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DPSS ePolicy

MEDI-CAL

Social Security Number Requirement

Release Date
03/10/2020

Section Heading

Purpose

To convert existing policy to new webpage - No content changes.


The purpose for this Administrative Directive is to reinforce policy regarding the Social Security Number (SSN) requirement for applicants/beneficiaries applying for Medi-Cal (MC) benefits only.


Policy

An applicant must provide a SSN at application when requesting full-scope MC benefits.  When the individual does not have a SSN, benefits must be approved, if otherwise eligible.  However, the SSN must be provided or an application for a SSN must be submitted within 60 days of the date of application.  Individuals applying for the following programs are not required to provide a SSN:

  • Minor Consent Services; and
  • Pregnancy Related Services.

Newborns are also not required to provide a SSN until infant turns age one.  In addition, individuals without Satisfactory Immigration Status (SIS) eligible for full-scope or restricted MC benefits are also exempt from providing the SSN.

MC benefits must not be delayed, denied, or discontinued unless the applicant/beneficiary refuses to cooperate, apply for, or provide a SSN for self, or a child over age one.


Background

Title 22, California Code of Regulations, Section 50168, states that counties must obtain verification of the SSN or evidence that an application for an SSN has been made, within 60 days from the initial MC application date, but not necessarily prior to approval of eligibility.


Definitions

Terms and Descriptions


Burman Hold

A Burman Hold is generated due to an unresolved discrepancy between the LEADER Replacement System (LRS) and MC Eligibility Data System (MEDS) and no immediate action has been taken to resolve the discrepancy.  A review and evaluation must be completed to ensure information is corrected in LRS and/or MEDS.


Deferred Action For Childhood Arrivals (DACA)

Also referred to as the Dream Act, is a type of administrative relief from deportation where a non-U.S. citizen is permitted to temporarily remain in the United States.


Electronic Document Management System (EDMS)

An electronic document system that manages the creation, storage and control of documents submitted to the county as verification of information needed for eligibility purposes.


Electronic Verification (e-Verified)

The process of sending self-attested information to the Federal Data Service Hub (FDSH) for verification.  If the attested information is e-Verified by the FDSH, then there is no need to request physical verification (e.g. copy of SSN card, check stubs) from the applicant/beneficiary.


Ex-Parte

The process of reviewing all information available to the County that is relevant to the beneficiary’s MC eligibility, such as LRS, MEDS, EDMS, Income and Eligibility Verification System (IEVS) abstracts, and Systematic Alien Verification for Entitlement (SAVE) to determine ongoing MC eligibility without having to contact the beneficiary or request verifications.


Federal Data Service Hub (FDSH)

An e-Verify system that is used to compare and verify information with other federal and State systems during the eligibility determination process.


Income And Eligibility Verification System (IEVS)

An electronic system which matches applicant name and SSN against federal and State income and asset data files.


MC Eligibility Data System (MEDS)

The State system that contains data and eligibility information for various health and public assistance programs, including MC.


Senate Bill (SB) 75

A State law which grants children under 19 years of age eligibility for full-scope MC benefits, regardless of immigration status, if otherwise eligible to MC.


SB 104

A State law which grants individuals ages 19 through 25, eligibility for full-scope MC benefits, regardless of immigration status, if otherwise eligible to MC.


Systematic Alien Verification and Entitlement (SAVE)

An e-Verify process used to verify immigration status of applicants when required for health and public assistance programs, including MC.


Self-Attestation

A formal declaration by an applicant/beneficiary that information is true and correct.


Permanently Residing Under Color of Law (PRUCOL)

PRUCOL is a public benefits category created by the federal courts that grants full-scope MC eligibility to immigrants residing "under the color of law.”  For a person to be residing “under the color of law,” the United States Citizenship and Immigration Services (USCIS) must know of the person’s presence in the U.S. and provide the person with written assurance that enforcement of deportation is not planned.  PRUCOL is not recognized as an immigration status by the USCIS.


Trafficking And Crime Victims Assistance Program (TCVAP)

Allows full-scope eligibility for undocumented individuals who are victims of trafficking, domestic violence and other serious crimes, if otherwise eligible.


Violence Against Women Act (VAWA)

Allows abused noncitizens or child of a U.S. citizen or Legal Permanent Resident to apply directly on their own, for lawful immigration status without the assistance of the abusive spouse or parent.


Requirements

U.S. citizens and immigrants claiming SIS, requesting full-scope MC benefits, must provide a SSN, or verification of applying for a SSN within 60 days from the initial date of application.  Failure to comply will result in the discontinuance of MC benefits.

However, the following immigrant populations without SIS are exempt from the SSN requirement and may receive full-scope benefits, if otherwise eligible.

  • SB75;
  • SB104;
  • DACA;
  • PRUCOL/Category 16;
  • TCVAP; and
  • VAWA.

Immigrants without SIS and not part of the populations above may receive restricted/limited scope benefits, if otherwise eligible.

In addition, if an applicant/beneficiary without SIS provides a SSN, the information must be used as part of the eligibility determination for MC benefits.


Verification Docs

The following chart provides acceptable forms of verification when an applicant or beneficiary does not have an SSN or SSN is unknown:

If SSN is self-attested by the applicant/beneficiary, then acceptable verification may include:

  1. SSN verified via the FDSH;
  2. SSN verified via MEDS with a valid code in the SSN-VER field; 
  3. IEVS match;
  4. SAVE match; or
  5. Copy of SSN card on file.

If SSN is unknown by the applicant/beneficiary, then acceptable verification may include:

  1. A Social Security Administration (SSA) award letter with applicant/beneficiary name and SSN;
  2. A successful ex-parte review, which may include but not limited to:
    1. Acceptable SSN Verification Code in MEDS;
    2. SSN verified via FDSH; or
    3. Copy of SSN card on file.

If SSN is unknown by applicant/beneficiary and they applied for a SSN, then acceptable verification may include:

  1. Notification from SSA that application for a SSN has been made;
  2. Completed SS-5 (SSA form); or
  3. Completed SSA Information Referral Notice MC 194.

Note:  If the SSN card is provided by the applicant or SSN card is on file, it may be used as verification of SSN.


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