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Why do I have to provide my Social Security number to enroll in health insurance through the exchange?

Why do I have to provide my Social Security number to enroll in health insurance through the exchange?

Why does the health insurance marketplace need my Social Security Number?

Consumers are routinely told to keep our Social Security numbers private, but there are legitimate reasons why the health insurance exchange ( or a state-run exchange) needs your SSN.

It’s used to confirm that you’re lawfully present in the United States and to confirm that the income you’ve projected approximately matches the information the marketplace gets from trusted sources, including the IRS, the Social Security Administration, and Equifax Workforce Solutions.

If you’re not lawfully present in the U.S., you cannot enroll in coverage through the marketplace. (Note that Washington state has received federal approval to begin allowing undocumented immigrants to enroll through its state-run exchange in 2024, albeit without any federal subsidies. And Colorado has established a separate portal where undocumented immigrants can enroll in state-subsidized coverage.) The marketplace uses applicants’ SSNs to confirm that they are lawfully present residents. So you’ll need to provide SSNs for all household members who are applying for coverage, regardless of whether you’re applying for financial assistance.

If you’re applying for financial assistance – which the vast majority of marketplace enrollees are eligible to receive – you’ll need to provide SSNs for all members of the household who are listed on the household’s tax return, regardless of whether they’re applying for coverage. This is so that the marketplace can confirm the household’s total income, which is used to determine eligibility for premium subsidies and cost-sharing reductions.

If you fail to provide your SSN, it can trigger a data matching issue (DMI), which means the marketplace will reach out to you to get more information. It’s also important to keep in mind that the names you provide to the marketplace should match the names on file with the Social Security Administration. If they aren’t the same, that could result in a DMI, despite the fact that you provided the correct SSN. So if you’ve changed your name recently, you’ll want to make sure you’ve updated the records on file with the Social Security Administration.

Should I give my SSN to my insurance broker?

If you’re working with a trusted broker or Navigator who is certified to enroll people in coverage through the marketplace or using a third-party enrollment site such as INSXCloud, you will need to provide your SSN so that they can facilitate your enrollment in health coverage. Without it, they will either be unable to submit the application (in some states) or you’ll find yourself receiving a DMI notification once the application is processed.

Even if you take the DIY approach and enroll without assistance, there are employees and contractors at the exchange who will need to have access to the data in your application, including your SSN. But all of these people – including brokers, Navigators, and people who work at the exchange – have received training on how to safeguard applicants’ personal information, and are bound by rules that require them to do so.

As is always the case with important personal information, you’ll want to do your due diligence before providing any details. As a general rule, don’t give your SSN (or any other private information) to someone who cold calls you. Before working with an agent or broker, you should confirm that they are licensed by the insurance department in your state, and certified to work with the exchange. Navigators are not licensed by state insurance departments, but they are certified by the exchange.

Here’s insurance department contact information for every state, and here’s a tool where you can find brokers and enrollment assisters who are certified to work with the federally-run exchange, which is used in 33 states. The remaining states run their own exchanges, and they have similar tools that you can use to ensure that a broker or enrollment assister is certified by the exchange.

If you don’t provide your SSN on your application and you get a follow-up call from the marketplace, here’s what to know about protecting your personal information and avoiding fraud.

What will happen if I don’t give my SSN to the exchange?

If you don’t include your SSN on your application and it results in a data matching issue, it’s essential that you respond to the marketplace within the timeframe that they specify in their request for more information.

If you fail to submit the necessary details – including your SSN, if that’s what’s missing – the result will either be loss of coverage altogether if they couldn’t verify that you’re lawfully present in the U.S., or loss of financial subsidies if they couldn’t verify your income. For most people, loss of subsidies will result in loss of coverage, as the premiums tend to be unaffordable for most applicants without subsidies. So you definitely don’t want to ignore a DMI notification from the marketplace.

But prevention is the best cure, and avoiding DMIs in the first place will make your life easier. This is why it’s important to fill in all the fields on the application, including SSN.

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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