Enter the application in the name of the applicant for “W” type of assistance. Only one individual may be registered on a “W” type of assistance. Register a separate application for each spouse if both apply for QDWI benefits.
All regular IM application procedures apply. The use of the IM-1 and IM-2 or IM-1MA, and availability of fair hearings is the same as for any other adult Medicaid program. Instruct the client to complete pages 1-7 of the IM-2.
Take the following steps to approve a case for QDWI:
- Contact the IM Program and Policy Unit in State Office requesting verification of SSA QDWI status and the date of the change to premium Part A.
- Determine eligibility factors.
- Complete an IM-30A for determining initial eligibility based on need.
- Record whether the applicant is eligible for any other type of assistance.
- Determine prior quarter coverage, if applicable.
- Complete the IMU5 entries:
- The “W” Type of Assistance;
- The claimant’s address;
- The reason for opening code “08”;
- The claimant’s Social Security Claim Number;
- A “Y” In Field 13M 1 and the beginning date of coverage in Field 13M 2;
- Information from the IM-30A; and
- Other entries needed for approval.
If ineligible, reject the application using the appropriate rejection code.