Page 51

COMAR 10.09.24.03

350 State of Maryland Medical Assistance Manual Revised July 2012 Must meet technical requirements for Medical assistance, (such as filing an application, enumeration, citizenship, identity, residency, assignment of rights, etc.). The ABD rules apply to SLMBs.

Must meet the other requirements for QMB. When determining resource eligibility for SLMB, CM should use the QMB resource standard. SLMB eligibility is determined only after a person has applied for MA and QMB and has been determined ineligible for both. The income standard is higher. It requires that income not only be at or below 120% of poverty, but that it also be greater than 100% of poverty. Application

SLMB only pays the premium; deductable and co pays are not covered. Call local department of social services and request an application for QMB/SLMB. Fill out the packet the mail-in application. A person may not apply for SLMB only. Return the application to your nearest LDSS. The LDSS/LHD numbers are on the last page of the document for customers to keep for their records.

When customers mail form, they are requesting QMB or SLMB benefits through the Maryland MA Program. Once they are found eligible, each year the LDSS/LHD will mail the customer a case information form (CIF) to be reviewed and returned so the customer eligibility for continued QMB/SLMB benefits can be redetermined.

Certification

SLMB eligibility starts at the beginning of the month of the application. Regarding retro- eligibility, it starts in the earlier retro month and extends for a 12 month period. Scheduled redeterminations are required every 12 months. If you are eligible for SLMB, you will pay only your monthly Medicare Part B medical insurance premium. You will receive a letter in the mail telling you if you are eligible, but you will not receive a card. The MMIS-II is unable to manage this Medicaid information; therefore another system has been developed. SLMB certifications will be made via CARES; however, this data will be maintained on a personal computer file instead of MMIS-II. The following procedures must be used to certify a SLMB Unique Case Number Assignment. SLMB will be assigned a unique M.A. case number by the LDSS CM.