- TO:
- ALL COUNTY OFFICES
- FROM:
- ALYSON CAMPBELL, DIRECTOR
- SUBJECT:
- EXPLORING QUALIFIED MEDICARE BENEFICIARY (QMB) AND SPECIFIED LOW INCOME MEDICARE BENEFICIARY (SLMB1 AND SLMB2) ELIGIBILITY FOR ALL PARTICIPANTS APPLYING FOR LOW INCOME SUBSIDY
DISCUSSION:
The Medicare Improvement for Patients and Providers Act of 2008 required that states explore Qualified Medicare Beneficiary (QMB) and the Specified Low Income Beneficiary (SLMB1 and SLMB 2) program eligibility for all individuals applying for Low Income Subsidy (LIS). Information received from the Social Security Administration on LIS applicants is being transferred to a report that will be sent to the MO HealthNet Program and Policy Unit. The MO HealthNet Program and Policy Unit will e-mail the reports to the County Manager. Requests to have LIS reports sent to additional county staff must be submitted by the County Manager to the MO HealthNet Program and Policy Unit at Cole.MHNPolicy@dss.mo.gov. A copy of the report is attached. MO HealthNet Program and Policy staff will be monitoring these reports to ensure that applications are being registered and processed timely.
The QMB/SLMB application must be registered using the run date listed on the LIS report. The “check question 3” field indicates whether or not the participant wished to pursue LIS benefits even though they stated they were over the resource or income limits for the LIS program. A “Y” entry in this field indicates the participant did not need to complete the LIS application unless a formal decision was requested therefore there may not be income or resource information listed, which will be noted on the bottom of the report. The resource and income fields are broken down by the code number in parenthesis indicating the type of resource or the income source. The total household income is listed as well. Eligibility Specialists are required to verify all of the income and resource information listed on the report as well as all of the other eligibility factors for the QMB/SLMB programs. Eligibility specialists must explore eligibility for these programs each time this report is received. If the participant is already receiving benefits under QMB or SLMB no action is required.
NECESSARY ACTION:
- Review this memorandum with appropriate staff.
- Effective immediately eligibility must be explored for all Medicare Cost Savings programs upon receipt of this report
SS