Applies to All Applications Except SSI/SSP

A

Death of applicant

B

Application withdrawn

C

Moved out of state

D

Loss of contact/unable to locate applicant

E

Failure to cooperate

F

Does not meet California residency requirements

G

Excess resources

H

No program linkage

I

Potential state-only program eligible did not apply for ongoing Medi-Cal

J

No deprivation

K

Client living in a public non-Medical institution (prison, etc.)

L

Existing CalWORKs/Medi-Cal/CMSP recipient

M

Existing SSI/SSP recipient

N

Receiving Medi-Cal in another state

P

Duplicate pending application

Q

MEDS generated when IE/RR terminates AE

R

Other Reason not specified

S

Applicant can’t apply for the person on the application

T

Previous presumptive eligibility (PE) for same pregnancy (PE use only)

U

Over age limit for presumptive eligibility (PE use only)

V

Application for MAGI and APTC/CSR denied

W

Not Part of the Tax Household

X

Excess Income - Denied for MAGI and Qualified for APTC/CSR

Y

Erroneously reported application

Z

MEDS generated when no valid data reported

0

Existing Medicare Recipient

1

Premium not paid

2

Income does not meet requirements

3

State of home address is missing or invalid, must be California

4

End date for employer sponsored insurance is missing or invalid

5

Child is eligible for Medicare Part A and B

6

Funding not available

7

Child age 19 or over not eligible for HFP

8

Incarcerated

9

Not a US Citizen, National or Lawfully Present

Applies to SSI/SSP Applications

N01

Non-pay. Recipient’s countable income exceeds SSI payment amount and state’s payment standard.