QMB Recipient under Medicare SNF Care

If the QMB recipient qualifies for Medicare Skilled Nursing Facility (SNF) care, Medicaid is required to pay the copayments even if that amount is zero. QMB individuals are not required to apply for Nursing Home Medicaid if they do not desire to do so. (Note: after the first 100 days in a benefit period QMB recipients will be responsible for all costs.)

When a QMB recipient is admitted to a nursing facility under Medicare SNF care, the nursing facility will complete a Form DMA-59, Sections I, II, and III and email form to dma-59.forms@dch.ga.gov . The nursing facility will notify DCH when the individual is discharged from Medicare SNF care by completing Section IV of the same Form DMA-59 and emailing the form to dma-59.forms@dch.ga.gov .

If an individual is already eligible for QMB or SLMB and later applies for, and is eligible for, a full Medicaid aid category, such as SSI, Nursing Home or Waivered Services, the MSP program should remain open. The individual is dually eligible.