0865.000.00 Qualified Medicare Beneficiaries (QMB)

0865.030.05 QMB-Only Is Approved for Another TOA

When an individual who is receiving QMB coverage only, applies and is also eligible for another type of assistance, DO NOT CLOSE THE QMB CASE. Approve the new type of assistance and enter a “Y” in field 13M1, and RE-ENTER the old QMB eligibility date in field 13M2 of the new case. This action allows continuing coverage for QMB. On the same date that the approval action is processed, the system automatically closes the QMB-only case. The closing action appears on the Daily Transaction listing and generates a QMB turnaround IM-5 with a case action code of “29C” and a reason for closing of “39”.