Page 3

BEM 169 3 of 4 QUALIFIED DISABLED WORKING INDIVIDUALS BPB 2016-006 4-1-2016

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Assets Countable assets cannot exceed the asset limit in BEM 400. Countable assets are determined based on the MA policies in BEM 400 and 401. Divestment Do not apply policy in BEM 405. Income Eligibility Income eligibility exists when net income does not exceed the income limit in RFT 246. Income eligibility cannot be established with a patient-pay amount or by spending-down. Apply the MA policies in BEM 500, 530, 540 (for children) and 541 (for adults) to determine net income. COVERAGE The only MA benefit is payment of Medicare Part A premiums. The mi health card, is not issued. Note: An ex parte review (see glossary) is required before Medicaid closures when there is an actual or anticipated change, unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories. See BAM 115 and 220. VERIFICATION REQUIREMENTS Verification requirements for all eligibility factors are in the appropri- ate manual items. Verification of Medicare Part A eligibility and premium is required. The following are accepted as verification of Medicare Part A or Hospital Insurance premiums being charged:  SOLQ.  Correspondence from SSA.  Contact with SSA.

loading…

Page 3

Official source

BEM 169 3 of 4 QUALIFIED DISABLED WORKING INDIVIDUALS BPB 2016-006 4-1-2016

BRIDGES ELIGIBILITY MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

Assets Countable assets cannot exceed the asset limit in BEM 400. Countable assets are determined based on the MA policies in BEM 400 and 401. Divestment Do not apply policy in BEM 405. Income Eligibility Income eligibility exists when net income does not exceed the income limit in RFT 246. Income eligibility cannot be established with a patient-pay amount or by spending-down. Apply the MA policies in BEM 500, 530, 540 (for children) and 541 (for adults) to determine net income. COVERAGE The only MA benefit is payment of Medicare Part A premiums. The mi health card, is not issued. Note: An ex parte review (see glossary) is required before Medicaid closures when there is an actual or anticipated change, unless the change would result in closure due to ineligibility for all Medicaid. When possible, an ex parte review should begin at least 90 days before the anticipated change is expected to result in case closure. The review includes consideration of all MA categories. See BAM 115 and 220. VERIFICATION REQUIREMENTS Verification requirements for all eligibility factors are in the appropri- ate manual items. Verification of Medicare Part A eligibility and premium is required. The following are accepted as verification of Medicare Part A or Hospital Insurance premiums being charged:  SOLQ.  Correspondence from SSA.  Contact with SSA.