Family and Children's Medicaid MA-3355 ENUMERATION PROCEDURES

REVISED 07/01/10 – CHANGE NOTICE 08-10

I. Policy principles

A. Enumeration Requirement

All members of the assistance unit must provide their social security number (SSN) or apply for a SSN to be eligible for Medicaid or NC Health Choice for Children. There are exceptions listed in D. below.

1. If an SSN or SS card cannot be provided for an assistance unit member, the assistance unit member or his representative must make an application for a SSN or a replacement card.

2. Do not deny, delay, or discontinue assistance if the assistance unit member or his representative cooperates in providing the SSN or applying for a number.

B. A non-au member who is applying for assistance for another is not required to provide his SSN. This applies even if he has financial responsibility for an assistance unit member. For example, a mother who is applying for Medicaid for only her children cannot be required to provide her SSN.

The IMC may request non-AU, financially responsible individuals to provide their SSN. However, the IMC must inform the individual how the number will be used and that the disclosure is voluntary. Refer to MA-3515, Automated Inquiry and Match Procedures.

C. Penalty for Failure to Comply with Enumeration

An assistance unit member is ineligible for Medicaid and NC Health Choice if he or his representative refuses to provide his SSN or refuses to apply for a SSN.

D. Exceptions to Enumeration

The following do not need to provide a SSN:

1. Non-qualified aliens, described in MA-3330, Alien Requirements, who are eligible only for emergency medical services and can not apply for a SSN. For example, undocumented aliens or aliens who are here without the knowledge of the Bureau of Citizenship and Immigration Service (BCIS) cannot apply for a SSN.

REISSUED 07/01/10 – CHANGE NOTICE 08-10

(I.D.)

2. Deceased individuals. Social Security Administration (SSA) does not issue SSN's to deceased individuals. However, to verify a SSN issued prior to death, follow procedures in III. below.

3. Newborns automatically eligible for Medicaid as described in MA-3230, Eligibility of Individuals Under 21. Once newborn protection ends, the newborn must meet enumeration requirements.

4. Pregnant women determined presumptively eligible for M-PW as described in MA-3245, Presumptive Eligibility for Pregnant Women.

E. Verification of Enumeration

An assistance unit member is enumerated when:

1. He provides his SSN, either verbally or by providing his Social Security card. Always make a copy of the social security card if provided. Do not copy a metal card as this is not a true social security card.

2. The birth certificate, including the Mother's copy, verifies block 17c is checked "yes" to indicate the parent applied for a SSN using the birth certificate for a child 6 months or younger, or

3. The Register of Deeds/Health Department verifies block 17c on the birth certificate is checked "yes" to indicate the parent applied for a SSN using the birth certificate for a child 6 months or younger, or

4. The agency mails the completed SS-5, DSS-8174, and certified documents to the Social Security Administration office (SSA), or

5. SSA returns the signed DSS-8174 or SSA-5028 to the agency.

F. Cooperation with Local Social Security Office

The agency director must establish with the manager of his district SSA office acceptable enumeration procedures. It is recommended that SSA accept the DSS-8174 as a public assistance ID and accept SSN applications by mail.

REVISED 11/01/06 – CHANGE NOTICE 19-06

(I.)

G. Time Standards

The client must provide or apply for a SSN for all au members prior to authorization for Medicaid or NCHC. You can deny an application on the 45th day if an assistance unit member has not provided or applied for a number. However, once enumeration is verified, eligibility begins based on the month of application, provided all other eligibility requirements are met.