0870.000.00 Specified Low-Income Medicare Beneficiaries (SLMB1) and Qualifying Individuals (SLMB2)

0870.030.20 SLMB Eligibility Continues, Other Type of Assistance Closes

When an individual receiving another type of assistance and SLMB group 1 coverage, reports a change, re-determine eligibility for both programs. If the change results in ineligibility for the other type of assistance, but SLMB eligibility continues, close the other type of assistance using regular IMU5 procedures, and enter an “L”, “2” or “3” in Field 13M1 and the original date of SLMB eligibility for that group in Field 13M2. This is a required entry. Failure to make an entry in this field will result in an online edit, which states “QMB/SLMB INDICATOR AND BEGIN DATE ENTRY REQUIRED”.

Enter SLMB budget figures in Fields 33-35. Failure to enter appropriate SLMB budget figures in these fields will result in an edit stating “SLMB EXPENSE INVALID”.

On the same date the above action is processed, the system automatically opens a SLMB only case. This transaction appears on the Daily Transaction report and generates an “L” type of assistance turnaround IM-5 with a case action of “08C”.

NOTE: Do not make a re-entry in Field 13M1 and 13M2 without determining continued eligibility for SLMB. An “L” “2” or “3” entry is, in effect, an approval of SLMB eligibility.

Additionally, when closing another type of assistance and continuing SLMB coverage, use transaction IMU5. As the system must automatically open another case, an overnight function is required. The system will not allow the closing of these cases using the transaction ICLS. An attempt to close these cases, using ICLS will produce the error message “QMB/SLMB INDIVIDUAL ON CASE. USE IMU5 TO CLOSE.”