverage since it has been more than 12 months since your pregnancy ended. |
|
214 |
TANF Pregnancy Only - Father of Unborn Not Eligible |
None Required |
|
215 |
Failed Work Registration Requirements |
You did not on 00/00/00. You cannot get benefits from 00/00/00 to 00/00/00 unless you . If you don't do this, you will have to reapply after 00/00/00 and start participating. |
|
218 |
Roomer - Food Assistance |
None Required |
|
219 |
Voluntary Quit |
You quit your job or reduced your work effort at on 00/00/00. You cannot get benefits until [disqualification period] unless you become exempt from work registration. If you want benefits, you must reapply. You can get food assistance, during this time if you become exempt from work registration. |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
220 |
Failed Age Requirement - Medical |
You must be to get benefits from this program. |
|
221 |
Failed Incapacity Requirement |
During your financial interview on 00/00/0000, you did not report an incapacity. If a 14-118 (IND) is received, use the mandatory free form text included in the 14-118. |
|
222 |
Eligibility Not Established For Month |
None Required |
|
223 |
Failed E&T Requirements - 2nd Offense |
You did not on 00/00/00. You cannot get benefits until 00/00/00. If you want food assistance after that, you must reapply and start participating. |
|
224 |
Failed E&T Requirements - 3rd Offense |
You did not on 00/00/00. You cannot get benefits until 00/00/00. If you want food assistance after that, you must reapply and start participating. |
|
225 |
Now Receiving SSI |
None Required |
|
226 |
Residing In Inpatient Psychiatric Institution |
388-400-0005
|
None Required |
227 |
Under Previous Work Registration Penalty - Food Assistance |
You cannot get benefits until 00/00/00. We told you about this on 00/00/00. |
|
228 |
IV-D Non-Cooperation |
DCS told us that you (specify non-cooperation) . |
|
229 |
Exceeds Adult Recipient TANF Time Limits An adult or emancipated minor in your assistance unit received 60 months of TANF/SFA cash assistance and doesn't qualify for a time limit hardship extension. |
None Required |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
230 |
Verification |
On 00/00/00, I asked you to provide the following items by 00/00/00: List of items |
|
232 |
IPV Disqualified |
This is the (first/second/third) time that (name) has done this. S/he cannot get benefits again until 00/00/00. |
|
233 |
Change In Household Size |
(Name) moved in/out on 00/00/00. or (Name) is now/no longer getting benefits with you because. |
|
235 |
Review Not Complete |
None Required |
|
237 |
Change In Shelter Cost / Shelter Deduction |
For cash assistance: or For food assistance: |
|
238 |
Change In Food Assistance Medical Expenses |
If newly elderly/disabled: Since you are now considered disabled or elderly we are using your medical expenses to figure out how much of your income counts. |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
240 |
CEAP AUTO Close - For Administrative Use Only |
None |
None Required |
242 |
Prior Lump Sum Penalty Period Exists |
You got $ from on 00/00/00. You cannot get benefits until 00/00/00. We told you about this on 00/00/00. |
|
244 |
Death |
Specify the person who died. |
|
245 |
No Eligible Household Members |
If no other reason code or letter: No one is eligible because (specify the requirement if not met. If more than one specify the one that applies to all members or the one that primarily prevented eligibility) . |
|
246 |
Under Previous Penalty |
You cannot get benefits because (specify what action caused the penalty). . We told you about this on 00/00/00. You cannot get benefits until 00/00/00. |
|
247 |
Under Previous Non-Cooperation With QC Penalty |
You cannot get benefits for # months because (specify what action caused the penalty) . You can regain your eligibility by (specify actions needed to be eligible again . If you have any questions about this, call the Quality Assurance worker at (000) 000-0000. |
|
248 |
Head of Household Not Eligible |
(Name) cannot get benefits because (specify why that person cannot get benefits - requirement not met and why they don't meet it). |
|
249 |
Receipt Of Benefits From Another State During Month |
You already got benefits from (Name of State). |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
250 |
Not Aged, Blind Or Disabled - Medical |
None Required |
|
251 |
Already Received Food Assistance |
None Required |
|
252 |
Non-Compliance Sanction for not participating in the WorkFirst program as required See WAC rule (Washington Administrative Code): |
(Name) is in non-compliance sanction status. |
|
254 |
Under Previous Transfer Of Resources Penalty - Food Assistance |
You transferred your (type of property) on 00/00/00. Since you did not get the fair market value, you cannot get benefits from 00/00/00 to 00/00/00. We told you about this on 00/00/00. |
|
255 |
Transfer Penalty Still In Effect (MA) |
You transferred your (type of property) on 00/00/00. Since you did not get the fair market value, you cannot get benefits from 00/00/00 to 00/00/00. We told you about this on 00/00/00. |
|
256 |
Fleeing Felon & Parole Violation - CA / FA |
Specify the information used to verify that A/R was fleeing or breaking probation/parole, and what the violation is. A finding that the A/R is breaking probation or parole must be from an administrative body or court. |
|
258 |
Failed ABAWD Requirement |
None required. |
|
259 |
Temporary Absence Change Not Reported In 5 Days |
(Name of child(ren)) left your house on (date). You knew they were going to be gone for longer than 90 days because (specify information source and how recipient knew this). |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
260 |
Food Assistance Voluntary Quit - 2nd Offense |
You quit your job at on 00/00/00. You cannot get benefits until 00/00/00 unless you reapply and (specify what client has to do to get benefits before that). |
|
261 |
Food Assistance Voluntary Quit - 3rd Or Subsequent Offense |
You quit your job at on 00/00/00. You cannot get benefits until 00/00/00 unless you reapply and (specify what client has to do to get benefits before that).. |
|
262 |
Convicted of Receiving PA In 2 Or More States |
Specify which other state the benefits were received in and when they were received. |
|
263 |
Convicted Of Unlawful Practices |
|
You were convicted on 00/00/00. The court says you cannot get benefits until 00/00/00. |
264 |
Minor Parent Inappropriate Living Situation |
None Required |
|
265 |
Minor Parent Failed School Requirement |
None Required |
|
266 |
Non-Cooperation With TPL |
None Required |
|
268 |
40% WorkFirst Sanction |
(Name) did not (specify IRPrequirement not met) on 00/00/00. We told you about this on 00/00/00. (Name) can regain eligibility by . |
|
269 |
10-Year Penalty For Fraudulent Statement |
You were convicted on 00/00/00. |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
271 |
Trafficking Less Than $500 Or For Controlled Substance |
You cannot get benefits from 00/00/00 to 00/00/00 because you . |
|
272 |
Permanent Disqualification - Illegal Trafficking More Than $500 Or For Controlled Substance
See WAC rule (Washington Administrative Code): |
You cannot get benefits from 00/00/00 to 00/00/00 because you . |
|
275 |
No Longer Receiving SSI |
None Required |
|
276 |
Your medical condition doesn’t meet the emergency medical requirements for Washington Apple Health Alien Emergency Medical Coverage. |
None Required |
|
277 |
Not Receiving Medical when Child is Born The mother of the child listed above was not receiving medical assistance when the child was born. |
182-505-0115 | None Required |
279 |
QMB Start Date - Administrative Use Only |
None |
None Required |
Code |
Reason Code Title / Text |
WAC References |
Free Form Text |
---|---|---|---|
280 |
Not Entitled To Medicare Part A |
None Required |
|
281 |
Waiver Not Approved |
We do not have a plan of care for your (type of home or community based (HCB) program). |
|
282 |
Indian Food Distribution Program |
None Required |
|
284 |
Failed To Meet Spenddown Requirement |
None Required |
|
285 |
Income Exceeds 250% Of FPL (CHIP) |
The income limit for your family size is $_____ |
|
286 |
Cash Diversion - Not Eligible ForTANF |
If no other reason code or letter: You are not eligible for TANF/SFA because . |
|
288 |
Ineligible ESLMB Already Receiving MA |
None Required |
|
289 |
Failed To Appear For Application Appointment CA/MA/FA |
None Required |
Code |
Reason Code Title / Text |
WACReferences |
Free Form Text |
---|---|---|---|
290 |
Overdue Incapacity Review |
None Required |
|
292 |
Group Home Decertified |
You live at (Name of Facility). |
|
294 |
Changed To Family Planning |
None Required |
|
295 |
Dependent Has Creditable Medical Coverage (CHIP) |
None Required |