10-144-332 Me. Code R. § 2-5

Current through 2024-51, December 18, 2024

Section 144-332-2-5 - SOCIAL SECURITY NUMBERS

All individuals applying for Medicaid coverage are required to have a Social Security number or proof of having applied for one, except:

I. Undocumented noncitizens;

II. Individuals with a religious exemption; or

III. A child who is born to a mother covered by Medicaid at the time of their birth. By the time the child turns one a Social Security number or proof of having applied for one, must be provided.

All individuals applying for Medicaid coverage are asked to provide their Social Security number at the time of application.

Except as noted in Paragraphs I-III of this section, an applicant seeking benefits is required to furnish the Department with a Social Security number. If the applicant has a Social Security number but is unable to provide it, the Department must contact the Social Security Administration to obtain the number.

The applicant is required to apply to the Social Security Administration for a Social Security number if they do not have one. The Department must assist the individual in obtaining verification necessary to apply for a Social Security number. This includes obtaining documents to prove date of birth, citizenship, or identity if these materials cannot be provided by the individual. The Department cannot pay any costs incurred in obtaining this information. The applicant or recipient must provide the Department with verification that the application for a Social Security number has been made. The Social Security number will be provided by the Social Security Administration.

For a child born to a mother not covered by Medicaid at the time of the child's birth, the Social Security number requirement must be met by the first day of the second month following the month in which the child's mother is discharged from the hospital.

Examples

1. A child is born on July 3. Mother leaves the hospital on July 6. Application for a Social Security number for the child must be completed by September 1.

2. A child is born on July 31. Mother leaves the hospital on August 2. Application for a Social Security number for the child must be completed by October 1.

MaineCare will not be withheld or terminated for lack of a Social Security number if an individual provides verification of application for a Social Security number for those requesting assistance.

MaineCare will not be withheld or terminated while verification of the individual's Social Security number is being obtained from the Social Security Administration.

Section 5.1:Social Security Non-Compliance and Sanctions

For any individual who fails to provide, or apply, for a Social Security number as required, Medicaid and/or CHIP must be denied or terminated.

When the Social Security number requirements for a dependent child are not met, the parent/caretaker relative as well as the child must be denied or terminated for Medicaid and/or CHIP.

I. When an individual is not eligible for MaineCare due to non-compliance, the individual is counted in the assistance unit and the individual's income and assets (when applicable) are used to determine eligibility for other members within the assistance unit.

II. SSI-Related only - When a stepparent must be sanctioned for non-compliance, the stepparent's income will be considered as if the stepparent chose to be excluded from the assistance unit. The assets owned solely by the stepparent are not considered available to the assistance unit. The stepparent is not considered a member of the assistance unit when determining eligibility under the appropriate Federal Poverty Levels.

III. SSI-Related only - When a caretaker relative other than a parent or stepparent must be sanctioned for non-compliance, the caretaker relative's income and assets are considered in the same manner as a sanctioned parent's income and assets would be considered. However, such a sanctioned caretaker relative may choose to be excluded from the assistance unit.

An individual may request good cause for not providing a Social Security number. See Section 8 of this Part for specific information regarding good cause.

Section 5.2:Retroactive Coverage

If otherwise eligible, retroactive coverage will be granted if the Social Security number requirements are met during the application process. If the Social Security number requirements are not met, but at a later date the individual cooperates with these requirements, the retroactive coverage cannot be granted.

Examples

1. A parent refuses to apply for a Social Security number for a child. The parent and the child are denied coverage. One month later, the parent agrees to comply. The parent and child are eligible, effective the first day of the month in which the application for a Social Security number is made. Retroactive coverage cannot be granted.

2. A parent refuses to apply for a Social Security number. Coverage for the parent only must be denied. A year later, the person reapplies and gives a Social Security number proving application for the number was made six months previously. Eligibility may be authorized with up to three months' retroactive coverage because the applicant complied with the Social Security number requirements prior to the retroactive period.

Individuals must be informed that the Social Security number will be used to administer the MaineCare benefit, including eligibility decisions, and will be used for verification of information such as wages, unemployment benefits and bank accounts.

10-144 C.M.R. ch. 332, § 2-5