Department of Social Services
Family Support Division
PO Box 2320
Jefferson City, Missouri
TO: ALL FAMILY SUPPORT OFFICES
FROM: KIM EVANS, DIRECTOR
SUBJECT: QUALIFIED MEDICARE BENEFICIARY (QMB) AND SPECIFIED LOW-INCOME MEDICARE BENEFICIARY GROUP 1 (SLMB1) ENROLLMENT IS AUTOMATIC FOR MO HEALTHNET (MHN) PARTICIPANTS
MANUAL REVISION #
| 0805.000.00 | 0865.035.05 |
| 0820.035.00 | 0870.000.00 |
| 0840.010.40 | 0870.035.00 |
| 0865.000.00 | 1805.065.00 |
| 0865.035.00 | 1885.045.00 |
DISCUSSION:
Enrollment in QMB and SLMB1 is automatic for all eligible MHN participants. Eligibility for QMB and SLMB1 must be explored when processing an application for MHN coverage.
Explore eligibility for QMB and SLMB1 when completing annual renewals, changes in circumstance, or applications for other types of assistance. If the claimant does not already receive QMB or SLMB1 coverage and appears to be eligible, take actions to add QMB or SLMB1 coverage.
When a participant becomes eligible for QMB or SLMB1, the SMI premium is no longer an allowable deduction. This may cause an increase in spend down or cause a non-spend down participant to have a spend down. A participant may choose to close QMB or SLMB1 coverage. If the participant makes the request in person or by phone, explain the financial impact so the participant makes an informed decision.
Note: Medical expenses must be updated on the Medical Expense screen (MEDEXP/FMXA) in the eligibility system.
The following sections were added to the Family MO HealthNet (MAGI) Manual:
- 1805.065.00 Enrollment in Medicare Savings Programs (MSP)
- 1885.045.00 Participant Becomes Eligible for Medicare
The following section was added to the MO HealthNet for the Aged, Blind, and Disabled (MHABD) Manual:
The remaining MHABD Manual sections listed above are updated to reflect automatic enrollment policy, update general terminology and remove outdated processes.
Note: Continue to follow current processing procedures for Non-MAGI applications.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
KE/sh