100 Series reason codes

Revised date

November 21, 2018

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
101	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).	388-400-0060 388-400-0070 388-474-0010	None Required
102	WASHCAP Application Month Denied - For Administrative Use Only	None	None Required
103	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.	388-492-0030	None Required
104	SSA Terminates WASHCAP Food Assistance Social Security asked us to stop your food benefits See WAC rule (Washington Administrative Code)	388-492-0110	None Required
105	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.	388-492-0030	None Required
106	WASHCAP Terminates - Individual Getting $1.00 Or Less SSI Money You stopped receiving SSI cash.	388-492-0030	None Required
107	WASHCAP Terminates - Individual Not Eligible For SSI Money Or Medical SSA decided that you cannot get SSI. See WAC rule (Washington Administrative Code):	388-492-0030	None Required
109	Not SSP Eligible - Individual's SSI Terminated You can't receive a state supplemental payment if you're not receiving a SSI payment	388-474-0012	None Required
111	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.	388-474-0012	None Required
112	Receiving Tribal TANF Benefits We believe you are eligible for cash benefits from the tribe	388-400-0005	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.
120	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.	388-490-0005	Specify the persons who are ineligible due to lack of proof of citizenship	182-503-0535	None Required
121	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
130	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.	388-408-0035 388-489-0005	None Required
131	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.	388-489-0025	Specify the person who is receiving TANF or Tribal TANF.
141	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.	388-418-0011	None Required
142	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.	388-418-0011	None Required
167	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
168	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
187	Individual Already Received CN Medicaid In Another AU For This Benefit Month - For Administrative Use Only	None	None Required	182-503-0510	None Required
188	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.	388-511-1105	Specify person who is being terminated.
190	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
191	Federally Qualified Individual Changed to Non-Federally Qualified You are no longer eligible to receive health care coverage			182-503-0535	None Required
193	Alien Emergency Medical Requirement You don't meet the requirements to receive Washington Apple Health Alien Emergency Medical coverage.			182-507-0110	None Required

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